Vaccination: A Dot for One and Cure for Two

By: Hilleman Laboratories on November 27, 2017

The concept of vicarious learning is well known in the field of psychology. It suggests that a person can learn or unlearn a behavior just by observing the outcomes of that behavior, from someone else. That sets a good ground for the concern that would be discussed here today. We will discuss how vaccinating your child - especially when you have access to it can play a role in protecting those who do not have accessibility to these life-saving vaccines. Vaccination is a basic medical amenity, but is still a privilege for many in emerging economies.

Vaccination has shown a significant amount of reduction in many life-threatening diseases in the past few years. It is a way of making the body immune to diseases, by injecting weakened antigens (germs) of a disease such as measles or smallpox into the body. To its reaction, the body produces antibodies (protein) to fight these germs. It is a way of preparing the body to provide immunity from a disease. Moreover, vaccination is seen not only as a way of curing a disease for the one who gets vaccinated, but also for others around you, who unfortunately cannot afford this treatment with the help of Herd Immunity.

WHO published a report based on the Global Health Observatory (GHO) data in the year 2016, which stated that 5.6 million children died under the age of 5. The same sources have also reported that diarrhea is one of the most significant causes of death, along with other diseases such as malaria, measles and a few others^1,2.

In a report by Global Disease Burden, 2016, it was revealed that India alone registered deaths of 0.9 million children under the age of 5. What is more shocking is that it is the highest number globally, even more than the countries ranking below India in poverty rates³.

When a child is vaccinated, it eliminates both the risk of the disease as well as its spread. However, these vaccines are not accessible to a large part of the population, especially in developing countries like India, due to costs and maintenance factors. As a result, parents who have accessibility to these vaccines are advised to get their children vaccinated, as it cuts down on the spread rate of these diseases.

Making this happen does not seem like a distant dream now, with some organizations already working towards it. One such initiative, in this direction, is taken by an India based organization, Hilleman Laboratories. Hilleman has adopted innovative technological modes to create vaccines at much lower prices, with the technique of novel packaging. This way, the cost reduction in manufacturing will also affect the accessibility cost.

1. http://www.who.int/gho/child_health/mortality/mortality_under_five_text/en/
2. http://www.who.int/gho/child_health/mortality/causes/en/
3. http://indianexpress.com/article/india/under-five-mortality-rate-highest-in-india-report-lancet-uttar-pradesh-kerala-4845938/

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How Recent Innovation in Vaccination will ‘Help Combat Cholera in Present & Future Times’

By: Hilleman Laboratories on November 27, 2017

During the mid of 19th century, in the Ganges Delta, a pandemic broke out in Jessore area of India, due to contaminated rice. This disease was quick to spread to the modern-day Myanmar and Sri Lanka. Fast forward to present times - we all know the disease as cholera ,as it was caused due to a bacterium named, Vibrio Cholerae¹.

By the year 1820, cholera had already spread in countries like Thailand, Indonesia and Philippines, killing 0.1 million people in Java alone². Thereafter, Cholera has been a regular cause of death among children worldwide. Though cholera is still a global threat, it majorly affects developing nations where proper sanitation and access to safe drinking water remain a distant dream³. India is also among those countries which are struggling to eliminate this disease to lower its mortality rates.

Every year at least 525,000 children under the age of 5 die due to diarrhea, out of a total 1.7 billion diagnosed cases across the globe.Lack of access to treatment is the root cause of these deaths. To deal with this situation, it is important that accessibility for proper vaccination is provided to sufferers of this disease, especially in underdeveloped countries, where the disease affects the most.

This concept of affordable and easy to access vaccine seems to have well understood by a rather new organization - Hilleman Laboratories, a joint venture partnership between Merck Sharp & Dohme (MSD) and Wellcome Trust.

