The serum of life

He has been referred to by Bill Gates as "one of his seven vaccine heroes.” "Obviously I had an exhilarating feeling to be called one of his vaccine heroes as others he referred to included Nobel laureates,” Dr Cyrus Poonawalla, chairman of the Poonawalla Group and Serum Institute of India, told Parsiana. "His Serum Institute makes more vaccines than anybody, including one for meningitis that sells for a mere 50 cents a dose,” noted Gates who is the co-chair of the Bill and Melinda Gates Foundation which works for charitable causes, particularly healthcare, worldwide. Among the vaccine heroes Gates mentioned are renowned researchers like Albert Sabin (who created the oral polio vaccine), Jonas Salk who discovered the first safe, effective polio vaccine in the 1950s, Nobel Prize winner John Enders… "These pioneers in breakthrough research (and in one case, manufacturing) are fascinating, mythic guys,” Gates stated.

On July 4, 2012, Poonawalla announced that Serum Institute, India’s largest vaccine maker, had made its first overseas acquisition by buying 100 percent stake in Bilthoven Biologicals of the Netherlands for Rs 550 crore. "The total deal size is 80 million euros. We have already paid 32 million euros (Rs 225 crore). The remaining amount will have to be paid over a period of two to three years because of the liabilities and assets, which are pending,” Poonawalla declared.

"This acquisition will significantly strengthen our position in the global vaccines market while giving us access to the technology and production facility of Injectable Polio Vaccine (Salk), which is the only logical solution available to the world for the eradication of polio. This will also significantly enhance our earlier offerings in the pediatric vaccines segment including DPT (diphtheria, pertussis and tetanus), measles and MMR (measles, mumps and rubella) vaccines where we are the global leaders today,” stated the 71-year-old whose drive and determination is as strong as ever. Bilthoven Biologicals is located in the town of Bilthoven, 45 minutes from Amsterdam, and has a manufacturing facility spread over 20 acres, employing over 200 people. The loss-making company, which was owned by the Netherlands government, has a manufacturing capacity of more than 20 million doses of vaccine a year.

"The Poonawalla Group is committed to investing over 70-80 million euros over the next three years to augment the infrastructure and enhance the manufacturing capacity of Bilthoven’s facilities,” said Adar Poonawalla, Cyrus’ son, who is the Group’s executive director. "Serum Institute has one of the world’s largest manufacturing facilities at Poona, India and with this second manufacturing facility based in Europe, the company aims to access the developed markets of Europe and USA for its existing and future products.” Serum Institute will certainly look at other acquisitions if they complement their product line, Adar Poonawalla told The Financial Express, July 12, 2012. "There are very few players in the vaccine field. Consolidation in this industry does not happen very often, even globally speaking,” he told the paper. "My vision and hope is that after five years we will be selling in Europe and the US, which we are not doing today, and hopefully also launch a new basket of vaccines such as pneumococcal (against pneumonia), rotavirus (vomiting and diarrhea) and HPV (human papilloma virus, which may cause cervical and other cancers), among others.”

Just over a month earlier, Gates had visited Serum Institute’s manufacturing facility at Hadapsar in Poona. "This is an amazing company and its facilities would be considered state of the art anywhere in the world… So I was really honored to be welcomed by Dr Cyrus Poona­walla… This year Serum will ship a billion doses of vaccines worldwide,” Gates states in the video which can be viewed online on the gates notes. "Serum is extremely good at making high-quality vaccines for many different diseases — and doing it at low cost so that poor countries can afford them... It’s a great example of the potential for innovation in developing and newly industrializing countries,” Gates noted. Donning cap and gown, Gates was taken into the manufacturing facility: "I was able to meet with a number of Serum’s top scientists and get to look at their impressive manufacturing line. I was particularly happy to see their work on the pentavalent vaccines. This is a five-in-one vaccine given to children to protect them from life-threatening haemophilus influenza type B, diphtheria, pertussis, tetanus and hepatitis B. Serum’s work has dramatically lowered the cost of these vaccines (and a great many others) and is a true contribution by India to the well-being of the world,” remarks Gates in the video. In an overview of his India visit, Gates noted that Serum had gradually evolved from making relatively simple vaccines for things like tetanus to making more advanced ones.

