Need Government's Support to Reach The Last Mile: Dr Davinder Gill

Describing their journey in the field of Research & Development for vaccines and vaccination, Dr Davinder Gill says, “The journey has been quite exciting. Ten years ago, we started as a startup organisation to address the needs of the vaccine R&D in countries like India.”  

Hilleman Laboratories embarked on a strategy with the initial approach to try and address the needs of the problems that exist in children less than five in developing countries. And more specifically, they looked at enteric and diarrheal diseases, which are very prevalent in developing countries, also, the cause of a large number of mortality and morbidity rates. And they began to develop vaccines to research & development in this area.  

“Over the course of time, we built a portfolio of products to address this need in the area of diarrhoea. And we are very fortunate that over the last 10 years we've managed to advance some of our vaccine candidates. And while they're still in the final stages of clinical development, we have been able to move from a very concept-based stage to finally a product stage,” adds Dr Gill. 

Last decade in Research & Development 

Dr Gill says, “We have fully equipped R&D operations here in New Delhi. We have highly qualified staffing not only on the R&D side but also on the business side and support side. A key element of our journey has been collaborations with academic institutions and stakeholders in India and across countries. For our vaccine research in the enteric disease space, we have partnered with organizations such as the Indian Council of Medical Research (ICMR) New Delhi and National Institute of Cholera and Enteric Disease (NICED) Kolkata, and Gotavax AB-Sweden as well as some others for clinical trial partnerships in Bangladesh. Our journey so far covers a wide spectrum of organizational advancements, portfolio advancements as well as advancements on cooperation and collaborations globally and in India.”

Research & Development is another term for evolution in science. Upon asking him, what has been evolved in the field of medical sciences in the last 10 years? He answered, “There has been a lot of changes in the last 10 years. I'll begin by pointing out the renewed emphasis that we see on healthcare and health-related initiatives. funding on behalf of the Indian government.  

In the last two to three years with programmes like the universal health coverage, increase boosts towards vaccines and vaccinations government has pushed the health sector towards progress. In addition to that, the regulatory environment has changed with the help of removal of bottlenecks we had, policies have been opened up and also the agencies have become much more approachable in terms of, discussions and dialogues. On the vaccine front, India as a country has made huge advances and we continue to be the dominant supplier of low-cost vaccines to the world.” 

He added, “We saw the launch of the first indigenous vaccine Rotavac in India. Hilleman was also very privileged that we actually could do some work in the area of heat-stable, rotavirus vaccine. And at the global level, the increased emphasis on vaccines and vaccinations, even in terms of their approach systems, we have seen an improvement in that as well.  

Heat Stable Vaccine 

Diarrhoea is one of the leading causes of child mortality rate in India. It kills approximately half a million children around the world. In India alone, the disease claims more than 200,000 lives every year. Rotavirus, Cholera, are the pathogens for this fatal infection. 

We chose to address this area, which is an unmet need. Hilleman Labs is coming forward with a novel formulation of cholera vaccine in collaboration with Bharat biotech and also working on India’s first Shigella vaccine in collaboration with the ICMR and NICED. This class of vaccine tends to be very complex and countries like India need the capacity and the capability to innovate on conjugate vaccines.

Vaccine Industry 

Globally, the vaccine industry is expanding anywhere from $40 to $50 billion USD. The Indian share in this industry is interesting. If you look at the supply of vaccines on the dose and the number of dose bases, India is the biggest manufacturer and supplier of vaccine doses around the world. But if you look at our market shares aren't very high because what we supply are affordable vaccines. What that means is that there's a lot of potential for India. The increased emphasis that the Indian government has given them on universal health care coupled with the fact that there is a renewed focus on vaccines and vaccination. A wide range of innovative vaccines like rotavirus vaccine, pneumococcal conjugate vaccine, and even the HPV vaccine for cervical cancer is now part of various immunization programs. 

The need of the Country 

Most importantly, the government needs to keep supporting vaccines, innovation and the energy behind it. They need to empower various stakeholders to simplify and incentivizing R & D.  

Lately, there has been an observance of vaccine hesitation that the upper-middle-class people, who have never experienced these kinds of diseases are now starting to become a little hesitant. We need the support of the government and various stakeholders in order to address those needs. Otherwise, I think we'll end up in the situation opposite to what we are trying to create.  

With such a vast geographical spread and heterogeneous population, we need to reach the last mile to vaccinate every child, irrespective of their exposure to these vaccines, We need to put emphasis on systems and processes that allow us to address these delivery gaps.

At Hilleman labs, we have embarked upon research and development areas such as thermostable technology which increases the shelf life of a vaccine and innovative vaccine delivery mechanisms like a Vaxipak. These are the innovations capable of addressing the challenges in India. More recently, we also looking at needle-free injection with the use of microarray patches. As an R&D organization, we are doing what we can, but I think we also need the support of the government in order to address this gap of what we call ‘the last mile reach’.