The vaccine that was built from scratch

I have no plans to read ICMR chief Balram Bhargava’s new book, Going Viral, about the “inside story” of Covaxin’s making, and am grateful for that reason for Dr Jammi Nagaraj Rao’s quick but seemingly thorough review in The Wire Science. My lack of interest in the book itself also means I’m going to take those bits from the book quoted in Rao’s review literally, in no need of additional context (a reasonable assumption given the rest of the review and Bhargava’s now-tattered reputation). With this preamble: reading Rao’s review brought three things to mind.

First, is the Indian clinical research establishment aware of the catch-22 inherent to defending its decisions regarding Covaxin over and over in the public domain? Of the two major COVID-19 vaccines in use in India, Covishield hasn’t prompted even a tenth of the amount of defending (say, by number of words or inches in newspaper columns) Covaxin has seemed to need to maintain its reputation – even when there were multiple news reports in February and March to suggest Covishield may be associated with most vaccine-associated severe adverse events at the time.

Then again, the establishment will say – as it has said so far – that Covaxin has required defending because you were bent on attacking it for no good reason. And with Bhargava continuing to deflect criticism in his book, this circus will only continue. However, while both us critics and the establishment can keep going, as if our energies were conserved, the catch-22 is that Covaxin’s reputation is not: the longer the circus goes on, the more it will decline.

Second, the Indian government has progressively invaded multiple public institutions and yoked their machineries to the ruling party’s electoral agenda. Perhaps the most ‘notable’ was the fall of the Election Commission, which, in a recent example, drafted the dates for West Bengal’s assembly poll phases to the BJP’s convenience. But Balram Bhargava’s new book seems to be a new frontier: Rao’s review indicates that Going Viral is one large advertisement for the Indian government, and for the BJP by extension. It’s a new frontier because it’s a book, and it’s a book by the head of a public institution that the government has already invaded. Put another way, there may be nothing Bhargava can say or do as the ICMR chief – including write a book – that we can assume will have any distance between himself and the party itself. (Once he’s done as ICMR chief, of course, the party is likely to offer him a cushy posting in some low-intensity government position.)

Now, it is tempting to consider that by guiding the composition of a whole book and stamping some pandering functionary’s name on the cover, the BJP is also attempting to invade the space of books as an expression of intellectual achievement, of the sort that the current government has liked to associate with its fiercer critics.

Third, there is a curious line in Rao’s review that may provide the fort of insight into Covaxin’s development that no government official (at least of this government) will ever admit. Rao writes that the book

… is not a detailed exposition of the science behind vaccine development in general or Covaxin’s development in particular. There is a retelling of the well-known Edward Jenner story, and some interesting details about why Bharat Biotech was uniquely placed to develop Covaxin: mainly that it operated BSL-3 facilities and had a track record of developing vaccines from scratch.

One reason the BJP, essentially Prime Minister Narendra Modi, blessed Bharat Biotech was that it could develop vaccines from ‘scratch’? Why should this matter during a pandemic with billions of people around the planet desperately looking for an affordable and good-quality vaccine – except the power that the words “homegrown” and “Made in India” carry for the party, and the government? Neither I nor others can offer dispositive proof that this is what Prime Minister Modi was thinking when he toured Bharat Biotech’s and Serum Institute’s facilities in November last year; the closest we can come is the way in which the party-government combine micromanaged every aspect of Covaxin – down to its ridiculous approval on January 3, 2021, in “clinical trial mode”.

This façade of self-sufficiency is just that, as two counter-examples can show. First, let me quote from Rao’s review:

… in his zeal to characterise Covaxin as a ‘completely indigenous vaccine, an epitome of Atmanirbhar Bharat’, Bhargava overlooks the fact that the thing that made Covaxin appropriately immunogenic was the inspired use of an adjuvant called Alhydroxyquim-II, under license from an American research company named Virovax. The licensing arrangement between Virovax, funded by the US National Institute of Health, and Bharat Biotech dates to before the pandemic, in 2019, in a collaboration set up at a meeting organised by the Indo-US Vaccine Action Program. The terms were later extended to include Covaxin.

Second, there’s a twisted irony in insisting on building a vaccine from scratch at home (because that is politically advantageous) instead of equally supporting both vaccine development and license-based vaccine-manufacturing, then dragging your feet on licensing a vaccine when you do have one to public-sector manufacturers within the country (much less anyone else), while demanding in international fora that vaccine-makers abroad and their respective governments be okay with waiving IP rights to broaden manufacturing.