 Hello and welcome to NewsClick. Today we have with us Dr. Satyajit Rat and we are going to discuss what we've been threatening for quite some time. How do we look at the vaccines, the prospects of being able to roll out vaccines much faster than we have been doing either to and also looking at vaccine apathy and Mr. Bill Gates statement recently that unless the West we and he uses the word we in a very evocative sense you know basically the white saviour whiff comes from that statement we transfer technology and give them money how they can they do anything. This is in fact said about Indian factories so it's not something which is really about just generic third world but really about Indian factories particularly because the world has looked upon India till date as the global pharmacy for the poor so that is the context within which this was being said. Satyajit first let's look at quickly the issue that this though not an immediate urgent issue like say trying to stop the transmission links trying to reduce the numbers and oxygen etc for the hospitals nevertheless the vaccines are going to be extremely important. So can you tell us that what are the basic technologies and for countries like India and large parts of the world which are the technologies which are at the moment more appropriate more suitable more amenable to our public health system that we can think of. So let's get a couple of things as you say said right away Praveen. The first point is as you point out that we need not to lose our focus on vaccination and we need not to lose our focus on vaccination because it is vaccination that is going to reduce the intensity of the pandemic over the intermediate term just there's absolutely no question about that. Number one number two in the same context let me make a an even stronger point about the need for intermediate term equitable global vaccination and that point is not simply a point of human rights and justice it's also a point of the medical science involved the biomedical science involved because given that the SARS-CoV-2 virus of COVID-19 is spreading in communities across the world if we do not cover pretty much all the world at pretty much the same time give or take a few months at most then we are going to be in a situation where there will be communities such as in the global north which will be hugely vaccinated and communities such as in the particularly poor global south who will not be vaccinated at all or very poorly vaccinated and the virus circulating in the unvaccinated communities is going to keep lapping against the shore of the vaccine protected territory and that in ecological terms is where true vaccine resistant virus variants will begin to emerge that's the ecosystem where vaccine resistant variants will begin to emerge when it is said that unless everybody is safe nobody is safe it's really that and what I pointed out is the background of that statement that you just quoted and therefore not simply from the point of view of equity and justice but from the point of view of the medical biology involved across the world close to simultaneous global vaccination is advisable if not essential let me just add one little point to what you're saying that apart from enlightened self-interest which is what this is also is there is also the other calculation which have been done by the global chamber of commerce which said that unless the global south the poor countries are also able to recover the global economy including the rich countries economy is not going to recover in fact we talk of trillion dollar trillions of dollars of losses both in the global north and the global south the rich countries and the poor countries unless we stop the pandemic worldwide let's go to the point that you brought up what are the platform technologies that would be applicable clearly the current state even today of the mRNA based platform technology is that the NIH moderna vaccine and the bio and tech Pfizer vaccine utilized still depend on ultra cold storage of minus 70 minus 80 degrees celsius and therefore are really unlikely to be applicable in the global south on a large scale this does not mean that the elites of the global metropolitan urban south cannot use these vaccines in fact I would argue that the elites of the global metropolitan urban south can use these vaccines and therefore to some extent at least reduce the pressure on vaccination campaigns in the global south on other vaccines that are actually technically appropriate and usable for white backs widespread vaccination campaigns the adenoviral vaccine platforms as well as the protein vaccine platforms the adenoviral vaccine platforms I remind our our listeners such as the astrozenica vaccine such as the gamalia institute vaccine such as at least two of the chinese origin vaccines all of these as well as the protein vaccine platforms which again includes the inovavax vaccine which includes again some chinese vaccines as some indian vaccines that are in in development and the dna based vaccines such as the zyda skedilla vaccine against one of the chinese company vaccines all of these depend to a much depend on a much more available cold storage which is essentially a refrigeration cold storage and therefore are applicable in the global south there's also the third vaccine which is the oldest manufacturing technology using eggs in fact you can also use other places to grow these vaccines eggs being supposedly the most used one for this kind of proposals right now but the synofarm the synovac the corona vaccine india's co-vaccine are all essentially inactivated virus and that's the oldest technology it cannot perhaps scaled up that rapidly and it also as you had pointed out earlier has live virus to be grown so therefore needs better manufacturing practices but this is something which has been used for nearly a hundred years so that's also available and it can also be it cannot be need not be scaled up at that level but multiple centers multiple facilities exist both in india and china for example other countries as well so that that platform also exists oh absolutely does i in my head i tend to treat it as a protein platform because essentially it's a it's a way of delivering proteins but you're absolutely right it does exist as a platform it it has strengths and limitations as you point out the strengths are that it's relatively easy for a biotech competent manufacturing sector to adopt the technology the limitation is that as you point out it's growing the infectious virus i should i should make a comment that in terms of the scale up for manufacturing technology the making the adenoviral vaccine formulation and the inactivated vaccine formulation require equal levels of technology competence so it's not as if the growing the infectious virus is easier to scale up than scaling up the adenovirus because for both you know the development process is different the the infectious virus is once you grow it your vaccine design is essentially just inactivated and injected whereas for the adenovirus you have to engineer the adenovirus and so on and so forth but once you have the adenovirus and the original infectious SARS-CoV-2 virus scaling up for manufacture is actually the same process because you're using cell lines in large bioreactors in which you are growing a virus whether you're growing the adenovirus or the SARS-CoV-2 Satyajit recently in this context we had Mr. Bill Gates mention that he doesn't think intellectual property is an issue and what the need is really private parties in other other countries and he mentioned Indian factories quite pejoratively said without us giving technology and money they really can't do anything this therefore intellectual property rights is not the issue our knowledge recipes you call them are the issue and there we have to do this otherwise they can't do it by themselves now I would like really your reaction to that because you know