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”
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