There has been absolutely no compromise in clinical testing of Covid-19 vaccines: Gangandeep Kang

Seeking to allay apprehension of people over the safety and efficacy of Covid-19 vaccines, noted clinical scientist Gagandeep Kang said that though vaccines for the coronavirus are being developed in a short period of time, there has been absolutely no compromise in their clinical testing.

Kang, who is associated with the Coalition for Epidemic Preparedness, a global consortium involved in facilitating vaccine candidates for the novel coronavirus, also said that there should be equitable Covid-19 vaccine access globally and domestically.

Known for her inter-disciplinary research on transmission, development and prevention of infections and their sequelae in children in India, Kang is also the first Indian woman to be inducted as a Fellow of the Royal Society in London.

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Though vaccines for the coronavirus are being developed in a "very short period of time", all clinical phases of testing are being done, she told PTI in an interview.

"What has changed is the approach to the testing where all steps that used to happen between phases of clinical trials have been cut out, which means regulators are working much longer and harder than they ever have before," Kang said.

Everybody is talking about things being done very fast but "I think it is very important to know what steps we are cutting out and quite frankly, in all of the testing of vaccines that is being done, there is no aspect of testing that is being removed from the development pathway", she said.

"I think it is very important to understand that there has been absolutely no compromise in clinical testing of Covid-19 vaccines. The only thing that we do not have from these trials, that we might have had otherwise, is the duration of safety follow-up. Generally, we follow up on trials for six months or one year, and generally, we do not find anything extra in the six months or one year," Kang said.

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Kang, who was the executive director of the Translational Health Science and Technology Institute (THSTI) but resigned in July, said that another thing that is different in the development of Covid-19 vaccines is that clinical trials have been made very large to get results faster.

To a question on availability of cold chain capacity to store vaccines, she said that equitable access to Covid-19 vaccines should be ensured.

The case should not be that those who live in big cities, where there is better cold chain capacity, get vaccinated while those in rural areas or small towns do not get it because of lack of storage facilities, Kang said.

"My worry with all of it is the question of equity, will we end up with a system where we have freezers in big cities and some classes of people can get vaccines, whereas in rural areas or small towns there is no access to these vaccines as cold chain capacity does not exist," she said.

"Even in the work that we are planning to do with the Lancet Commission, equity is a big part of looking at what services are provided to whom and where, and making sure that where you live and what your socio-economic status does not determine what kind of services you get," Kang said.

The Lancet, a global health journal, on Friday launched the Lancet Citizens' Commission on Reimagining India's Health System, which will work on developing a strategy for implementing universal health coverage (UHC) in India.

The journal and the Lakshmi Mittal and Family South Asia Institute, Harvard University, together formulated the commission.

Speaking about the Lancet commission, Kang said that its purpose is to aim for universal health coverage to examine all health concerns, to look at mental and physical health problems and their solutions, to ensure that catastrophic health expenditure does not happen and make sure coverage is accessible and affordable.

The commission is being led by four distinguished health and business leaders, including Kang and CMD Biocon Ltd Kiran Mazumdar Shaw.

"If we think about Sustainable Development Goals (SDGs), which have a target of 2030, there is no way we can achieve these goals with the trajectory that we have at the moment. So what we are seeking to do over the next few years is to try and layout a road-map to make sure we are on a better path to achieving the SDGs," Kang said.

She said in India, out of pocket payments for healthcare continue to be highest in the world and it is one of many reasons why many families are driven into poverty. This kind of "catastrophic health expenditure" actually winds up promoting further health inequities in the system, Kang said.

"We have a situation where the most vulnerable in our population don't get services that they want and there is a problem in terms of accountability where the poor are treated as beneficiaries rather than as clients of the system, and there seems to be a lack of trust in the quality of the care that is provided by the healthcare system," she said.