newer vaccines - drive by science or commerce, jammu, may 2016

Newer VaccinesDriven by Science or Commerce?

Dr. Gaurav Gupta, Pediatrician,Mohali

Overview

• Are vaccines important lifesaving tools? Yes• Are vaccinations a means to earn money?

Maybe• Should we stop EXPENSIVE vaccinations? No –

BUTWe can make them Cheaper – HOW ?

Purpose of vaccination

• To prevent VPDs- death & morbidity

• To control / eradicate diseases

Whose responsibility?

• US and Europe- Health of people is State's

responsibility.- Include (almost) every vaccine in NIP – Hepatitis A, Varicella, Rota, PCV, HPV etc.

• India–People's health is Personal responsibility.– Treating Diseases = More Money–Health & disease prevention is not in

human control, it is God/ Fate

Mind seteg. Hep A deaths, Finger loss due to CPe.g Treatment for VPDs like typhoid, cholera, etc. from personal pocketbut will not prevent them through Public Health.• Priorities – Latest mobile, fancy branded

dresses, toys – not vaccines.• Personal Safety is NOT

Why feel vaccination is commercializing?

• EXPENSIVE …..• Older diseases like Mumps, measles not

eradicated; newer vaccines being pushed• Where will it all end ?

Role of the Vaccine Manufacturers?

• Profit is not a dirty word• Economic superpowers• Large numbers• Weak/ Ineffective agencies• Vaccines can be aggressively promoted – even

with doubtful / unproven needs

Cont…

Manufacturers use • Academic Channel – Sponsored Scientific

Sessions with prominent experts to talk about specific products

• Commercial Channel – Extensive marketing advertising and significantly discounted vaccines

Can Create bias in Doctor’s minds

Lest we Forget …..• Medicine is a Science. Newer and older

diseases to be tackled simultaneously• Newer vaccine - Expensive R & D• Developed countries vaccine costs > >

compared to developing nations• No subsidies on essentials like foods, clothing,

housing – so why vaccines?

How to strike a balance?

• Better R and D in India – Indigenous vaccines• More public awareness• Increased patient options• CME’s

R and D

• Make in India• Example Aurolab in Arvind eye hospital

- Knives 550 -> 75- Dye 450 -> 110- IOL 4700 -> 950

• Indian Rotavirus Vaccine• ZIKA VIRUS Vaccine in Pipeline

Public awareness

• Improved awareness of non UIP vaccines in the lower SES

• Dept of Public Health, None in India• Wealthy countries DEMAND a

solution (vaccination) for diseases of Public Health Importance

• Poorer countries do not, they may not even know, and even if they do, these demands are ignored, eg, better TB & Measles Vaccine

Increasing Patient Options

• Make aware of choices of vaccines available

• Match vaccines to the patient’s SES - More options to patients

CME’s

• Non-sponsored, neutral, or common platform

Need of the hour

• Focus on R & D, NOT the price• R & D is expensive, but paying the price of

foreign patents• Disease Surveillance, Disease Surveillance &

Disease Surveillance …..• Encourage manufacturers to create vaccines

as per local disease burden – CHEAPER Vaccines

Science & Commerce are Compatible• Robust guidelines, use appropriate vaccines

extensively to get a SEA of VaccinesSustainable Effective Affordable

• Convert UIP in to CCCP – focusing on disease reduction rather than just vaccine coverage

“If you do not make your own plans, you become a part of someone else’s plan”