India or Israel? Meet the other 'vaccination nation'

Nicknamed the “pharmacy of the world” even before the pandemic, the country produced 60% of vaccines globally.

A woman walks past a painting of Indian Prime Minister Narendra Modi a day before the inauguration of the COVID-19 vaccination drive on a street in Mumbai, India, January 15, 2021. (photo credit: REUTERS/FRANCIS MASCARENHAS)
A woman walks past a painting of Indian Prime Minister Narendra Modi a day before the inauguration of the COVID-19 vaccination drive on a street in Mumbai, India, January 15, 2021.
Prime Minister Benjamin Netanyahu has called Israel the “vaccination nation” because of the country’s success in inoculating more than five million people in just a few months. However, less than 3,000 miles away, another country vaccinated that many in only three days – and manufactured millions of COVID-19 vaccines in just a few short months.
Meet India.
Nicknamed the “pharmacy of the world” even before the pandemic, the country produced 60% of vaccines globally. Now, it is geared up to become the world’s second largest COVID vaccine-maker after the United States, with the capacity to produce enough doses to protect its own population and those of other developing countries.  
“Regardless of who comes up with a vaccine or where it is invented, it will remain meaningless if it is not manufactured on a large scale,” India’s ambassador to Israel Shri Sanjeev Kumar Singla told The Jerusalem Post. “That’s where India’s manufacturing strengths become a crucial global asset.”
He said that “India has deep strengths in biotechnology and the pharmaceutical sector, both in research and development and in manufacturing. Indian companies have been producing vaccines for the world even before COVID-19. Therefore, the transition for them has not been a major challenge.”
The world’s single largest vaccine manufacturing plant is in India, a private company in Pune called the Serum Institute of India.
Several global companies have already tied up with Indian pharma companies for production of COVID-19 vaccines. These include Britain’s AstraZeneca, Russia’s Sputnik V and two American companies: Johnson & Johnson and Novavax. Johnson & Johnson is also carrying out part of its Phase III clinical trial in the country.  
A billion doses of the American vaccine are expected to be produced in India for distribution next year to countries in the Indo-Pacific region, Singla told the Post – a decision that was made by US President Joe Biden, Japanese Prime Minister Yoshihide Suga, Australian Prime Minister Scott Morrison and Indian Prime Minister Narendra Modi during their Quad Summit meeting in mid March.
 India has not only sold but has gifted millions of COVID-19 doses to several countries.
“We have a foundational, civilizational belief that we must share with everyone else, especially with the developing countries,” Singla said about the country’s export of more than 64 million vaccine doses to more than 82 countries – at the time exceeding the number of vaccines it had administered internally.
“This belief is encapsulated in the Sanskrit term ‘Vasudhaiva Kutumbakam,’ which means that the world is one family,” he explained. “COVID-19 has only reiterated this since it has shown that no country is an island, and we are not safe until everyone else is safe.”
India sold some 25,000 doses of the AstraZeneca vaccine to the Palestinian Authority earlier this year and said it would provide more if asked.
About 18% of the other exported vaccines went to countries near Israel, such as Algeria, Bahrain, Egypt, Iran, Kuwait, Morocco, Oman, Saudi Arabia, the United Arab Emirates and Yemen. Another 40% were distributed to countries in Africa, and approximately 28% went to the World Health Organization’s COVAX program, which aims to provide COVID vaccine doses for at least 20% of any country’s population that otherwise might not be able to afford them.
India also supplied vaccines to the UN Peacekeeping forces.
While Singla said that “it is too early” to look at vaccination in geopolitical terms, he admitted that “people do remember who came to their aid in times of desperate need. The goodwill stays.”
 “Such benefits would be corollary but are not the primary driver” for the country’s manufacturing and distribution efforts, he said. In fact, India recently called on the World Trade Organization to use the provision provided in the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) to grant a temporary waiver for intellectual property rights for COVID-19 vaccines so that they could be produced in greater volume. The request was not accepted.
MEANWHILE, as mentioned, India has made massive efforts to vaccinate its own population of 1.3 billion people. To date, according to the Indian Health Ministry, India has distributed more than 90 million doses to its people at an average of 2.2 million people per day.
Its daily vaccination rate is second in the world, after the United States. However, with 1.3 billion people in the country, the campaign is expected to take months, if not more than a year, to complete.
Two vaccines are being used in India: AstraZeneca and its own locally developed vaccine known as Covaxin, which was created by Bharat Biotech in association with the Indian Council of Medical Research and India’s National Institute of Virology.
The vaccine’s clinical trials showed it to be 81% effective. So far, the vaccine has been approved for emergency use in Iran, Mauritius, Myanmar, Paraguay and Zimbabwe.
Modi was inoculated with the Indian vaccine.
The country also has another local COVID-19 vaccine candidate known as ZyCoV-D, which is being developed by the Indian firm Zydus Cadilla and is currently in the midst of its Phase III trial.
BUT NOT everything has gone well for India over the past year. Some 166,000 people have died from the virus – a large number, although the population is very large and therefore the country’s case fatality ratio is still one of the lowest in the world. India, like Israel, provides free universal health care services. However, health care in India has been chronically underfunded and the public system tends to be used only by the lower classes: The ambassador noted that the country is boosting its public health expenditure to nearly 2.5% of its GDP by more than doubling its budget allocation to over $30 billion.
India is in the midst of another coronavirus wave, with around 100,000 new cases registered each day, mainly in around six states, partially due to the public’s behavior. It is currently “festival season” in India and there is also an election campaign underway.
Parts of the country have already locked down and there is talk of a potential national lockdown.
While India has not completely sealed its borders, regardless of vaccination status, anyone who does arrive in the country must have taken a PCR test before boarding the plane and on arrival. There is also a mandatory quarantine requirement if one tests positive.
Because India understands that “COVID is unlikely to go away in the next year and we could have other pandemics,” the ambassador said it is also taking part in other efforts to improve the management of COVID-19.
Some of those initiatives are with Israel.
India and Israel are cooperating on developing non-invasive audio based, Terahertz, breath analyzer and scent diagnostic kits for detecting COVID-19. Over the summer, a delegation of Israeli defense and medical personnel traveled to India to kick off the program, testing the novel screening kits on some 25,000 Indian citizens.
Singla said that Israel’s Defense Research and Development Directorate is calibrating the results. Once the work is concluded – and he did not have a timeline – he said that “it has the potential to transform the way we tackle the pandemic.”
Israel and India are also exploring collaboration in the use of artificial intelligence to map and forecast the spatial spread of the virus.
“There is a desire to go back to our normal lives – and to do it, we need a vaccine very quickly,” Singla said.
“To the extent that we can help control [the virus], we would be very happy,” he continued, adding that “no one looks out for developing countries in this world so we have to look after each other.”