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The CEO of the world's biggest vaccine maker told "Axios on HBO" he expects low-income countries will start receiving much-needed exports of his COVID-19 vaccines this week, now that India's Prime Minister Narendra Modi is lifting restrictions.

Why this matters: Billionaire Adar Poonawalla's Serum Institute of India is the biggest supplier of vaccines to low-income countries. But for months, he was blocked from meeting his commitments to supply vaccines to the world's poor, putting him “on the verge of a nervous breakdown.” 

  • When a second wave of COVID-19 hit India in the spring, Modi cut off all exports in order to keep vaccines for his own population.
  • Poonawalla defended Modi's decision, but it was devastating to his pledge of 1.1 billion doses of vaccine for the developing world. Suddenly he could only give them to Indians.
  • COVAX, the global consortium charged with equitably vaccinating the world, was left empty-handed.

Details: Now that India has emerged from a brutal second wave, Poonawalla says he's allowed to resume exporting Covishield — his version of the Oxford-AstraZeneca vaccine — to COVAX.

  • Unlike the Pfizer and Moderna vaccines, Covishield doesn't need to be stored in freezing temperatures, which makes it ideal for vaccinating people in low-income countries.
  • "I think by the tenth of November you're gonna see the first — if not a bit sooner — you're gonna see the first doses arrive in Africa," Poonawalla said.
  • Once shipments begin, Poonawalla said he expects to send around 30 million doses per month, to COVAX primarily.

The big picture: Advocates say the vaccination divide between rich and poor countries is unconscionable.

  • More than a year after the COVID vaccine was authorized, over half of people living in many developed countries are vaccinated while less than 5% of people in low-income countries have received a shot.

Between the lines: Poonawalla had some tough words of his own for how countries including the U.S. are contributing to the global vaccination drive.

  • He said he would "absolutely" call on wealthy countries to stop giving out booster shots and vaccinating children until people living in low-income countries have been vaccinated.
  • He also called on other COVID-19 vaccine manufacturers to donate more doses to COVAX. “Why should only Serum Institute provide vaccines at a $3 price to the low-income countries?" he said. "These are giant companies... they’ll still make billions of dollars of profits.” 

Behind the scenes: "Axios on HBO" visited Poonawalla last week at the Serum Institute's headquarters in Pune — a four-hour drive from Mumbai's international airport in midnight traffic on roads packed with fast-swerving trucks.

  • Poonawalla is a billionaire with flashy tastes. He collects fast cars and converted one of them into a Batmobile. He works out of a grounded Airbus plane that has been converted into a lavish boardroom office.
  • Adar's father, Cyrus, started out breeding racehorses. He used to sell his aging horses to the Indian government to develop vaccines, but realized he could cut out the middle-man and mass produce cheap vaccines by extracting serum from his own horses. In 1966, he founded the Serum Institute.
  • Adar took over the Serum Institute in 2011 when he was 30. He's dramatically expanded the private company, which now supplies 140 countries. The developing world disproportionately relies on Serum to produce cheap vaccines of many varieties.

The intrigue: When the COVID-19 pandemic began, Poonawalla did what only somebody in his situation could have gotten away with.

  • He called his father and told him he wanted to invest several hundred million dollars and enter a deal to begin producing a potential COVID-19 vaccine that hadn't even gone through clinical trials.
  • Luckily, for Poonawalla and — finally, soon — recipients around the world, the bet paid off.

Go deeper

Updated 14 hours ago - Health

First North American Omicron cases identified in Canada

COVID-19 testing personnel at Toronto Pearson International Airport in September. Photo: Steve Russell/Toronto Star via Getty Images

The first two cases of the new Omicron variant have been detected in North America, the Canadian government announced Sunday evening.

Driving the news: The World Health Organization has named Omicron a "variant of concern," but cautioned earlier on Sunday that it is not yet clear whether it's more transmissible than other strains of COVID-19.

Nov 28, 2021 - Health

Moderna says updated vaccine for Omicron could be ready in early 2022

Syringes and a vial of Moderna COVID-19 vaccine. Photo: Ben Hasty/MediaNews Group/Reading Eagle via Getty Images

Moderna's chief medical officer Paul Burton said Sunday that a reformulated vaccine against the newly identified Omicron coronavirus variant could be ready as soon as early 2022 if it's found to be necessary.

Why it matters: Burton's comments on BBC's "Andrew Marr Show" come as companies are testing whether current COVID-19 vaccines will provide adequate protection against the strain.

45 mins ago - World

Scoop: Iran preparing to enrich weapons-grade uranium, Israel warns U.S.

Iranian President Ebrahim Raisi holds a press conference. Photo: Presidency of Iran handout via Getty

Israel has shared intelligence over the past two weeks with the U.S. and several European allies suggesting that Iran is taking technical steps to prepare to enrich uranium to 90% purity — the level needed to produce a nuclear weapon, two U.S. sources briefed on the issue tell me.

Why it matters: Enriching to 90% would bring Iran closer than ever to the nuclear threshold. The Israeli warnings come as nuclear talks resume in Vienna, with Iran returning to the negotiating table on Monday after a five-month hiatus.