Now, three months later, coronavirus infections in the Himalayan nation have spiraled out of control, leading to a shortage of hospital beds and oxygen, and sending most of the country into lockdown.
But despite needing it more than ever, the 67-year-old retired banker has no idea when he’ll get his second dose of Covishield, the AstraZeneca vaccine manufactured by the Serum Institute of India (SII).
“As an older person, I’m afraid of contracting the virus,” he said from his home in Nepal’s capital Kathmandu. “I have chosen to stay indoors.”
While SII’s decision will be a lifeline for India, which is still reporting about 200,000 new cases a day, the delay poses a huge problem for developing countries that depend on COVAX to control large outbreaks of their own.
That creates a very real problem, not just for countries with limited access to vaccines where cases are exploding, but also for the whole world.
Why there are COVAX shortfalls
But as of Tuesday, only about 30 million SII doses had been distributed via COVAX, according to Gavi.
“We continue to scale up manufacturing and prioritize India. We also hope to start delivering to COVAX and other countries by end of this year,” Poonwalla said.
Poonwalla said SII had never exported vaccines “at the cost of the people in India” and would “remain committed to do everything we can in support of the vaccination drive in the country.” “We have been working with the government tirelessly to do our best for humanity and will continue in the same spirit,” he said.
A Gavi spokesperson said in a statement that it was in close contact with both SII and the Indian government, and hoped deliveries could resume in a reduced capacity in the third quarter of this year.
What this means for developing countries
Across the border in Nepal, where coronavirus cases and deaths are soaring, SII’s announcement has left authorities scrambling.
The spokesperson for the Ministry of Health and Population, Dr. Jageshwor Gautam, said last week the country only has about 50,000 to 60,000 doses of SII’s Covishield in storage for “emergency purposes.” Nepal’s Health Minister Hridayesh Tripathi said last week that authorities planned to use them in a few days to give elderly people their second dose.
Millions of Nepalis have received no dose at all, and 1.5 million people — most of them 65 or older — have received one dose of the vaccine, but haven’t yet received their second, prompting concerns about how long their immunity will last.
“I haven’t heard anything since the first dose,” said Durga Kaumari Paudel, 66, a housewife who lives with her husband and son in Kathmandu. One of her neighbors died this month from Covid-19, which only adds to her concern — she has been so afraid she hasn’t stepped outside her house in a month.
Health Minister Tripathi said Nepal is in talks with a number of countries in a bid to get the vaccines it needs. He said he’s talked to officials from the United States, the United Kingdom and other countries about the AstraZeneca vaccine, and sent letters to the health ministers of the US, UK, China and Russia Wednesday updating them about Nepal’s needs.
“We’ll get the vaccines we need soon. We are quite confident,” he said.
Nepal isn’t alone. Bangladesh was set to receive more than 10 million Covishield doses by the end of May, according to Gavi’s allocations. But it’s unclear if those ever arrived — and Bangladesh has now run out of vaccines, according to the International Federation of Red Cross and Red Crescent Societies (IFRC).
Papua New Guinea, Sri Lanka and Cambodia were also expecting Covishield deliveries, and are all now experiencing spikes in cases. According to IFRC, a “majority” of countries in Asia were struggling with vaccine shortages.
“Asia is now the epicenter of this global pandemic,” said Alexander Matheou, IRFC’s Asia-Pacific director. “Tens of thousands of lives are being lost each week and vaccines must be available so that we can prevent further terrible tolls in the weeks and months ahead.”
What this means for the world
A hamstrung COVAX isn’t just a problem for countries in Asia — it has potentially worldwide ramifications.
The Gavi spokesperson said one of its top priorities currently was to work with governments with the largest supplies to deliver vaccines through Covax to countries where they could have “an immediate impact in addressing this short-term supply disruption.” They did not specify which countries this included.
But, as Fore points out, SII isn’t the only group that can help solve the vaccine shortage.
UNICEF said in an email that it was urging countries with excess doses to share them as an immediate stop-gap measure. IFRC is also calling for states and pharmaceutical companies to move faster in distributing vaccines.
Tedros called on manufacturers to give COVAX the first right of refusal on new vaccines, or commit 50% of vaccines to COVAX this year.
“There is no diplomatic way to say it,” he added. “A small group of countries that make and buy the majority of the world’s vaccines control the fate of the rest of the world.”
CNN’s Julia Hollingsworth wrote and reported from Hong Kong. Sugam Pokharel reported from Atlanta. Asha Thapa, Nishant Khanal and Kosh Raj Koirala reported from Kathmandu, Nepal.