Much ado over vaccines
Prime Minister Narendra Modi himself has been seeking support from Bill Gates - technocrat, philanthropist and the world's wealthiest man - for his ambitious Universal Immunisation Programme
Osama bin Laden isn't dead. Global warming is a hoax. NASA faked the moon landings. Vaccines cause autism. And Bill Gates?
On Wednesday, February 7, conspiracy theorists had a field day when a report emerged: 'Centre shuts health mission gate on Bill & Melinda Gates Foundation'. At the heart of it was a Big Money, Big Pharma, Big Corruption plot: how the biggest philanthropic organisation in the world was "influencing" India's vaccination strategy, to the advantage of global pharma giants.
The government's decision to snap ties with BMGF was, apparently, informed by "arguments from senior medical professionals and outfits like the Swadeshi Jagran Manch".
Instantly, the news went viral, resounding across domestic and international media.
The 23 members of the country's highest advisory committee on immunisation-the National Immunisation Technical Advisory Group (NTAGI)-scratched their heads in bewilderment. And the Union ministry for health, with three of its seniormost bureaucrats co-chairing the NTAGI, kicked into overdrive: the vaccination strategy, after all, was one of Prime Minister Narendra Modi's flagship projects.
The very next day, on February 8, a press note was released: that the reports were "inaccurate and misleading"; that there was no financial link between NTAGI and BMGF; that the latter continued to "collaborate and support the ministry".
The news comes at a time when India is trying to take its basket of free vaccines for children towards the international standard, after years of remaining static.
The prime minister himself has been seeking support from Bill Gates - technocrat, philanthropist and the world's wealthiest man - for his ambitious Universal Immunisation Programme.
Four new vaccines have been rolled out across the country this year (see Pipeline Perks Up), recommended by the NTAGI and with product support of the Global Alliance for Vaccines and Immunisation (GAVI)-an international non-profit partnership, backed by Gates, that works to ensure affordable access to essential vaccines to 73 low- and middle-income countries of the world, backed by Gates.
"Conflict of interest generally refers to when someone participating in a decision-making process seeks to have a decision made that enhances their best interests in some way, usually a financial benefit," says K. Vijayraghavan, scientist and secretary, Department of Biotechnology, health ministry.
"At the NTAGI subcommittee, we ask all members to declare their conflicts of interest and this is done. The policy we follow is similar to that of WHO."
The Big Money, Big Pharma, Big Corruption plot just doesn't work, adds Dr Soumya Swaminathan, secretary, Department of Health Research, health ministry.
To begin with, the NTAGI is not a 'body', but a committee of some of the best scientists, public health experts and civil servants in the country, who take decisions in their independent capacity.
The BMGF may have "big money", but it is not represented in the NTAGI. And as the largest vaccine manufacturers in the world, India itself is 'big pharma'. "If our strategy can be influenced, what does it say about our expertise, intelligence or integrity?" asks Dr Soumya.
And it raises the biggest question of all: the fate of India's under-immunised children, half a million of whom die of vaccine-preventable diseases every year. "We have a long way to go to protect our children," says Vijayraghavan.
"India gives vaccines against eight diseases nationally, whereas the US offers vaccine against 16 diseases." India needs to more than quadruple its spending on vaccines to protect children.
And, Gates, as an international donor, is key in fulfilling that requirement. "Conspiracy theories, without any evidence, can greatly harm the immunisation programme," adds Dr K. Srinath Reddy, president of the Public Health Foundation of India in Delhi.
It's a familiar image: a mother holding a scared, bawling child, while a smiling health worker forces red polio drops down its throat. An essential rite of passage: routine immunisation. First adopted in 1978, with vaccines against tuberculosis, diphtheria, whooping cough, tetanus and polio, India has been carrying on with pretty much the same basket.
In 1985, with the measles vaccine added, it got a new name: Universal Immunisation Programme. Yet, 32 years later, of the 27 million babies born each year-more than in any other country-just 62 per cent are fully fortified with vaccines, the rest are at risk of at least 13 life-threatening infections because they are unimmunised or partially immunised. In contrast, 90 per cent of two-year-olds in India's much poorer neighbour, Bangladesh, are fully immunised.
"Vaccination has not been a really regulated thing in India," says Dr Jayaprakash Muliyil, epidemiologist and former principal of the Christian Medical College in Vellore. Take rubella, for instance. "It causes the silliest disease in the world," he says, similar to measles, but very mild and transient. "But if you get it in your reproductive age, and you happen to be pregnant, the baby comes out with abnormalities."
India had rubella outbreaks about every seven years, everybody got infected and immune. Things changed with the coming of the expensive measles-mumps-rubella vaccine (MMR) in the private sector in the cities, he explains.
The cycle of outbreaks got delayed and started affecting poorer women of child-bearing age in urban areas, who did not have the vaccine, leading to congenital defects.
The vaccine, long resisted by the government, has now been made part of routine immunisation. "Vaccination can harm if not done well. And you need a body that can give you advice and direction," says Muliyil. The NTAGI was streamlined to serve that purpose.
https://www.indiatoday.in/magazine/heal ... 2017-02-27
