India urged to use evidence in vaccine policy
[NEW DELHI] India must develop an objective and evidence-based vaccination policy based on national disease prevalence data — not pharmaceutical companies' marketing agenda, the head of the country's top medical research organisation says.
Vishwa Mohan Katoch, director-general of Indian Council of Medical Research (ICMR), told a two-day workshop on vaccine policy this month (4 June) that the lack of proper information on local strains of various pathogens is a major problem in making informed decisions about the introduction of vaccines for infections such as influenza and measles.
Katoch said that although pharmaceutical companies may push their own agenda for vaccine introduction, the council should make decisions based on its own studies.
He also stressed the need for indigenous capacity in vaccine production, both through public sector vaccine units and domestic companies.
Yennapu Madhavi, a scientist at the National Institute for Science, Technology and Development Studies that organised the workshop with the ICMR, says that an increasing gap between supply and demand of universal vaccines — such as for diphtheria, tetanus and tuberculosis — in India is a "worrisome reality".
India's public sector's role in vaccine production is declining, Madhavi says.
He adds that there is an unregulated proliferation of several new and expensive vaccines recommended by private practitioners but not the universal immunisation programme. And new combination vaccines that have not been properly evaluated for safety, efficacy or cost effectiveness are on the market.
Experts at the workshop said that any new vaccine introduction must be based on epidemiological evidence, suitability and efficacy to local pathogens and human populations; and analysis of cost, risk and benefits.
In January 2008 the health ministry cancelled licenses of three public-sector vaccine manufacturing units that supplied the bulk of vaccines for the country's national immunisation programme, on grounds that they did not meet manufacturing standards. The ministry said it would set up an alternative vaccine park near Chennai — with private, mostly multinational, companies.
On the first day of the vaccine workshop, India's president Pratibha Patil — addressing the newly elected parliament — announced that the public sector units would be revived to support the country's immunisation programme.