Two lab technicians dressed in white protective gear organize vials.

US loosens export restrictions to help India's 'full-blown' coronavirus crisis

The Defense Production Act has historically allowed the US to prioritize American needs in times of crisis. In an abrupt shift, the Biden administration will allow shipments of raw materials for the manufacture of COVID-19 vaccines to India, explains Matt Kavanagh, an assistant professor of global health at Georgetown University.

The World

On Monday, India set another record for new COVID-19 cases for the fifth day in a row, with more than 350,000 infections. 

Now, help is on the way — marking an abrupt shift in US policy. 

The Biden administration is allowing shipments of some raw materials for the manufacture of COVID-19 vaccines. The White House is also sending test kits, ventilators and personal protective gear.

Related: How India's Serum Institute became a COVID-19 vaccine powerhouse 

The news couldn't come soon enough as India continues to struggle with an outbreak that is pushing its health care system to the brink.

Dr. Mathew Varghese, in Delhi, recently told The World that he can't keep up with the frantic calls from patients' families, seeking oxygen and other treatments for COVID-19. 

In addition to oxygen running out, intensive care units are operating at full capacity and nearly all ventilators are in use. As the death toll mounts, the night skies in some Indian cities glow from the funeral pyres, as crematories are overwhelmed and bodies are burned in the open air.

Related: WTO Director-General Ngozi Okonjo-Iweala discusses vaccines

Matt Kavanagh, an assistant professor of global health at Georgetown University, talks to The World about the US policy shift that is making it possible to export essential raw materials to India at this dire time. 

Marco Werman: Explain why the White House is now going to go ahead and loosen restrictions on these raw materials to make vaccines. 

Matt Kavanagh: India is in a full-blown crisis right now, and we're seeing that not just India, but also Nepal, and various other countries in the region, are seeing such remarkable spiking cases of coronavirus that we just have to act. And so, they're beginning to allow a certain set of materials to be shared with Indian manufacturers so that they can make vaccines to serve the Indian market and to serve the region. 

I don't know if you would have called this a ban on exporting these materials, but what was the legislation and mechanism that imposed this? 

This is the Defense Production Act. It's a 1950s law that dates back to the Korean War. And what it does is it allows the president to order certain companies to prioritize certain orders. Right. So, vaccine orders from companies making things that are needed for vaccines ... those have to go first to vaccine manufacturers here in the United States and even ahead of other things, right? So, companies that might have been making, you know, vitamins, now have to focus on providing those same technologies or those same products to vaccine manufacturers here in the US. And sometimes, you have to get permission ahead of time to actually export those goods.

Explain what these raw materials are, exactly. What is their role for COVID-19 vaccines?

We don't know exactly which raw materials we're talking about that the Biden administration's decided to share with the rest of the world right now because they haven't publicized that. But the Serum Institute in India has talked about some of the elements that they're missing and it includes things like giant, sterile bioreactor bags that are ... required to produce a bunch of the vaccines, certain chemicals that are needed in the production, certain specialized filters. And these are highly specialized pieces that you can only get in a handful of places. So, there's companies in the United States and also in Europe and a couple of other places that make these very specialized pieces. And everybody has been saying, look, we need to prioritize these into vaccine manufacturing, but because they're not made in India, Indian companies have to import them. And so, when the United States says they have to go first to Pfizer or first to Moderna, they can't then also go to the Serum Institute. And so, that's been the permission that's been lacking. 

Where would India have been getting these materials from otherwise? And is this part of the cause of the spike in India?

India has been ordering from a global supply chain. And the thing to know about the global making of vaccines as well as other pharmaceutical products is that we're talking about a highly integrated global market for these pieces. So, you might make a bag in the United States that's used in a production line in India, that also goes along with something that's made in Australia, and something that's made in Germany, and something that's made in South Korea. And all these pieces are needed by each of the vaccine manufacturers to make those vaccines. The challenge is right now, every government has been clamping down on the export of elements. And so, in Germany, they're clamping down and giving them to BioNTech. In the United States, they're clamping down and giving them to Moderna. So, India has been trying very hard in the companies that are making it to get those goods into Indian factories. But they've been running into increasing problems as the US has prioritized only itself. 

I'm getting a really good picture of this highly integrated global market you're talking about. What is the intended impact of loosening up the availability of these inputs and how soon can we start to see the impact? 

So, look, this is an important move, but it's only a very short-term solution. The bigger problem is that most of the world's middle-income and low-income countries are currently depending on one or two vaccine manufacturers, which means that low- and middle-income countries around the world are not going to be able to get access to vaccines because we've only got these couple of companies that are making them. If the US government really wants to get in the game, India has dozens of companies that could be making vaccines —  they're not because of the monopolies that exist out there. And so right now, we're dependent on a handful of companies and that's the real danger that we've got.

This interview was edited and condensed for clarity. AP contributed to this report. 

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