Serum Institute of India CEO Adar Poonawalla Bets He Can Still End COVID-19 Globally

Dar Poonawalla has a history of gambling. His multibillion dollar empire is due to several big wagers that paid handsomely. Cyrus Poonawalla, his father, made his own fortune on horses—and then multiplied it by making another bet in 1966: that he could make more money producing vaccines than he could on horse breeding and racing. His father founded the Serum Institute of India, which was slow to grow for more than three decades. The company sold lifesaving and antivenoms for India.

When Adar, then just 21, joined the company in 2001, he persuaded his father to dramatically ramp up production—wagering that they could fill a gap in global supply by making low-cost vaccines in very large quantities. By 2017, SII was the world’s largest vaccine manufacturer.

Adar Poonawalla was gambling again in 2020 when COVID-19 began spreading quickly around the globe. He gambled on the development of a vaccine to combat the new coronavirus. He started producing millions of doses in September 2020 with his Pune-based company months before the Oxford AstraZeneca shot was officially approved. Poonawalla was relieved when the vaccine proved to be safe and efficient later in that year. When Poonawalla reflected on his decision to invest big in the vaccine, the Serum Institute was the only one capable of making such a huge swing. “If we don’t do it, who will?” he told TIME in March. “The other chaps don’t have the capabilities that we do in terms of scale.”

The world soon came to rely on the 41-year-old executive, better known before the pandemic for his slick suits, glamorous horse-racing parties and flashy cars than for his company’s work in producing vaccines. COVAX—a program mounted by the World Health Organization (WHO) and GAVI, the Vaccine Alliance, to ensure equitable vaccine distribution—made the Serum Institute the backbone of its efforts based on its CEO’s guarantee that it would produce 1.1 billion doses for export in 2021.

The company didn’t deliver, however. It was hit with problems including a fire at the manufacturing plant and a ban on global vaccine exports. Criticism suggests that Poonawalla might have taken into consideration some of these issues earlier. “The hype clearly didn’t match the reality on the ground,” says Neeta Sanghi, a consultant in pharmaceutical supply chains. “They thought that they could be the savior of the world.”

Poonawalla still tries to make good his promise to his company and deliver his vaccines one year later, but now he faces new challenges that could hinder his efforts at putting the Serum Institute in the lead of global COVID-19 supply.

SII’s stumble in 2021 is one reason for the woefully unequal global distribution of vaccines. But it’s also the case that wealthy parts of the world, like the U.S. and the E.U., have prioritized their own populations—administering booster shots widely while fewer than 3.5% of people in low-income countries have received their first vaccine dose. That’s a problem for the entire world; after all, it’s likely that new variants of SARS-CoV-2—the virus that causes COVID-19—will continue to emerge in places where it’s able to spread unchecked. The Omicron variant may have resulted from the relatively low vaccination rate—26%—in South Africa, where it was first detected.

Over the past months, many wealthy nations have offered to give more dosages to less fortunate countries. In September, Joe Biden, the U.S. president committed to buying 500 million doses for other countries. But actual deliveries still lag far behind. Poonawalla has another opportunity to win his wagers. “The gap has only widened and become more entrenched,” says Andrea Taylor of the Duke Global Health Institute. “And so Serum is still a pivotal part of the world’s story in the months to come.”

Poonawalla has two missions. Poonawalla set out to create vaccines which could be used in large areas of the globe and possibly end the pandemic. He still thinks that’s possible. But he’s also working to restore the reputation and reach of his company. After the COVID-19 vaccine debacle, “we were so severely criticized, and everyone thought it was all over,” Poonawalla told TIME in October. “We need this comeback to regain the lost confidence and market share.”

SII had been little-known before the pandemic. A meningococcal or meningitis shot from SII costs less than $1. This compares to more than $100 in the U.S. for a meningococcal-vaccination.

In 2011, Poonawalla was appointed CEO of SII. Cyrus Poonawalla, who supplies vaccines in poor areas of India, was nicknamed “The Vaccine Kings” by his father. Adar had a reputation for an extravagant lifestyle, but in the background he was expanding his company’s reach. Twenty-five years ago, vaccines were supplied by the Serum Institute to 35 different countries. It has agreements with 140 countries today.

He was determined to disrupt the current trend of the global pharmaceutical sector, which stopped making routine vaccines against many diseases. Although such vaccines were still needed, they weren’t very lucrative. The low-cost, high-volume business model—combined with SII’s long-standing partnership with GAVI, the Vaccine Alliance—made the company vital to childhood immunization campaigns around the world, especially in poorer countries. By early 2020, SII was producing 1.5 billion doses per year, boasting that 65% of the world’s children had received at least one of its vaccines.

