<span class="Apple-style-span" style="font-family: 'times new roman'; font-size: 16px; "><p align="justify"><b><span class="headline_INSIDE">Special Article</span></b></p><p class="story_text" align="justify"><span class="story_text">Vanishing vaccines<br>
<br>Serious Threat To Public Health<br><br>By Bharat Dogra</span></p><p class="story_text" align="justify"><span class="story_text">@ <a href="http://www.thestatesman.net/page.news.php?clid=3&theme=&usrsess=1&id=234941">http://www.thestatesman.net/page.news.php?clid=3&theme=&usrsess=1&id=234941</a><br>
<br>The Universal Immunisation Programme is a very important segment of India's public health effort. In view of the enormous scale of the operations, the government has to ensure an adequate supply of vaccines at a reasonable cost. Keeping costs reasonably low is important in a country like India which has to cope with a serious resource constraint in the face of a huge task. <br>
Unfortunately the global vaccine industry is today more interested in selling high-profit vaccines, rather than ensuring a bulk supply of the most-needed vaccines at a low cost. As a recent editorial in the Indian Journal of Medical Research noted, "In the face of the burgeoning and aggressive marketing of vaccines of doubtful utility, we have a widening demands-supply gap in the Expanded Programme on Immunisation (EPI) vaccines. Over the last few decades, due to the decline of the public sector and the growing disinterest of the private sector, the number of firms supplying EPI vaccines has declined drastically both in India and abroad. This has prompted the UNICEF to express serious concern over the shortage of EPI vaccines. <br>
<br>High prices<br><br>"Private manufacturers prefer to sell them as 'value-added cocktail vaccines' at exorbitant prices in the open market, rather than supply to EPI. The general tendency to combine EPI vaccines with non-EPI ones not only creates an artificial scarcity for affordable EPI vaccines, but also opens up a backdoor method for the entry of expensive and perhaps unnecessary non-EPI vaccines into the universal immunisation programme, riding piggyback on the EPI vaccines." <br>
The government should have strengthened the vaccine production in its existing facilities. Instead, in a decision that sent shockwaves in public health circles in January the Union health ministry cancelled the licences of three vaccine-manufacturing public enterprises ~ the 103-year-old Central Research Institute (CRI), Kasauli; the 100-year-old Pasteur Institute of India (PII), Coonoor; and the 60-year-old BCG Vaccine Laboratory (BCGVL) in Chennai. <br>
The reason given was that these institutes lacked the latest facilities in accordance with international norms. Actually, however, the Centre had repeatedly ignored the appeals from these institutes for upgradation of facilities and greater autonomy to ensure better talent. First ignore the pleas for better facilities and then snatch away the licences citing lack of proper facilities. This indeed is a strange argument, one that conceals the hidden agenda of facilitating the entry of imports and big business. <br>
This hidden agenda is also revealed in the case of oral polio vaccine (OPV). During 1967-77, OPV was indigenously produced at the Pasteur Institute of India. This production was suddenly stopped when one batch was alleged to be virulent, even though subsequent tests by reputed scientists revealed that this finding was incorrect and the vaccine was of good quality. Even if the earlier allegation had been true, the batch in dispute could have been rejected. The production of OPV should not have been stopped for all time. In this case, even when the allegation of virulence was found to be totally false, the manufacture of OPV was not resumed. <br>
This was also the time when the demand for OPV was increasing in India. Since 1978 the country has been importing OPV. Midway, an effort was made to resume the production of OPV at Bharat Biologicals and Immunologicals Corporation Ltd but this too was terminated all too suddenly, all too quickly. Efforts to produce inactivated polio vaccine (IPV), an injectable vaccine at the Indian Vaccine Corporation Ltd Gurgaon, never materialised as they were not pursued vigorously enough. <br>
As the country became entirely dependent on OPV imports for its polio eradication programme, this campaign was pursued in such a manner as to prolong the need for excessive imports. This is clear from background papers written for the officially constituted National Commission on Macroeconomics and Health (NCMH) and included in its official publication titled 'Financing and Delivery of Health Care Services in India.' In one of these papers, titled 'Delivery of Health Services in the Public Sector', the secretary of NCMH, K Sujatha Rao, wrote, "The single-point pursuit of polio-eradication has resulted in adversely affecting the routine immunisation, which was initiated in 1986 as a technology mission for achieving full protection against all vaccine-preventable diseases by 2000. As per a household survey conducted in 1998 and again in 2003 (Indian Institute of Population Sciences 2004), the data for 220 districts showed that in the majority of the districts, there was either a declining performance or no improvement at all under the Universal Immunisation Programme (UIP). <br>
"Discussions with field staff seemed to suggest that this decline was largely on account of the emphasis given to polio, which not only commanded better resources and visibility in the media but also consumed nearly one-third of the time, 30 times the cost and exhausted the staff." <br>
Another paper in the same publication titled 'Financing of Health in India' informs us that an estimated Rs 3,592 crore was spent on Pulse Polio Initiative during 1996-2005. This amount does not include the "extra-budgetary expenditures incurred by WHO on the appointment of over 1,000 consultants in the country to monitor the programme and the amount being incurred by UNICEF or IEC." Nearly 13 per cent of the health department's budget in 2003-04 was spent on this single activity. This paper adds, "It is estimated that one drop of polio vaccine is almost 30 times more than the drop given in routine UIP."<br>
<br>Dubious role<br><br>In fact a leading role in perpetuating this huge distortion for years has been played by highly-paid international consultants who were repeatedly brought in to endorse blatantly wrong policies. Their dubious role extended to several other developing countries, as is evident from the following resolution which was passed by the 'II World Social Forum on Health' and adopted by the WSF (World Social Forum) 2007, on 24 January, 2007, in Nairobi. <br>
"The II World Social Forum on health condemns the World Health Organisation's lack of transparency in acknowledging the failure of the Global Polio Eradication Initiative strategy and instead, identifying a few low-income countries as scapegoats; subjecting the children of these countries to an unprecedentedly high number of Oral Polio Vaccine (OPV) through the pulse polio programmes with no concern for its negative impact; and the use of monovalent OPV, an untested vaccine without informed consent. <br>
"While the WSF on health acknowledges the place of OPV in the overall immunisation programme as part of integrated public health services, the strategy of intensive pulse polio rounds has had a detrimental fragmenting effect on the already weak public health systems in low-income countries." <br>
<br>The writer is a social activist</span></p><div style="text-align: justify;"><br></div></span>