Waiting for a vaccine

The world has been thrown into a spin as never before by the Covid virus. The high and the mighty are fighting a raging battle, while hundreds of thousands of their citizens die like flies, cemeteries are running out of burial ground and crematoria are working round the clock. This funereal sepulchral picture no doubt rivals what may have existed during the times of World War 11, the Plague and the 1918 flu pandemic. Yet the cold war attitude lingers on in Covid politics. Covid, though successful in teaching several lessons, has not succeeded in bringing warring factions, both cold and hot together, even when the world is at death’s door. Maybe billions of dollars are at stake. And what have the billionaires been doing; sixteen of the US billionaires have doubled their net worth since March 2020 despite Covid. Elon Musk’s (business magnate billionaire) wealth has tripled, while poor people in the USA die due to unavailability of ventilators.

The Covid-19 virus has the right characteristics necessary for the immune reaction to be successful. So there is hope. The latest progress reports say 240 candidate vaccines are in their early stages of development, 40 are undergoing clinical trials, and nine of them are in the final stage of human clinical trials. The UK , China and the USA vaccines have reached the final stages, while the situation regarding the Russian vaccines are uncertain. The vaccine being developed at the Oxford University is in the final clinical trial stage, and an order for hundred million doses for the UK have already been placed. Several US pharmaceutical companies such as Johnson & Johnson, Pfizer have produced vaccines which are now in stage two trials. Scientists involved in this work say a safe and effective vaccine hopefully would be available to everybody by mid-2021. The health workers involved in the management of Covid may be given a vaccine by the end of this year in the US and the UK.

Several methods have been employed to produce vaccines, and some of these methods are being tried out for the first time. The earliest method was to use killed or weakened viruses, the first vaccine used for Smallpox was similarly an attenuated virus. Genetic material of the virus carried in a harmless vector virus is another method used in these trials. The spike protein that protrudes out of the spherical Covid-19 virus, and which plays a role in the disease causing process, has also been used either inside a vector virus or directly. The latter method where the spike protein is used directly is a novel innovative method supposed to be successful in the trials. This protein, when directly injected into humans the body cells, produces more of the protein which induces the immune system to produce antibodies.

Our neighbour India has the largest vaccine manufacturing institution, the Serum Institute of India. Oxford University vaccine when ready may be produced in commercial scale in this institution. Would that be of some use to Sri Lanka, would India make a special case of Sri Lanka and make it available to us? Perhaps, India with a population of 1.3 billion and a rampaging pandemic needs it more than anybody else. Anyway there is a fear that the poor countries may be left in the lurch as the rich countries would grab as much of the vaccine as possible. WHO is trying to prevent this and 80 rich countries, except the US, have pledged their support for this effort.

The other question is, if the availability is limited, who would be considered as priority to be given the vaccine first; would it be the most vulnerable or those in the forefront of the battle against the infection or those who are capable of reviving the economy? The WHO and the UN may have to develop criteria and guidelines in this regard, and also it would be the responsibility of the WHO to see that poor countries are not forced to be at the mercy of the pharmaceutical industry. But would these international bodies have the necessary power to carry out such a meritorious act?

China has said it will give Sri Lanka the vaccine when it is available. A friend indeed. Therefore, it is worthwhile to see how China is progressing in vaccine making. The Lancet Infectious Diseases Journal (Oct. 2020 issue) carried an article reporting that a well controlled clinical trial in China had shown a vaccine consisting of an inactivated whole SARS-CoV-2 virus to be safe, and that it elicits an antibody reaction. Other reports in health journals say that China has produced 11 candidate vaccines, and several of them are in their final trial stage. These are being tested on volunteers in the UAE, Bahrain, Peru and Argentina.

Indonesia, with 350,000 cases and 12,000 deaths, has sent a team to China to inspect the safety and efficacy of these vaccines and the capacity to supply Indonesia’s requirements. Three companies, Sinovac, Sinopharm, and CanSino have promised Indonesia to supply a total of 40 million doses by 2021 and the first shipments are to start in November 2020. Chinese premier has also promised to supply vaccines to the Philippines, Cambodia, Burma, Thailand, Vietnam and Laos. No doubt China is determined to capture the global vaccine market. A country which has the technology to create the Huawei 5G phone, perhaps has the capability to produce a safe and effective vaccine against the elusive Covid-19.

China has already started giving vaccines to its citizens. People in thousands are queueing to get vaccinated. 350,000 people outside the normal clinical trials are said to have received it by now. The ethics of this act is being questioned by Western scientists, as the knowledge about the efficacy as well as the possible serious side effects is lacking. However, serious side effects have not been reported.

China is a true friend of Sri Lanka and it has promised our Prime Minister that it could give us our requirements of the vaccine when it is ready. Let us wish the Chinese success in their endeavour.

N.A.de S. AMARATUNGA