India's vaccine industry has been one of the fastest growing industries in the world so much so that it has been hailed as the world's vaccine epicentre. Public access, affordability, and India being a manufacturing hub for vaccines has contributed to the success of the Indian vaccine industry. Complementing this success is the rise of both the private and the public vaccination markets. Vaccine production is catering both to domestic as well as international demand and, in this regard, India is also one of the largest exporters of vaccines beating China by a huge margin.

In the midst of this, India, unfortunately, suffers from an influx of vaccine imports, especially from China.

Figure 1: Monthly Aggregate Vaccine Imports from the world (2017-19)

Though Chinese imports of vaccines isn't the largest when compared to imports from other countries, what is concerning is the quality of the vaccines being imported. For instance, in August 2018, news broke out in China regarding fabrication of production and inspection of records of one of the largest vaccine producers. Following this, India banned the import of the rabies vaccine from China.

Figure 2: Imports of Rabies vaccine (2017-19)

Note: Dots represent import values of rabies vaccine imports from China. Dots that are unconnected represent no data for imports.

What is striking here is a downward trend in the import of the rabies vaccine starting in the second half of 2018. This period corresponds with India's ban on the imports of the defective rabies vaccine. Complementing this is the fact that rabies vaccines are imported majorly only from China (with a very small share being imported from Germany, Turkey, and Bangladesh). It is clear from this that the downward trend in imports of rabies vaccines is solely due to the ban on Chinese imports.

When looking at Indian imports of vaccines globally, we observe that China's share is small relative to a few other countries. However, China is among the top 10 exporters of vaccines to India. In this regard, imports are highest from Belgium, Indonesia, and France.

Figure 3: Share of vaccine imports by country (2017-19)

However, given India's immunisation coverage of 65%, against China's 99%, it is important that the vaccine industry be given a more "level-playing field" to perform even better. This is important also because it would help tackle and keep in check China's and South Korea's aggressive strategies to dominate the Vaccine industry in India. A few suggestions have been made in order to keep a check on such strategies. One is to ensure stricter quality checks, including on imports, which would help curb access and availability of foreign manufactured vaccines. This is important because, for a foreign entity to manufacture vaccines in India now, there are no strict regulations. However, an Indian manufacturer has to enter into a 50- 50 partnership with a local manufacturer abroad and also share technology with them. The second suggestion is to push the government to ensure that foreign manufacturers invest in R&D of Indian firms to make progress in manufacturing techniques. The final suggestion is to increase public healthcare expenditure, which is currently at 1.02% of GDP (2019). These three suggestions, if implemented, will help bring about a certain balance and stability to vaccine manufacturing in the country.