NOEL KING, HOST:
India is the world's leading producer of vaccines. And during the pandemic, the Indian government has been able to donate and sell doses of the COVID-19 vaccine to other countries. Now the country's role in vaccine production is about to get even bigger. NPR's Lauren Frayer has this story from India's biggest vaccine factory.
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LAUREN FRAYER, BYLINE: There are rows of palm trees here, green lawns - a little bit like a college campus.
UNIDENTIFIED PERSON #1: Yeah.
FRAYER: We're riding in a golf cart up to the factory.
UNIDENTIFIED PERSON #1: Yeah, some - our production facilities are there - measles, mumps, rubella, rabies vaccine.
FRAYER: The Serum Institute of India was already the world's biggest vaccine manufacturer even before this pandemic. The company says two-thirds of all children in the world get its vaccines, and most of them are made here at a sprawling factory complex in western India. Inside...
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FRAYER: ...These are conveyor belts with all these tiny, little vials just whizzing past.
UNIDENTIFIED PERSON #2: Going to our automatic visual inspection.
FRAYER: Automatic visual inspection.
UNIDENTIFIED PERSON #2: Yeah.
FRAYER: So a machine is inspecting these.
UNIDENTIFIED PERSON #2: Yeah.
FRAYER: It's a high-tech operation. But look outside the factory window, and you see a reminder of this company's more humble roots - horses. In the 1960s, this was a farm breeding racehorses. And one day, one of the horses got bitten by a snake. Suresh Jadhav, Serum's executive director, explains what happened next.
SURESH JADHAV: In those days, the telephone lines were not working great in India, so they could not get the anti-snake-venom serum.
FRAYER: They could not get anti-snake-venom serum in time. The horse died. But its owner had an idea.
JADHAV: He suggested, why not start making it ourself?
FRAYER: So the Serum Institute of India was born. It began making serums against tetanus and snake venom and later added vaccines against all sorts of childhood diseases. They specialize in generic versions at low profit margins and export to 170 different countries. Last spring, a tiny package arrived here by courier from Oxford University in England.
UMESH SHALIGRAM: Yeah, yeah - not in bottle. It is a very small vial.
FRAYER: Chief scientist Umesh Shaligram describes what was inside, components of a viral vector vaccine against the coronavirus. Serum scrambled to start mass producing them immediately in huge floor-to-ceiling stainless steel vats of...
PEDDI REDDY: Human embryonic kidney cells.
FRAYER: Human embryonic...
REDDY: Kidney cell line, yeah.
FRAYER: Scientist Peddi Reddy recalls how he was developing other vaccines in these vats when his supervisor told him to quickly convert everything over to the coronavirus vaccine while under lockdown as the pandemic exploded.
REDDY: It was difficult. And we had to follow very strict rules of isolation.
FRAYER: Did you work overtime?
REDDY: Yes, definitely.
FRAYER: And this was before clinical trials showed that the Oxford-AstraZeneca vaccine would work. It was a gamble with so much at stake, he says.
REDDY: Everybody's waiting for it. The whole mankind is waiting for it. The whole world is waiting for it.
FRAYER: And so this winter, when trials finally proved this vaccine did indeed work...
REDDY: We celebrated internally - not, like, party, or something, but we had that moment of joy.
FRAYER: You didn't open a Champagne inside this laboratory?
REDDY: No, no (laughter). No, no.
FRAYER: Serum hopes to soon be churning out a hundred million doses per month of this one vaccine on top of all the other vaccines they're still producing here. The Oxford-AstraZeneca vaccine has been temporarily suspended, though, in numerous countries after reports that some recipients developed blood clots. But it's the vaccine most used in India and other low- and middle-income countries because it needs just regular refrigeration, not subzero temperatures.
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UNIDENTIFIED PERSON #3: This is a cold storage area. The capacity of cold room is 70 million doses.
FRAYER: So what we're looking at right here is enough to vaccinate whole countries.
UNIDENTIFIED PERSON #3: It's an ongoing process.
FRAYER: Out of cold storage, along these conveyor belts and out to 68 countries so far, racing against Russia and China in what some are calling vaccine diplomacy. India's huge capacity has attracted interest from the so-called Quad, the U.S., Japan, Australia and India. On Friday, they announced financing to help another Indian producer make a billion more doses of another COVID vaccine.
But while Indian manufacturers are partnering with global pharmaceutical companies, the Indian government is challenging them. At the World Trade Organization...
RACHEL THRASHER: There is an agreement that binds all WTO members to certain levels of protection for intellectual property - 20-year patents.
FRAYER: Rachel Thrasher is a legal scholar at the Global Development Policy Center in Boston. She explains how India and South Africa are asking the WTO to suspend those patents for COVID vaccines so that companies like Serum can crank out generic versions quickly and cheaply.
THRASHER: In certain countries, the majority of the population won't be vaccinated for something like five years. That gives those viruses a long time to mutate. So the argument they're making is not, hey, look out for us, but more, this is in the interests of all of us.
FRAYER: Serum's executive director, Jadhav, says he supports that effort at the WTO.
JADHAV: What we require is a vaccine today, not tomorrow. You want to stop the disease and stop its spread. And that can happen only if there is no restriction on using the technology.
FRAYER: Many global health experts agree. The Pope has said he does, too. But some companies, including AstraZeneca, have pledged to sell their vaccines at cost without profit. And suspending their patents, they say, is not the answer. It would kill innovation and would not speed up distribution. Bottlenecks have more to do with supply chains than access to the vaccine technology itself.
DANIEL HEMEL: I think both sides of this debate are overemphasizing the role of patents.
FRAYER: Daniel Hemel is a law professor at the University of Chicago. He says the Serum Institute's success shows a middle path. It got a license from AstraZeneca. It's been able to mass produce vaccines within the current regulatory environment.
HEMEL: It shows the potential of licensing arrangements. Without canceling patents, Serum Institute is able to gain rights to make vaccines on a large scale. That's a good thing.
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FRAYER: Back at Serum's factory, as vials of coronavirus vaccines whiz off conveyor belts inside, chief scientist Umesh Shaligram points to construction underway outside on a new pandemic preparedness facility.
SHALIGRAM: Another year or two, when you come, you'll see that facility, actually.
FRAYER: The idea is to have extra machines, extra labs all on hand to make billions of doses of vaccine against whatever virus hits next.
Lauren Frayer, NPR News at the Serum Institute in Pune, India.
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