A five-minute phone call from a son to his father is where it all began.

Adar Poonawalla was driving to work when he took the decision. His family’s collection of luxury cars, including a custom-fitted Mercedes Batmobile, a Rolls-Royce and a Ferrari 458 Speciale Aperta, of which there are fewer than 500 units around the world, had always made it to the glossies. But today the flamboyant businessman’s mind was elsewhere.

It was the month of April 2020 and a statement from the Jenner Institute at Oxford University announced a partnership with pharmaceutical giant AstraZeneca to develop a Covid vaccine.

Poonawalla knew Adrian Hill, the institute’s director, because of their earlier collaboration on the malaria vaccine.

He felt the Serum Institute, the world’s largest vaccine maker, could not sit this one out, despite the inherent risks. But he needed the approval of his father, Cyrus.

The Jenner Institute was named after Edward Jenner, the eighth of nine children born to a British vicar, and who was inoculated for smallpox as a child at school. The side effects would have a lifelong impact on Jenner’s health. Eventually, he would be the scientist who would reimagine the modern smallpox vaccine by experimenting with cowpox, a mild viral infection in cows that did not appear to produce any major discomfort in humans.

In the strange way that the dots of the universe sometimes conspire to connect, Jenner was awarded with the Degree of Doctor of Science, Honoris Causa, by the University of Oxford in 1813. More than 200 years later, in 2019, Cyrus Poonawalla became only the second person to be recognised with the same honorary doctorate. And a year later, his son was keen to work with the same institute to manufacture arguably the most important vaccine of the twenty-first century.

“Dad was apprehensive,” Adar said about his billionaire father, the son of a horse breeder with a love for Rembrandts, Brioni suits, thoroughbreds and a quintessentially Parsi joie de vivre, down to the discotheque built in the basement of his mansion. “He has built things from scratch, so he always feels he has more to lose than I do,” Adar Poonawalla told me, with a laugh.

Cyrus Poonawalla, who got into the business of making vaccines after accidentally discovering that they used horse serum, was hardly regarded as fiscally conservative by the outside world. He partied with Paris Hilton, dined with Kate Middleton and posed unapologetically with his gulf streams. Risk was no stranger to his life.

He and his brother Zavaray entered the vaccine manufacturing business with a 12-acre plot and a $12,000 investment, partially subsidised by their father. Yet, even by father Cyrus’s zany standards, his son was taking an extraordinary, crazy risk.

Adar Poonawalla argued that it was in keeping with his ambition to expand capacity at the company.

When he began work at Serum in 2001 at the age of twenty, their company exported vaccines to no more than forty nations. By the time Adar had turned thirty-six, they were present in 147 countries. It is estimated that about 65 per cent of children in the world receive at least one vaccine manufactured by the Serum Institute. In 2017, Adar, in constant pursuit of new technologies, declared that they would be able to launch a new vaccine in under a year and a half.

In 2020, that proclamation was put to the test like never before, with shorter timelines and without any agreed-on technology. Before COVID, the mumps vaccine was the fastest vaccine to be developed, taking four years.

“I won’t stop you if you want to do it,” Cyrus said to Adar, “but is it worth it to jump in like a mad man so early on?”

“This will be a race,” the son argued. “If I can’t be the first, I don’t want to be the last,” Adar made his case.

“He has never stopped me, but he wasn’t keen to take a chance like this,” Adar Poonawalla told me later, looking back at his audacity of those months.

Cyrus gave his consent but with a caveat. There was to be a finite budget – no more than $250 million of the company’s resources were to be spent on the bungee jump into the deep end of science. At first, Adar thought it would be more than enough.

Now, they needed to find a contact at AstraZeneca to get an accelerated partnership status. There was no time for the normal round of Zoom calls and get-to-know negotiations. Time was of the essence, and though Adar declined to say yes or no, word is that Prince Charles helped expedite things.

Charles had made a visit to the institute in Pune in 2013 and had asked sincere questions about measles and mumps. Adar and his wife Natasha also hosted Camilla and Charles for dinner at their 100-hectare farmhouse done up in metal and leather with a bespoke all-glass conservatory that opened up to a canopy of Australian pines.

A month later, the agreement with AstraZeneca was ready.

The normally sluggish bureaucracy had also fast-tracked the ten licences needed for any vaccine to be made in India. And Poonawalla was set for what would be the biggest gamble of his professional life.

There was a reason he chose to back this particular vaccine, Poonawalla explained. “I wanted to build a giant capacity. My choice was driven by yield,” he said, referring to the viral vector technology that powers the AstraZeneca, or the Covishield vaccine as we know it in India.

Traditional vaccines train your body to fight a pathogen by infecting you with a part of it. A vector-driven vaccine, by contrast, takes a harmless virus that delivers a genetic code to your cells that mimics the infective virus. The cells then make a protein that creates immunity. In other words, you acquire resistance without first being partially infected.

The third category of COVID vaccines, the new and radical mRNA shots, relies on tricking your cells into making some of the viral proteins COVID would have normally produced, after which the cells mount a defence against them. While swifter to make to scale, they were not an option for Indian manufacturers because of the subzero storage requirements and demands for a complicated cold chain.

And so, Serum Institute chose to throw its money and people behind a vaccine that used a chimpanzee common-cold virus to stimulate Covid immunity.

Even in peacetime, vaccine producers need a six-month head time to organise the raw material, glass vials, chemicals and plants required to bring out a vaccine. Now, as Adar and his team started doing the maths, they swiftly understood that to make the Covid vaccine they would have to stop or postpone the production of some other vaccine.

Serum pushed back the launch of the HPV vaccine. The dengue monoclonal vaccine that had been announced in 2019 for unveiling within four years had to be paused. Plants that had been allocated for its production were taken over for the Covid vaccine.

But within a month of starting the process, Adar Poonawalla stopped sleeping at night. He would toss and turn as he did the numbers in his head and slipped into greater and greater panic. “I had made a promise to the world,” Adar told me, “and I was worried sick that I was going to fall short.”

He realised that the expenditure calculations he had made were way off the mark. As the Covid cases mounted, it was clear that he would need four times the $250 million cut-off the Institute had set. He considered approaching private banks and equity ventures for a loan or an investment. In the meantime, the company decided to sell a polio vaccine plant in Czechoslovakia to American pharmaceutical giant Novavax, raising $167 million from the deal. But they were still significantly short.

“You’re getting in over your head,” Cyrus Poonawalla warned.

To Hell and Back: Humans of Covid

Excerpted with permission from To Hell and Back: Humans of Covid, Barkha Dutt, Juggernaut Books.