this area much better than I do particularly how the pharmaceutical sector developed in India the fact that Indian vaccine manufacturers actually are the biggest in terms of quantity it to the world supplying it to the world in terms of quantity they're much larger in terms of value they're much lower because they're the big companies like Pfizer and all make much more money out of it so how do you look at Mr. Bill Gates statement what is the truth in that? At one level I tend to raise an eyebrow and say 21st century version of the white man's burden but that said let me struggle to encompass that point of view and that struggle to encompass that point of view is the following the Brazilian Anvisa has pointed out documentary deficiencies with Bharat biotics co-vaccine manufacturing process this doesn't surprise either you or I in the sense that as a soft regulatory regime Indian companies tend to try to get away with as much as they can this is not however and this is where I begin to then defer from Mr. Gates this is not however a matter of failure of technology capacity this is simply a private sector response to a perceived soft regulatory regime this is precisely what the private sector in the global north does with their own regulatory regimes attempt to get away with as much as they can so the point that somehow the global south is technologically incompetent or unabsorptive is fundamentally in error because it is using as evidence this kind of stuff that is based on the capitalist economy rather than anything to do with technological capacity the fact is that he is calling his fellow capitalist in the global south names for doing in the global south what he does in the global north. I'm going to ask you this question and you have said this in our programs earlier as well that there are whole number of companies who can manufacture vaccines who do manufacture vaccines if knowledge is shared with them and I'm talking again not patents but knowledge is shared with them they're quite capable of manufacturing COVID-19 vaccines and Indian biologic companies other biologic companies can also do it and that's the only way we can reach 14 billion doses that we need this year if that is the target that's the only way we can reach it. Don't you what how do you see this play out? So you know rather than discuss Mr Gates's personal life or even actually the Gates Foundation itself what I would like to point out is that that point of view that he has recently articulated is precisely the point of view that the pharmaceutical companies have been arguing it is in fact the point of view that the US legislature both congress and senate are currently grappling with Jan Czakowski one of the US members of congress is putting together an appeal to the US president to put the presidential administration's weight behind the India-South Africa proposal for the way but that that you need reference to and the opposition comes within the US congress and senate from pharma company funded legislators through their talking points and their talking point has been the one that you alluded to which is you know let's not touch patents because patents are not really the problem it's the entire technological landscape that is the problem and that as Mr Gates and the pharma company point out is simply something that is not easily taught and therefore you know just just leave it to us to do it as best as we can and that is a fundamental problem it's a fundamental problem because all the licensure agreements for example between the vaccine COVID-19 vaccine designers of the global north and the vaccine scale manufacturers of the global south such as in India the agreement with the serum institute of India the agreement with parodbiotic which has its own partnership agreements with vaccine makers in the global north with biological you know the with the dr reddy's laboratories all of these easily a dozen vaccine manufacturers in India have no difficulties with putting together and learning and absorbing the vaccine technologies of the global north without any startup limitations in fact the serum institute itself has an ongoing arrangement with nova pass for a completely different technological platform altogether so in all of this i don't see the problem as being one of difficulty in teaching the companies of the global south how to do things i see the real problem as being working out the commercial licensure arrangements and it is that delay and that limitation that is serving as the major rate limiting factor if that rate limiting factor was at least alleviated if not eliminated then we would have a much larger scale of manufacture with not simply companies in India but companies in Malaysia companies in South Africa companies in Argentina companies in Brazil companies in Mexico at least one or maybe two companies in West Africa so in all of them in Bangladesh in all of this we are therefore looking at commercial considerations limiting the rate of expansion of manufacturing scale not technological limitations and that is the fundamental point that i think it's important to keep in mind. Satyajit last closing point we also see the start of a vaccine war because the way anything about the gamalia vaccine or the chinese vaccine human vaccine of course doesn't even figure in most of the global media this is a small country completely doesn't fit Mr. Bill Gates theory that vaccine can only be developed by the white man if you will and here is a vaccine development that is taking place in Cuba which is actually not just an inactivated virus vaccine but also looking at other vaccine platforms they have five such vaccines in the offing so you have a whole bunch of possibilities there but if you are trying to limit it only to western manufacture then of course you must also make others appear unattractive therefore continuous reference to poor chinese vaccines it's actually very dissimilar figures we can discuss it another day as to zenka being presented as much better than for instance the gamalia no such evidence seems to exist but that's what is being pushed all of it seems to be a continuation of the global market issue rather than a medical issue or epidemiological issue. Well let me let me say two things in response one is clearly vaccine capacity with perceptions that are built as I said earlier on differences in regulatory regime perceptions rather than in technologies efficacies or anything else but they are being used for the obvious purpose of geopolitical power games on the one hand and I think that this is an extraordinarily callous response to a global pandemic but going beyond that it is the inevitable outcome of a fundamental choice that all countries of the world seem to have made which is that public good in a pandemic is going to come out of the greed of the capitalist marketplace and once you given to that the commercial jockeying for profit advantage which is really the other face of what you describe is an inevitability to the point that here in India when we had a vaccine that was developed in the public sector by a quasi government organization the Indian council of medical research in its laboratories in the national institute of virology we followed exactly what the national institutes of health with its mRNA vaccine did in the United States it gave it with a public sector grant to be developed to a private company moderna so did ICMR give it to Bharat biotech through an exclusive licensing device for no conceivable rationale or reason except for the ideology of the patent protected marketplace so long as we are walking that road it is hard for me to see how we are going to square the circle of profit making from the opportunity of global need this is all the time we have today thanks Satyajit for being with us and going over another difficult technological terrain of vaccines this is all the time we have today do keep watching news click and do visit our website.