current stance of immunization and vaccine industry in … · current stance of immunization and...
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Current Stance of Immunization and Vaccine Industry in the OIC Countries
STATISTICAL, ECONOMIC AND SOCIAL RESEARCH AND TRAINING CENTRE FOR ISLAMIC COUNTRIES
O R G A N I Z A T I O N O F I S L A M I C C O O P E R A T I O N
Dr. Umut UNAL
Immunization
• Immunization is an essential component for reducing under-five
mortality. • Immunization coverage estimates are used to monitor coverage of
immunization services and to guide disease eradication and elimination efforts.
• It is a good indicator of health system performance.
2
• Childhood immunization is one of the most efficient and effective methods of preventing diseases like Measles, Meningitis, Diphtheria, Tetanus, Pertussis (whooping cough), Yellow fever, Polio and Hepatitis B.
84
66
8
61 69
55
5
51 56
44
5
41
0
20
40
60
80
100
OIC Countries DevelopingCountries
DevelopedCountries
World
per 1
000
live
birt
hs
1990 2000 2010
no d
ata
0
20
40
60
80
100
120
EAP ECA LAC MENA SA SSA
per 1
000
live
birt
hs
1990 2000 2010
114 108 103 99 99 93
9 8 7 6 6 5 0
20
40
60
80
100
120
140
per 1
000
live
birt
hs
Highest Lowest Infant mortality rate (IMR) indicates the number of deaths of babies less than one year of age per 1000 live births. Despite the impressive progress, IMR in OIC member countries remained quite higher than the developing countries and world.
3
Infant Mortality Rate (IMR)
126
95
10
88
103
79
7
73 82
62
5
57
0
20
40
60
80
100
120
140
OIC Countries DevelopingCountries
DevelopedCountries
World
per 1
000
live
birt
hs
1990 2000 2010
no d
ata
0
40
80
120
160
200
EAP ECA LAC MENA SA SSA
per 1
000
live
birt
hs
1990 2000 2010
180 178 176 174 173 150 149 143 143 136
16 16 15 11 10 9 8 7 7 6 0
40
80
120
160
200
240
Som
alia
Mal
iBu
rkin
a…Si
erra
…Ch
adG
uine
a-…
Afgh
anist
…N
iger
Nig
eria
Cam
eroo
nSy
riaTu
nisia
Mal
dive
sKu
wai
tBa
hrai
nO
man
Qat
arBr
unei
UAE
Mal
aysia
per 1
000
live
birt
hs
Highest Lowest The under-five mortality situation has also been improved in the OIC member countries and U5MR has fallen from 126 deaths per 1000 live births in 1990 to 82 in 2010, corresponding to decline of 35 per cent. However, despite this improvement, one in 12 children in OIC member countries die before their fifth birthday compared to one in 16 children in developing countries and one in 18 children in the world . 4
Under-Five Mortality Rate (U5MR)
0
20
40
60
80
100
0
20
40
60
80
100
2005 2006 2007 2008 2009 2010
OIC Other Developing World
0102030405060708090
100
2005 2006 2007 2008 2009 2010
SSA SA MENA ECA EAP LAC
DTP3: The third dose of Diphtheria-tetanus-pertussis vaccine
The third dose of combined Diphtheria-Tetanus-Pertussis (DTP3) immunization coverage has increased substantially in OIC countries during the last decade. The coverage rate increased to 83 per cent in 2010.
DTP3 coverage rates in LAC, ECA and MENA and regions remained higher than the OIC average and the world average. However, in contrast, SSA is still seriously lagging behind.
5
45 45
57 59
60 64
65 66
69 70
94 98 98 98
99 99 99 99 99 99 99
0 10 20 30 40 50 60 70 80 90 100
GabonSomaliaGuinea
ChadUganda
MauritaniaIraq
AfghanistanNigeria
Senegal
United Arab EmiratesGambia
Saudi ArabiaKuwait
AlbaniaBahrain
IranKazakhstan
MoroccoOman
Uzbekistan
DTP3: The third dose of Diphtheria-tetanus-pertussis vaccine
Top 10 and Worst 10 Performers
6
MCV: Measles Immunization Coverage
0102030405060708090100
0102030405060708090
100
2005 2006 2007 2008 2009 2010
OIC Other Developing World
0102030405060708090
100
2000 2001 2002 2003 2004 2005
SSA SA MENA ECA EAP LAC
Measles immunization coverage has increased substantially in OIC member countries and coverage rate increased to 80 percent in 2010. However, OIC countries still remained below the world, developing countries averages.
