Nepal’s vaccine import prospects are dwindling.

After India expressed its inability to export vaccines and COVAX, an international vaccine-sharing scheme, communicated delays in supply, Nepal was hoping to buy the jabs against Covid-19 from two American companies—Johnson & Johnson and Moderna.

But both American vaccine manufacturing firms have ruled out the possibility of selling the shots to Nepal before 2022 due to supply chain constraints and other reasons.

Nepal had in the third week of April reached out to Johnson & Johnson and Moderna to buy 5 million and 2 million doses, respectively, of their vaccines.

According to the Embassy of Nepal in Washington, DC, both companies have communicated that they are unable to sell vaccines this year.

The representatives of J&J during a virtual meeting indicated that there is less likelihood for it to sign new purchase agreements before 2022 due to issues related to the supply chain, the embassy said earlier this week. The embassy also said in its regular brief that Moderna has said the company is not in a position to supply its vaccines on a commercial basis until next year due to issues related to global supply chain.

The Nepali embassy was exploring the possibility of buying vaccines from Novavax, a Baltimore-based pharmaceutical company, which recently carried out a successful trial of its vaccine and is awaiting US Food and Drug Administration clearance. “They too cited their commitment to COVAX and expressed inability to make commercial supply to Nepal in the near term,” the embassy said.

“All these developments have been communicated to Kathmandu through appropriate channels,” a Nepali diplomat based in Washington, DC, told the Post over the phone. “There are issues of global supply chain, pre-booking and availability of raw materials for vaccine manufacturing, among others.”

The development comes as a major setback for Nepal which despite being one of the first countries in the world to launch a vaccination drive in January has inoculated just around nine percent of its 30 million population. Only 2.6 percent of the people have been administered both doses.

It has now become apparent that the KP Sharma Oli government has been making assurances of vaccinating all the eligible people by November, the election month declared by the government after dissolving the House of Representatives, without making any tangible progress on vaccine procurement.

Nepal started its vaccination drive on January 27 after receiving 1 million doses of AstraZeneca type vaccine, manufactured by the Serum Institute of India as Covishield, under Indian government’s grant assistance.

The Oli administration then in February signed a deal with the Serum Institute, the world’s largest vaccine manufacturer by volume, to buy 2 million additional doses. But after supplying 1 million doses, the Serum Institute in March expressed its inability to provide additional doses. The plan to purchase another 5 million doses never took off. Nepal in March received 348,000 doses of Covishield under the COVAX programme. Apart from these, Nepal has received 1.8 million doses of Vero Cell, a vaccine developed and manufactured by Sinopharm, a state-owned pharmaceutical company of China.

Pressure started building on the Oli administration to acquire vaccines after time came for 1.4 million people aged 65 and above to receive their second doses. These people had taken their first doses of Covishield between March 7 and March 15.

When the coronavirus second wave hit the country in April, a scrambling government started to look for more options, trying to buy vaccines from any country or manufacturer. Even President Bidya Devi Bhandari wrote to her counterparts in various countries, including the United States.

Exactly a month ago, on May 28, then foreign minister Pradeep Gyawali made a tall claim—that there would be a breakthrough in vaccine procurement “within 10 days”. He told journalists that negotiations were underway to buy 5 million doses of J&J.

According to the Nepali embassy in Washington, DC, though J&J representatives have ruled out any possibility of supplying vaccines within this year, they have assured that Nepal’s case will be reported to their global leadership.

But officials are not sure if the vaccines would arrive within this year, given the companies’ production lines, supply chain constraints and prior commitments.

“Vaccine manufacturing companies are under extreme pressure to deliver the doses to the countries they have promised or from whom they have received the signing amount or with which they have already reached bilateral agreements,” said another Nepali diplomat. “If we do not make pre-bookings with vaccine companies, we will not be able to immunise our population before mid-2022.”

According to the diplomat, when Nepal first approached the Serum Institute back in December for a commercial purchase deal, there were already 50 countries that had made pre-bookings.

As Nepal stares at a third wave with a more lethal Delta variant circulating, health experts have warned of a catastrophe because the country lacks the vaccine.

A senior Health Ministry official told the Post that since two US vaccine manufacturing companies have expressed their inability to supply vaccines before 2022, Nepal is left with limited options.

The government must reach out to India, China and other countries, including Russia, according to the official.

“We are likely to get 4 million doses of vaccine from China very soon,” said the official. “But there has been no further development on vaccines from Russia. We no doubt are in a tight spot. Even if we receive all the committed doses from COVAX, that won’t be sufficient for us.”

When the United States in April announced that it would share around 60 million doses of AstraZeneca vaccine and an additional 20 million doses of Pfizer, Moderna and J&J vaccines, with other countries, expectations were high in Nepal too.

Earlier this month, the White House said it would share 7 million doses of vaccine with Asian countries including Nepal. But the number of doses Nepal would receive and the time of dispatch were not immediately clear.

Many wonder if weak diplomacy has impacted Nepal’s vaccine procurements, besides political turmoil created by Prime Minister Oli.

Amid Nepal’s deepening vaccine crisis, the White House on Tuesday said that it had begun shipping 2.5 million doses of Moderna vaccine to Bangladesh.

Officials say the Oli administration must work to acquire the remaining 1 million doses of Covishield for which it has paid and then put pressure on India to provide more doses.

During a virtual meeting with India’s Railway Minister Piyush Goel last week, Nepal’s Ambassador to New Delhi Nilamber Acharya had raised how badly his country needs the vaccine.

A diplomat based in Delhi told the Post that there, however, has been no word from India’s Ministry of External Affairs as yet.

“They have said neither no nor yes on releasing the 1 million doses for which Nepal has already paid,” said the diplomat.

Just as Nepal scrambles for vaccines, it is currently in a political mess. There is no Parliament. Politicians are at each other’s throats over power, paying little attention to the pandemic. Oli has dissolved the House and declared polls for November. The House dissolution case is being examined by the Supreme Court.

A Supreme Court order has left the Cabinet with just five ministers, including the prime minister. The country currently does not have dedicated foreign and health ministers.

After new daily infections started to decline, authorities have eased restrictions that were imposed on April 29, and experts have warned of a surge in cases.

Hridayesh Tripathi, a former health minister, said with the American manufacturing companies expressing their inability to supply vaccines anytime soon, Nepal’s options have shrunk massively.

“There is no alternative than to turn our focus to India and China,” Tripathi told the Post. “I have been saying this for long that the Covid-19 vaccine is not like any other commodity, manufacturers too are under immense pressure.”

According to Tripathi, everyone must understand that the Covid-19 vaccine is a political and strategic commodity. “The government needs to make its moves accordingly,” said Tripathi.

Nepal has to inoculate 72 percent of its 30 million population–around 22 million people, as 28 percent constitute those aged 14 and below. COVAX has committed to providing around 13 million doses, enough to vaccinate 20 percent of the population. An additional 348,000 doses under COVAX are expected by July, but there is no communication on when the vaccine sharing scheme could supply more doses.

Foreign Ministry Spokesperson Sewa Lamsal said that there has been no breakthrough on vaccine procurement as of now.

“We are doing follow-ups with countries and manufacturing companies. There is no progress as of now,” Lamsal told the Post. “There is no response from India. We will be able to say something on acquiring vaccines from China if there is any tangible development. The Foreign Ministry, Nepali ambassadors and diplomats, however, have been trying hard to secure vaccine doses at the earliest.”