Disclaimer: This post discusses a development from mid-March 2026.
As readers of this blog are no doubt aware, vaccine policy in India has never quite been a straight road. It is always puddled with poor transparency and poorer access. Two developments (one involving an international IP licensing arrangement for a Nipah vaccine, and the other concerning the curious sidelining of an indigenous HPV vaccine, both involving the Serum Institute of India (SII)) offer another opportunity to assess the state of vaccine availability and affordability in India, and see intellectual property, public health priorities, and political economy continue to intersect (and occasionally collide).
Let me attempt to distill the essence of these developments before turning to the more uncomfortable questions they raise.
At one end, we have the University of Oxford entering into a non-exclusive global IP licensing agreement with Serum Institute of India (SII), backed by Coalition for Epidemic Preparedness Innovations (CEPI), to advance the ChAdOx1 NipahB vaccine candidate against Nipah virus. On paper, this is textbook “good IP”: voluntary licensing, technology transfer, global manufacturing capacity, and a clear public health objective.
At the other end, however, we see India’s own HPV vaccination rollout choosing to rely on Gardasil (supported by GAVI, the Vaccine Alliance) rather than SII’s indigenous Cervavac. This is despite years of waiting precisely for such a “Made in India” alternative.
If the first story is about the promise of IP-enabled collaboration, the second is a reminder that innovation alone does not guarantee adoption. And somewhere in between lies the messy reality of affordability, accessibility, and governance.
When the Stars Align, But the System Doesn’t
At first glance, the Oxford–SII licensing deal appears to be everything that global health advocates have been asking for: a voluntary, non-exclusive licence that enables manufacturing at scale in the Global South. Unlike the coercive overtones of compulsory licensing and IP waiver debates, this is a negotiated arrangement. This is arguably the gold standard within the current IP paradigm, with nations in FTAs demanding voluntary over compulsory licensing arrangements from India.
The use of the ChAdOx1 platform (which, incidentally, also powered the Oxford-AstraZeneca COVID-19 vaccine) signals a continuity of technological infrastructure. Add to this the backing of CEPI, and one might reasonably conclude that the “ecosystem” for pandemic preparedness is functioning as intended.
But (and there is always a “but”) this raises the obvious question: if this model works so well, why does it not translate into domestic public health decision-making with the same ease?
Because the HPV story suggests that the bottleneck is not merely about creating vaccines. It is about choosing them.
The Indigenous Paradox: Innovation Without Uptake
India’s HPV policy journey reads like a cautionary tale, as covered in this report by Abantika Ghosh. The recommendation to include the Human Papillomavirus vaccine in the Universal Immunisation Programme dates back to 2018, following deliberations by the National Technical Advisory Group on Immunisation (NTAGI). Yet, nearly eight years later, the rollout begins not with the long-awaited domestic vaccine but with an imported one.
The official rationale oscillates between cost concerns, logistical hurdles (two-dose regimens), and evolving scientific positions, particularly the shift towards single-dose efficacy, endorsed by the World Health Organization.
Now, in isolation, each of these reasons is defensible. Taken together, however, they begin to look suspiciously like what economists might call “moving goalposts.”
India waited for affordability: SII promised ₹200–400 per dose.
India waited for feasibility: single-dose schedules became the focus.
India waited for domestic capacity: Cervavac was developed.
And yet, when the moment arrived, the programme leaned on GAVI-supported procurement of Gardasil.
This is not merely ironic. It is structurally revealing and involves broader themes of discussion than mere IP.
What Is Actually Going On?
The surface narrative of “foreign vs swadeshi” goes deeper with respect to three underlying strands:
1. Risk Aversion Disguised as Pragmatism
Public health decision-making, particularly in vaccination, is inherently risk-averse. The shadow of the 2009 HPV trial controversy still looms large, and governments tend to prefer globally validated options over domestically newer entrants, especially when external funding (from GAVI in this case) reduces fiscal pressure.
2. The Political Economy of Donor Funding
GAVI’s involvement is not merely financial, but structural. By subsidising vaccine procurement, it effectively shapes adoption pathways. This is not necessarily problematic, but it does create a subtle dependency. When vaccines come bundled with funding, the “choice” becomes less neutral than it appears.
3. Fragmented Policy Objectives
India’s vaccine ecosystem operates at the intersection of multiple, sometimes conflicting goals of industrial policy (promote domestic manufacturing), public health (maximise coverage), fiscal prudence (minimise costs), and political optics (swadeshi vs global integration). The HPV episode reveals what happens when these objectives are not aligned: innovation is celebrated, but not necessarily utilised.
In light of this, it is tempting to view intellectual property as either the villain (restricting access) or the hero (enabling innovation). The reality, in practice, for IP is rather nuanced when it comes to the pharmaceutical sector. While the Oxford–SII deal demonstrates how IP can facilitate technology transfer, decentralised manufacturing, and rapid scaling during health emergencies. Non-exclusive licences, in particular, are most crucial to prevent monopolisation while preserving incentives for innovation. However, it is clear that IP alone does not solve procurement biases, regulatory delays, institutional inertia or other structural inequities. Even where IP barriers are minimal (as in the case of Cervavac), access can still be constrained by non-IP factors.
Moreover, one of the recurring confusions in vaccine discourse is the conflation of affordability (which is about price) with accessibility (which is about delivery). The policies since Covid have been called out time and again for being non-transparent and causing high prices to persist domestically, even when the country takes the stance supporting affordability on the global stage (as discussed by Prashant T Reddy here). But, as the HPV case illustrates, even a cheaper vaccine does not guarantee uptake if the system is not aligned to deploy it effectively. Accessibility can remain uneven due to logistical challenges (cold chains, last-mile delivery), sociocultural barriers (vaccine hesitancy, especially for HPV), and administrative capacity constraints.
So, Where Does This Leave Us?
On the one hand, India is the “pharmacy of the world” and is proactively entering into sophisticated IP arrangements and taking stands against onerous IP obligations. On the other, it struggles to integrate its own innovations into national programmes in a timely and consistent manner. This, hence, becomes fundamentally a question of governance. If the goal is to balance innovation with access, as the policy rhetoric goes, the Oxford-SII license will also have to go through fire if it wished to have a fate different from HPV vaccines’. The presence of Oxford with SII is likely to increase its rate of adoption for better conceived validation of the vaccine.