Immunization coverage in MENA, ECA and LAC regions remained quite high. The rest of the regions, particularly SSA and SA, are seriously lagging behind.
Measles is the most deadly of all childhood rash/fever illnesses.
7
28
46
55
56
58
61
62
63
67
67
94
98
99
99
99
99
99
99
99
99
99
0 10 20 30 40 50 60 70 80 90 100
Chad
Somalia
Gabon
Mali
Guinea
Guinea-Bissau
Afghanistan
Burkina Faso
Azerbaijan
Mauritania
United Arab Emirates
Saudi Arabia
Albania
Bahrain
Iran
Kazakhstan
Kuwait
Oman
Qatar
Turkmenistan
Uzbekistan
8
MCV: Measles Immunization Coverage
Top 10 and Worst 10 Performers
HepB3: The third dose of Hepatitis B vaccine.
0102030405060708090100
0102030405060708090
100
2005 2006 2007 2008 2009 2010
OIC Other Developing World
0102030405060708090
100
2005 2006 2007 2008 2009 2010
SSA SA MENA ECA EAP LAC 9
Hepatitis B is a serious infection that affects the liver. It is caused by the hepatitis B virus and 50 to 100 times more infectious than HIV.
As shown in figure, OIC coverage rate remained higher than that for developing and world averages in 2010.
According to the latest estimates of WHO, 25 percent of adults who become chronically infected during the childhood later die due to liver cancer.
In 2010, among the OIC regions, HepB3 coverage ranged from a low of 67 per cent in EAP region to a high of 93 per cent in ECA.
22 45
48 50
59 62
63 66 66 66
94 98 98 98 98
99 99 99 99 99 99
0 10 20 30 40 50 60 70 80 90 100
ChadGabon
AzerbaijanNigeriaGuinea
Côte d'IvoireIndonesia
AfghanistanCameroon
Syria
United Arab EmiratesLibya
MoroccoSaudi Arabia
TunisiaAlbaniaBahrain
IranKazakhstan
KuwaitOman
10
HepB3: The third dose of Hepatitis B vaccine.
Top 10 and Worst 10 Performers
Hib3: The third dose of haemophilus influenza type B vaccine
0102030405060708090100
0102030405060708090
100
2005 2006 2007 2008 2009 2010
OIC Other Developing World
0102030405060708090
100
2009 2010
SSA SA MENA ECA LAC 11
Haemophilus influenza type B a bacterium that can infect the outer lining of the brain causing meningitis.
As shown in figure, OIC coverage rate remained higher than that for developing and world averages in 2010. However, the coverage rate is still around 50 per cent.
The SSA and MENA regions are lagging behind the OIC average.
22 38
43 45
59 62
66 66
71 72
94
98 98 98
99 99 99 99 99 99 99
0 10 20 30 40 50 60 70 80 90 100
ChadAzerbaijan
TunisiaGabonGuinea
Côte d'IvoireAfghanistan
CameroonTurkmenistan
Mali
United Arab Emirates…
JordanLibya
Saudi ArabiaAlbaniaBahrainKuwait
MalaysiaMorocco
OmanUzbekistan
12
Hib3: The third dose of haemophilus influenza type B vaccine
Top 10 and Worst 10 Performers
BCG: Bacille Calmette-Guerin vaccine
0102030405060708090100
0102030405060708090
100
2005 2006 2007 2008 2009 2010
OIC Other Developing World
0102030405060708090
100
2005 2006 2007 2008 2009 2010
SSA SA MENA ECA EAP LAC13
BCG is a vaccine for tuberculosis (TB) disease.
During the period under consideration, the coverage in OIC countries are in line with the world and slightly lower than that of developing countries.
In 2010, the coverage rate increased to 87 per cent in OIC countries on average.
SSA and LAC regions are lagging behind. ECA and MENA are the leading regions.
41 53
59 61
64 68
74 76
80 82
98 99 99 99 99 99 99 99 99 99 99
0 10 20 30 40 50 60 70 80 90 100
SomaliaChad
YemenNiger
NigeriaAfghanistan
Côte d'IvoireComoros
CameroonAzerbaijan
United Arab EmiratesAlbaniaAlgeria
Burkina FasoIran
KuwaitLibya
MalaysiaMorocco
OmanUzbekistan
14
BCG: Bacille Calmette-Guerin vaccine
Top 10 and Worst 10 Performers
Polio Vaccine
0102030405060708090100
0102030405060708090
100
2005 2006 2007 2008 2009 2010
OIC Other Developing World
0102030405060708090
100
2005 2006 2007 2008 2009 2010
SSA SA MENA ECA EAP LAC15
Polio immunization protects against poliomyelitis, a severe disease that leads to the loss of movement.
