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Access to vaccines is a critical issue in ensuring
the health of children, especially in the developing countries. Access is
currently limited due to limited money available for vaccine procurement, high
prices of new vaccines for existing and emerging diseases and poor health
delivery infrastructure in developing countries. The vaccine industry has only
paid lip service to the cause of immunization of the world’s children. They
have kept their profit maximization objective foremost even in the interactions
with the international agencies and with health partnership initiatives.
However, if they avoid such selfish pursuits and look at shared value with
society, much can be gained in the immunization of children and their health.
The vaccine industry must shed its reticence, respond to the economic and
technological demands of immunization and work towards making immunization
affordable and accessible to all. This paper scans the vaccine industry and
analyses the issues concerning vaccine access and the role played by the
industry.
INTRODUCTION
Vaccines are primarily used to prepare and protect living beings
against diseases. Among the major dreaded diseases that vaccines offer
protection are measles, mumps, rubella, polio, pneumonia, hepatitis A and C,
diphtheria, pertussis, tetanus, rabies, influenza, pneumonia, cervical cancer
just to name a few. Vaccines are considered to be among the most cost-effective
health interventions known to man. Vaccines have saved millions of lives from
dreaded diseases [1]. Systematic use of vaccines has also led to the
eradication of life threatening diseases.
However, there is a sharp first world - third world divide in the
matter of access to vaccines. Children in the developed countries have access
to vaccines against several diseases and are effectively protected thanks to
robust immunization programmes. In contrast, children in the developing
countries have limited access to vaccines and immunization, mainly due to
resource constraints for vaccine procurement and use; and due to poor public
health delivery infrastructure. Compounding this is the issue of high prices of
vaccines charged by manufacturers in an industry which is dominated by
multinational companies and has an oligopolistic character.
Access to vaccines is one of the prime drivers in achieving
immunization goals. Access to vaccines and their use in immunization programmes
in some developing countries and most of least developed countries is supported
in good part by targeted immunization programmes piloted by multi-lateral
agencies and aided by generous donations from several charitable organizations.
While much has been achieved, much more remains to be done.
THEORETICAL VALUE OF
ARTICLE
The article, with well researched facts and figures, first traces the
progress in immunization in the world and how after facing stagnation, the
concerted action by the World Health Organization (WHO) and the Global Alliance
for Vaccines and Immunization (GAVI); and supported by munificent donors, has led
to a situation where immunization targets are now within striking range. It
points out that sustaining the levels of immunization and expansion of the list
of diseases covered by immunization programmes is becoming difficult. This is
attributed to increasing prices of vaccines and the decreasing marginal returns
of investments made in development of affordable vaccines.
The authors produce data to demonstrate that the profitability of
vaccine companies is on par, if not better than most pharmaceutical companies,
which has always been viewed as profiteering at the expense of consumers. They
also dispel the notion that the profitability of developing country vaccine
manufacturers is low by citing the example of a hugely profitable Indian
company. They then argue that rather than be driven by shareholder capitalism;
the vaccine companies must pursue the path of shared value with society.
The article presents the case for players in the vaccine industry to be
more egalitarian since they are dealing with a fundamental social need – of
protecting lives, especially of the vulnerable group of children and poor
people. The vaccine industry cannot be blind to the cause of the very people
that they benefit commercially from, especially the poorest of the poor in the
least developing countries. The authors make a clarion call to the industry to
contribute to vaccine access and immunization, a dire need in many parts of the
world, as part of their social responsibility.
CRITIQUE
The position taken by the authors regarding the lack of social
responsibility by the Industry may appear one sided to many in the developed
world. However, in the eyes of the poor in the developing countries, there
cannot be a better cause than fight diseases which plague their societies and
it is here that the purely profit seeking vaccine companies have been found
wanting.
The authors have assumed that pricing of new vaccines is exorbitant by
possibly not factoring the high cost of development of technology and costs
incurred in conducting in clinical trials to obtain regulatory approvals. This
has often been the argument of the multinational companies. This can be viewed
as a conjecture but considering that the authors are closely connected with the
Industry, this charge would not be tenable.
The issue of access also has to do with providing necessary health
infrastructure for which governments are responsible and not the vaccine
industry. The vaccine industry would have very little to do with this aspect.
The authors have taken cognizance of this but mention only in the passing.
It can be argued that social responsibility of commercial companies to
provide for public good cannot be mandated. Nevertheless, there is merit in the
authors’ premise that the biggest social contribution by vaccine companies
would be with making prices affordable, so that governments can make better
access to vaccines and immunization eminently possible.
CONCLUSION
1. Balasubramaniam
KV, Sita V (2014) Access to vaccines and the vaccine industry - An analysis. J
Vaccines Vaccin 5: 218.