New Delhi: The World Health Organisation (WHO) on Thursday hailed India’s efforts to fight and contain the Covid-19 pandemic.
In an exclusive interview with ETV Bharat's Gautam Debroy, Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia said that considering the time taken for licensure and mass production after the trials have been completed, the earliest that vaccine doses could be available is early- to mid-2021. She said that India’s response to COVID-19 outbreak has been strategic, tailored to the evolving pandemic and should be seen in the context of the country’s unique challenges.
Here are excerpts from the interview:
Q - How does WHO find India's Covid-19 containment strategy?
India's response to the COVID-19 outbreak has been strategic, tailored to the evolving pandemic and should be seen in the context of the country’s unique challenges – demographic, geographic among many others. Since early this year we have witnessed unprecedented efforts – whether it was scaling up testing capacities, setting up of COVID-19 hospitals and isolation centres, training of health workforce, local production of essential medical supplies such as PPEs and masks, etc to ensure a steady supply. Identifying hotspots, marking containment areas and focusing efforts to further scale up response, India has made tremendous efforts and these efforts need to continue.
As active cases plateau, now is the time to be even more alert. As we embrace the new normal and get back to our lives we have to constantly remind ourselves that we continue to live amidst a pandemic. Globally, numbers are still on the rise and humanity continues to be at risk from COVID-19. We need to continue to further strengthen implementation of core public health measures - test, detect, isolate and treat. Individuals should practice physical distancing, hand, and respiratory hygiene, and wear a mask when needed. We cannot let our guards down
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Q - What is your take on the prospective Covid-19 vaccines in India including two indigenous ones?
Globally, there are 44 candidate vaccines that are currently undergoing clinical trials. These include two indigenous candidates from India that are being developed by Bharat Biotech and Zydus Cadila. The Bharat Biotech vaccine has received permission to initiate Phase III trial, while Zydus Cadila is conducting Phase II trial. Some other vaccine developers have tied up with some Indian manufacturers to conduct Phase II trials in India. These include the University of Oxford/AstraZeneca vaccine and the Gamaleya Research Institute vaccine. In addition, there are 154 candidate vaccines that are in pre-clinical evaluation phase. Indian manufacturers are collaborating with international developers on some of these vaccines.
Q - When can we expect Covid-19 vaccine?
Currently, around 200 candidate vaccines are at some stage of development. Of these, 44 candidate vaccines are in human trials. Ten of these are in phase III trials. There are several others currently in Phase I/II, which will enter Phase III in the coming two months. WHO is working with companies and sponsors, as well as with Gavi, CEPI and others through the ACT Accelerator to expedite vaccine testing, as well as the scale-up of manufacturing so that countries will have access to sufficient doses if and when a vaccine is available.
At this stage, we cannot say with certainty when a vaccine will be available. It will depend on the time it takes to complete the Phase III trials and on the outcomes of the evaluation on efficacy and safety of individual vaccines. And this will take a few months for any of the vaccines, including those that are the front-runners. Considering the time taken for licensure and mass production after the trials have been completed, the earliest that vaccine doses could be available is early- to mid- 2021.
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It is hoped that if a successful vaccine is found within the next few months, there will be enough doses available for countries by the end of 2021 so that those in priority populations, who choose to be vaccinated, have access to them.
Q - Your view on the distribution and immunisation of Covid-19 vaccine.
In anticipation of the development of a safe and effective COVID-19 vaccine, countries should be prepared with an efficient and coordinated strategy and plan for the roll-out of COVID-19 vaccination. Vaccine availability is likely to be limited initially, hence it will be important to clearly identify goals of national vaccination strategies.
In the spirit of promoting fair and equitable access to vaccines across all countries, WHO is proposing that countries prioritize at-risk populations as they develop in-country vaccination strategies. Available vaccines should first be provided to priority populations and then expanded to others.
A national-level coordination committee would be needed to oversee vaccination; an expedited regulatory pathway for approval of new vaccines; a technical advisory group to recommend prioritization of risk groups; protocols on infection prevention and control measures to minimize exposure during immunization sessions; training plans for vaccine introduction; and monitoring systems to measure coverage, acceptability and disease surveillance.
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Countries would also need to strengthen vaccine cold chain systems; ensure trained staff perform vigilance activities for vaccine safety; and importantly, a vaccine demand generation plan to instil confidence and acceptance among people for the new vaccine.
WHO and partners have developed a COVID-19 Vaccine Introduction Readiness Assessment Tool (VIRAT) – which is helping countries plan for the introduction of the COVID-19 vaccine as well as to monitor their readiness and progress.
Q - India’s Covid-19 recovery rate is the highest in the world. Your views?
India has been making great efforts – scaling up testing, tracing contacts, isolating the affected and providing hospital care to those who need it. The pandemic is still not behind us. Our efforts to contain the spread of COVID-19 transmission needs to be more vigorous now.
Q - The coming festivals have been termed as super-spreaders for Coronavirus. Your view?
While governments must continue to test, track, isolate and treat, as individuals, we must continue to take responsibility for the need to maintain physical distance, hand hygiene, cough etiquette and wear a mask when and where needed. People must remember the three Cs - avoid crowded places, avoid closed settings and avoid confined and enclosed spaces with poor ventilation.
We must also remember that the cold and flu season is around the corner, so one must be extra careful. We don’t want to overburden health systems with cases of seasonal influenza and COVID-19. Many of the same measures that are effective in preventing COVID-19 are also effective for preventing influenza, including physical distancing, hand hygiene, covering coughs, ventilation and masks.
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