Despite some improvement, OIC countries are lagging behind the averages of the world and other developing countries during the period under consideration.
By 2010, SSA and EAP regions were seriously lagging behind.
31 44 44
49 57
58 66
67 70
71
94
98 99 99 99 99 99 99 99 99 99
0 10 20 30 40 50 60 70 80 90 100
ChadGabon
NigerSomaliaGuinea
Côte d'IvoireAfghanistan
CameroonIndonesia
Mali
United Arab Emirates…
TunisiaAlbaniaBahrain
Brunei DarussalamIran
KazakhstanKuwait
MalaysiaOman
Uzbekistan
16
Polio Vaccine
Top 10 and Worst 10 Performers
11,90 15,93 11,75
134,83
87,27 62,99
161,05
518,21
375,94
578,60
0,00%
1,00%
2,00%
3,00%
4,00%
5,00%
0
100
200
300
400
500
600
2007 2008 2009 2010 2011
Mill
ions
OIC Non-OIC Developing OIC as % of world
17
Exports of Vaccines for Human Use
OIC countries are still accounting for less than 1% of the total world vaccine exports. • OIC exports of vaccine recorded only 87.27 million USD in 2011.
0,25
0,66 0,69 0,86
1,19
0,85
2,04
3,01
3,72
3,07
0,00%
1,00%
2,00%
3,00%
4,00%
5,00%
6,00%
7,00%
8,00%
0,00
0,50
1,00
1,50
2,00
2,50
3,00
3,50
4,00
2007 2008 2009 2010 2011
Billi
ons
OIC Non-OIC Developing OIC as % of world
18
OIC countries accounted for 7% in total world vaccine imports in 2011. • OIC imports of vaccine recorded over 1.1 billion for the first time in 2011 which
is almost 13 times higher than their exports.
Imports of Vaccines for Human Use
Current Stance of Vaccine Supply
• OIC countries display heterogeneous structure in terms of being able to uptake new vaccines. – Low income countries obtain vaccines mostly through Global
Alliance Vaccines and Information (GAVI). – Middle income countries have been experiencing financial and
operational difficulties with the introduction of new vaccines. They have the following obstacles
• Lack of sufficient funds • Prevailing high prices of vaccines.
– High income countries such as GCC have been successful in the uptake of new vaccines.
19
Current Stance of Vaccine Distribution
• The purchase of vaccines is complex and requires a specialized knowledge and a precise approach.
• Due to the specificities of the vaccines, quality, safety and efficacy should be the first considerations to be taking into account.
• Cold chain conditions should be respected during shipment and cold room capacity should be available at the time of the receipt of the vaccines.
• There are many companies producing vaccines but only a few meet internationally-recognized standards of safety and efficacy.
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Policy Recommendations
• Supporting Local Production of Medicine and Vaccine. – Actions at National Level
• Provide direct government support to the local manufacturers of medical products i.e. policies that reduce the cost of manufacture such as grants, subsidies, land, tax and duty exemptions for imported inputs for local production
• Improve national capacity in producing raw material based on available local/natural resources, to initiate self-reliance of medicine
• Improve investment climate by simplifying the requirements for doing business in pharmaceutical and other medical products industry without making any concessions to quality
– Actions at OIC Level • Target bringing coherence of vision at the OIC level to support local production
of medical products/vaccines under the OIC program on achieving Self Reliance in Vaccine Production (SRVP) in the Islamic world
• Establish an intersectoral intra-OIC committee of experts on local production • Provide technical assistance to countries regarding the production of raw material
for drugs production
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Policy Recommendations • Increasing the Availability of Essential Medicines, Vaccines
and Medical Technologies. – Actions at National Level
• Implement regulations to prevent high mark-ups on essential medicines and vaccines
• Develop national guidelines related to distribution of vaccine and medicine in order to ensure the safety, efficacy, and quality well-maintained across distribution channel
• Support funding programs in order to improve the efficiency in the procurement and supply management
– Actions at OIC Level • Identify the countries where capacity building at the country level, at the
policy level or at the firm level is required • Keep cooperating and collaborating with Global Alliance Vaccines and
Information (GAVI) • Provide material and technical assistance to develop national guidelines
related to distribution of vaccines • Facilitate development of regional pooled procurement mechanism which
will enable local production to meet regional needs and allow for the mutual cooperation in increasing the availability of essential medicines and vaccines 22
Critical Perspectives on the Socio-Economic Development and Transformation in the Islamic World
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