India has bought 1.6 billion doses of Covid-19 vaccines, which is more than any other country, according to a global analysis. Using its massive manufacturing clout, the country purchased 500 million doses of the Oxford University-AstraZeneca vaccine candidate, one billion from the American company Novavax and 100 million doses of the Sputnik V candidate from Russia's Gamaleya Research Institute, said the USA-based Duke University Global Health Innovation Centre.
India, a middle-income country, bought more doses than high-income countries such as the USA and the UK, and more than the EU as a whole, all of which have in-country vaccine development capacity.
The European Union has pre-booked 1,58 billion doses and the US 1.01bn doses.
Before any vaccine candidates have been approved by regulatory agencies, there are confirmed purchases for 7.3 billion vaccine doses, with another 2.5 billion doses under negotiation.
Many of these countries will be able to vaccinate their entire populations - and some will be able to do so many times over - before billions of people are vaccinated in low-income countries, said the Duke report.
India's 1.6 billion doses would cover 800 million people, or 60% of its population. In November, India's Health Minister Harsh Vardhan said 400 million to 500 million doses of Covid-19 vaccines were estimated to be made available for 250 million to 300 million people in India by July-August 2021.
The Duke report explained that rich countries negotiated purchases by investing public funds into vaccine research and development, and by using their purchasing power to strike early deals. Since none of the vaccine candidates has received regulatory approval, the countries hedged their bets by purchasing multiple vaccine candidates, in case some don't materialize.
As a middle-income country, India has been able to move to the front of the queue by using another strategy: leveraging its large manufacturing infrastructure.
Countries with manufacturing capacity, such as India and Brazil, have been successful in negotiating large advance market commitments with leading vaccine candidates as part of the manufacturing agreements, said the Duke report, which was compiled after government officials across the world - including Indian officials - were consulted to explain their high procurement strategy.
India is the largest manufacturer of vaccines in the world, making 60% of the global vaccine supply. It is also home to the Pune-based Serum Institute of India (SII), the world's biggest vaccine producer.
Of the three vaccine candidates the South Asian country has booked, SII is manufacturing two within India: the Oxford University/Astra-Zeneca vaccine and the Novavax candidate. Of the 3.73 billion doses of the Oxford and Novavax vaccines purchased by all countries, about 3 billion would be produced by SII.