WHO KNOWS what he would think Achille Sclavo of the Italian rush to produce vaccines against Covid-19 announced by the minister Giancarlo Giorgetti. He who at the beginning of the last century understood the value of vaccination for public health so well that he dedicated his life and his savings to the creation of a serotherapy institute on the outskirts of Siena, in the rooms of his country residence. It was 1904 and Sclavo’s enemy was anthrax, a disease caused by the anthrax bacterium that is taken from animals. The Italian hygienist developed an effective vaccine starting a real school of infectious disease and vaccinology experts which led to Siena being considered one of the most advanced research centers in this field throughout the twentieth century.
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The census of the Italian companies that can produce anti-Covid vaccines 19
In short, can we say that we had at home what we are now anxiously trying to create within 6 months? Obviously not, in the sense that the production of vaccines at the time of Sclavo or in any case in the first decades of the twentieth century was certainly different. But a doubt can reasonably arise: if the State had invested in that center of excellence instead of abandoning it and, in fact, pushing it into the hands of foreign companies that have legitimately done what was most strategic for them, perhaps today we should not look for it. to make a census of the Italian companies that can participate in the effort of a tricolor production of vaccines against Covid-19.
One company is not enough: each one provides an element
Siena’s skills were defended mostly by the researchers who worked there – Rino Rappuoli in the lead, who is now responsible for external research and development at GlaxoSmithKline Vaccines in Siena – but certainly not by the various governments called upon to decide whether to put money into it, or not. Result: what has been saved on the vaccine front is too little to guarantee a hypothetical Italian production. Till today. And net of the investigations that Giorgetti and Farmindustria are carrying out to understand if it will be possible, at what price and when, to produce anti-Covid vaccines in Italy. What then, even on this we should understand. Dozens of different steps and the involvement of many companies are required to produce a vaccine, each providing an element or contributing to the production.
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The reagent sold in only two companies in the world: one in the USA, the other in Europe
Jonas Neubert, an engineer expert in innovation, has tried to calculate what it takes to produce an mRNA vaccine: in addition to the active ingredient, various excipients, fats and sugars are needed, each of which must be found on the market. To give an idea of the difficulties that can be encountered, just think that one of the vital phases for the creation of RNA is an operation called 5-capping for which it is necessary to add a reagent sold by only two companies all over the world. , one in the US, the other in Europe. But even making a viral vector vaccine isn’t easy. The pharmaceutical chemist Derek Lowe, who writes a blog on the site of Nature Translational Medicine, does the same operation as Neubert, but for the other vaccines on the market. And even in this case the count is very long and complex: it starts from the creation of the viral vector to its purification and packaging. With dozens of companies involved as suppliers of products or services.
A single nation cannot do it all by itself
Thanks to the work of the European Data Journalism Network, which made a list of all the European collaborations to get to the production, we understand how complex this operation is and that Italy already contributes, even if in a minimal part. Pfizer / Biontech and Moderna have agreements with 11 and 4 European companies respectively, none of which are Italian or who work in our territory. AstraZeneca has collaborations with 8 companies, including Catalent which is based in Italy but is American and the Italian Advent specialized in the processing of adenoviruses; Johnson & Jonhson with 4, including Catalent which will produce the Covid vaccine and therefore will start a second production line.
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If we take into consideration the vaccines not yet approved, but forthcoming, we see that the American Novavax and the German Curevax have partnerships respectively with 7 and 6 European companies, the French Valvena with 3 others, the joint venture between Gsk and Sanofi involves factories in Belgium, France, Italy and Germany. And then there is the Italian ReiThera which in any case has collaborations with companies in Belgium and Germany. In short, given the complexity of the scenario, it seems difficult to think of a future in which a single nation can do everything by itself. Much less Italy where, as mentioned, decades ago they gave up investing in the vaccine sector. In other words, with us there is no company that can offer itself as a partner on a global level, as Sanofi did in France with Gsk, or as happened in the USA with Merck which went to J&J’s aid.
The solutions on the horizon are only half Italian
Therefore, the solutions on the horizon for now are only half Italian. Thermo Fisher Scientific, which thanks to the announcement of the President of the Board Mario Draghi has jumped to number one in the ranking of companies engaged in Italian production, it is American and produces on behalf of third parties, but it has two production plants that could come into play at Ferentino, in Lazio, ea Monza, in Lombardy. The vaccine that will be produced in Italy will most likely be that of Pfizer / Biontech, provided that the bioreactor of the Monza plant is suitable or can be adapted quickly. Yes, because never before has an mRNA vaccine been authorized and therefore produced on a worldwide scale; no one has the right equipment except those who developed them; it is therefore a question of adapting in the shortest possible time machines and reactors not so dissimilar to those needed. Another company with bioreactors is Acs Dobfar, based near Milano but with one of the ad Anagni, where the production of vaccines could start, including the Russian Sputnik. ReiThera, the Italian company involved in the Italian Grad-Cov-2 vaccine, has bioreactors and, pending its product being authorized, could make a contribution to the production of AstraZeneca and Johnson & Johnson with which it shares the technology based of adenovirus.
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Finally, Fidia Farmaceutici, which ad Abano Terme already produces vaccines on behalf of third parties, it has said it is willing to make its plants available. Although no agreement has been made public to date. But even assuming that Italian production starts, can vaccines be considered “Italian”? That is, be destined for distribution only on our territory? It seems very unlikely: ownership always remains with the leading companies and agreements are mostly made at European level. Of course, the more “steps” of the complex production chain are made in Italy, the greater the Italian weight can be imagined at the European tables where the distribution of doses is decided.
The Italian factories ready to fill
For now Italy excels above all in the downstream filling of the more sophisticated process with which the biological material is obtained (the one for which the bioreactors are needed), its purification, mixing and formulation. A situation that is the mirror image of what is happening in the field of drugs, where Italy has the European primacy as a subcontractor: we produce on our territory more than any other European nation and therefore also export large quantities of medicines. A condition that exposes us more to competition from markets where labor, even the specialized one, costs less than in Italy. In addition, we are left orphaned of research, what may seem very expensive at the beginning, but which then allows us to develop innovations, for example mRNA vaccines. It is therefore right to accelerate the production of new vaccines against Covid-19 but, while we are at it, it would also be appropriate to rethink how to seriously finance research and make Italy an attractive country not only for production but also for the development of new ideas. .
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