Clockwise from top left: World class facilities at Serum’s SEZ; intra-nasal H1N1 (swine flu) vaccine; robotic arm and quality control and instrumentation

Gates’ visit on May 31 to the spic and span, verdant Serum BioPharma Park, (designated special economic zone for biotech and pharma) complex however meant coping with the Poona summer! "I’ll admit — as a guy from Seattle — that the temperatures have been a challenge (44° Celsius today)! The upside is that it’s the height of the mango season right now and I’ve been lucky enough to get them at just about every meal. They’re spectacular!” With the Poonawallas well-known for their beautiful racehorses and stud farm, style, substance and hospitality, they played host at a private dinner for the Microsoft founder at the Poonawalla home.

"In my opinion, Gates stands out. … he’s a soft- spoken man, full of humility,” Serum’s chairman told the Fly Kingfisher Winning Post interviewer who spoke to him at the Serum Institute after Gates’ visit. "Not only is he the biggest donor (from 1994 the Foundation has made total grant commitments of $26.19 billion to various causes worldwide — editors) but he has retired and sacrificed his whole life relentlessly working, explaining to various governments that it is important to give vaccinations from birth…” This not only saves children’s lives but their health improves at the first stage. Prevention is so much better than spending billions after they fall sick, Poonawalla asserted. For Adar, the father observed, the first lesson he learnt from Gates was humility: "He (Adar) has vowed to learn not only to donate but to try and spend time on the cause of saving children’s lives,” and that would be the biggest takeaway, he added.

With the Gates Foundation interested in several new products under research at the Institute, the software billionaire wanted to know whether the Serum Institute would continue to follow the philanthropic policy of keeping the price low, as well as ensure the uninterrupted supply of newer vaccines. Poonawalla assured him that they would hold the price line, after factoring in oil-price driven inflation, and not exploit the situation "even though we supply to 130 countries and have attained a position of monopoly (in the case of certain vaccines).” The health ministry is doing precious little compared to the resources they have, Poonawalla told the Winning Post team. "This is a complaint not only from me but from all the vaccine manufacturers. I’d offered to donate millions of doses of vaccines, but they did not bother to reply. I had to turn to the various United Nations agencies who wrote to several countries.”

At the GAVI (Global Alliance for Vaccines and Immunization) Pledging Conference in London on June 13, 2011 which was attended by the British Prime Minister David Cameron and Gates, Poonawalla offered GAVI the pentavalent vaccine at $1.75 a dose, the most affordable rate from any manufacturer worldwide. "Recently we have donated about 12 million doses of the measles-rubella vaccine to countries such as Laos and Uzbekistan and supplied 18.5 million doses at a 50 percent discounted rate to the Philippines in conjunction with WHO (World Health Organization) and UNICEF (United Nations Children’s Fund),” Poonawalla stated.

The Gates Foundation, which also funds clinical trials, is continuing to liaise with the Government of India to lay more emphasis on the immunization program and to go in for newer vaccines in this country. The health minister Ghulam Nabi Azad is an honest man and has promised to take this further, Poonawalla asserts. The greater availability of the newer vaccines will bring down the international price and make them more affordable. Asked how he had managed over several years to maintain high quality at low cost, Poonawalla stated that the secret lay in the numbers game. Making 300 million doses of one vaccine means that cost comes down and overheads are reduced. "That benefit we pass on to the user. I do not spend any money on publicity, brand equity or advertising. These are quite huge for pharma companies. Biotech companies have the advantage of high technology, high output. The same fermenters give you that much more productivity. This is a factor that drives all biotech companies which are successful.”

At a meeting of United Nations agencies and health ministers of BRIC (Brazil, Russia, India and China) held in Beijing in July last year, Dr Margaret Chan, WHO director general, singled out India’s effort and stated that when African countries wanted a meningococcal vaccine at a cost of not more than 50 cents a dose, it was the Serum Institute of India which came forward and did the job. "All the major manufacturers of the world were approached by WHO but could not meet the cost criteria, which was critical for the African countries. The supply of this vaccine by India has saved hundreds and thousands of lives in low and middle income African countries, where a person contracting meningitis often means four-five months of a household’s income,” Chan is quoted in a press release from the Press Information Bureau, Government of India, Ministry of Health and Family Welfare.

Immediately after the former Microsoft chief’s visit to his plant, Poonawalla was among the attendees at a closed door conference on philanthropy in Bangalore co-hosted by Wipro founder Azim Premji, Tata Group chairman Ratan Tata and Gates. Invitees included the rich and famous of corporate India and discussions centered round the need to give, though specific pledges were neither asked for nor given. "I was not very impressed with most of the speakers, as they talk about philanthropy and other philosophical ideas, which these speakers need to implement during their lifetime and not as a commitment they are making thereafter by bequeathing/donating part of their wealth, which we do not know will really happen or not,” Poonawalla said in response to Parsiana’s query about the conference.