Poonawalla was aware that his company played a key role in the COVID-19 epidemic. As we waited for vaccine information, Poonawalla made two major bets that would propel his company to the forefront of global attention. The first one worked. The other didn’t—and the world is still paying for it.

His first wager was in March 2020 to capitalize on his existing relationships and make an agreement to produce the Oxford AstraZeneca vaccine. He and his family invested $250 million in the venture. Additional $300 million was also invested by The Bill and Melinda Gates Foundation. SII raised $250 million by selling advance orders to other countries, including Bangladesh and Morocco. SII already had 50 million cold stored doses of vaccines when the U.K. authorized the vaccine for use in the late December 2020. After Liberia and Ivory Coast received 600,000 vaccines, the first COVAX shipment from SII arrived in Ghana. Vaccines produced by SII also became integral to India’s immunization campaign, which kick-started in mid-January.

Poonawalla’s second bet was that he could rapidly scale up production to more than 100 million doses a month and ship most of them overseas. SII fell apart almost immediately. First, there was the fire: on Jan. 21, 2021, a blaze broke out during construction at one of the company’s plants in Pune. Five workers were killed in the fire that was started by an electric short circuit, according to officials. SII initially claimed this wouldn’t affect COVID-19 vaccine production, but afterward, it struggled to produce more than 60 million doses a month. Poonawalla eventually admitted that production was hampered by the fire for up to three months.

Due to U.S. export bans in 2021 SII was unable to procure raw materials such as vials, bioreactor bags and syringes. This further slows down production. In India, cases rose sharply after that. This led to an even more devastating outbreak in May and April. Prime Minister Narendra Modi’s government had been vague to that point about how many vaccine doses it would purchase from SII, and had not given any financial assistance to the company to help it scale up production. The Modi government responded to Indian demands for vaccine supplies by banning exports of vaccines from April after Indian states started pressing it.

Poonawalla’s fall from grace was swift, in India and abroad. Vaccination drives in many countries were stalled, owing to their inability to get doses they’d expected from SII. AstraZeneca warned that the company could be sued for delays. In April, with COVID-19 deaths soaring in India, Poonawalla flew to London, citing threats to his safety—inviting further anger. He stopped being a regular on Indian TV News.

By early May, the Serum Institute had delivered about 30 million doses to the COVAX facility—less than 3% of the promised number. But it wasn’t long before Poonawalla got his second chance. He returned to India in June and took over the day-to-day supervision of SII. Partly due to a cash injection by the Indian government of almost $400 million to boost production capacity, he was able acquire a 50% share in SCHOTT Kaisa, a Mumbai-based firm that makes vials. He also invested in SII’s public image: in December, the company donated $66 million to establish the Poonawalla Vaccines Research Building at Oxford, focusing on global pandemic preparedness.

Finally, the results of these experiments are beginning to show. SII reports that it manufactured 250 million doses Oxford-AstraZeneca vaccinations in October. This is more than any other company. That same month—with the Indian government’s blessing after 60% of Indians received at least one vaccine dose—the company resumed some vaccine exports, sending 1 million shots to neighboring countries.

Poonawalla has been a mixed success story over the last two year, but he is moving ahead with his new ventures. Novavax (U.S.) has developed a COVID-19 vaccination that is being produced by The Serum Institute. This vaccine was officially approved for use by WHO in December. An intranasal and one-dose Russian Sputnik V shots are both in production.

This is all while Poonawalla faces a surprising challenge. Poonawalla revealed to the world that his company has run out of vaccines in December. India’s demand for vaccines has slowed, while new orders from COVAX and other countries have yet to pick up. Poonawalla, who announced that 500 million doses of AstraZeneca were in excess at the Serum Institute on December 7, said that production would be cut by half temporarily. COVAX has reiterated that its goal to distribute 2 billion doses by the first quarter of 2022 will rely on SII’s playing a key role, but says it will take time to figure out logistical issues before ordering from the company again.

In March 2021, before it was clear that the world’s bet on Poonawalla was going bust, he told TIME that he didn’t want to have any regrets “when history judges my actions.” Seven months later, in October, he was back to his old confident self. “It takes time to rebuild trust,” he said, but expressed certainty that orders would increase in the coming months. He said the Serum Institute is capable of both supplying COVAX and meeting India’s domestic vaccine demands. “We have scaled up more than we promised,” he said, and SII is champing at the bit to begin shipping millions of doses around the world.

Send an email to Abhishyant Kidangoor at abhishyant.kidangoor@time.com.