Hilleman started with a mission to provide affordable vaccines to the world for life-threatening diseases. On 12th October 2017, Hilleman Laboratories announced the results of Phase I/II clinical trial of their novel Oral Cholera Vaccine Hillchol^TM, at the Vaccines for Enteric Diseases Conference 2017, held in Albufeira, Portugal.

The clinical study was conducted in partnership with icddr, b(International Centre for Diarrheal Disease Research, Bangladesh)

Dr. Ajit Pal Singh, Vice President, Clinical R&D, Hilleman Laboratories, summarized the results of the study, saying that, Hillchol^TM proved to be safe and tolerable when studied on the 840 subjects, including adults and adolescents. The Hikojima strain in the vaccine expresses both the Ogawa and Inaba serotypes. He said that the results of the study were encouraging enough for them to continue the development of the cholera vaccine.

The current situation where, demand for the vaccine exceeds its supply rate, this project by Hilleman will prove to be a boon in the cholera treatment.

Dr. Davinder Gill, CEO, Hilleman Laboratories, also reciprocated the same thoughts - "There is an urgent need for effective and affordable cholera vaccine for use in both the cholera outbreaks as well as mass vaccination campaigns, also recommended by WHO”.

The development of this affordable vaccine by Hilleman Laboratories will prove to be beneficial for the developing countries in their fight against cholera, causing millions of deaths every year.

This move by Hilleman Laboratories also aims at contributing in the initiative announced by WHO to reduce cholera by 90%, by the year 2030, as stated by Dr. Davinder Gill. WHO Global Task Force on Cholera Control (GTFCC)is offering an effective platform to all multi-sector technical partners, to help the countries in their fight against cholera.

GTFCC brings together government andnon-governmental organization which work together to develop training, materials and technical guidelinesfor cholera control.

1. http://www.who.int/mediacentre/factsheets/fs107/en/
2. http://www.history.com/topics/history-of-cholera
3. http://www.who.int/topics/cholera/about/en/

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A war-torn Yemen is currently facing the world

By: Hilleman Laboratories on September 25, 2017

A war-torn Yemen is currently facing the “world’s worst cholera outbreak”, declared the United Nations recently. The ravaged country was on the brink of famine, and now it’s being destroyed by a humanitarian crisis of unprecedented proportions. According to International Health Authorities, the cholera outbreak has reached an estimated half a million people, while 5,000 more cases are reported each day. The disease has killed over 2,000 people since April 2017. 

Cholera, a water borne disease caused by the ingestion of infected food and water, is easily treatable with access to clean water, sanitation, replenishing fluids and good nutrition. But, the effects of a debilitating war that’s lasted for three years and counting has left long lasting depressions in Yemen. The public health systems have collapsed and is becoming difficult to achieve coverage. It is tragic, because the disease is vaccine preventable and contagious. A disease which can be cured today has taken the lives of so many.

“The total number of suspected cholera cases in Yemen this year hit the half a million mark in August  and nearly 2,000 people have died since the outbreak began to spread rapidly at the end of April,” WHO said in its statement.[2]

The ongoing war has devastated the country’s infrastructure and has left the majority of the population without access to basic services like clean water or even enough food. The levels of food insecurity and malnutrition are increasing, leaving the majority susceptible to a wide number of diseases. Medical attention is a scarce due to frequent bombings. The unlawful air-strikes have struck hospitals, food factories, prisons, trucks transporting food, schools and most recently a hotel. Each of these have shamefully targeted and killed civilians while displacing thousands.

“Yemen’s health workers are operating in impossible conditions. Thousands of people are sick, but there are not enough hospitals, not enough medicines, not enough clean water,” WHO Director-General Dr. Tedros Adhanom Ghebreyesus said in a statement. “To save lives in Yemen today we must support the health system, especially the health workers.” [3]

    

WHO and its partners are efforting to control the cholera outbreak while working closely with UNICEF, Yemen’s local health authorities to treat the affected and control further outbreak. They have sent thousands of bags of intravenous fluids to the country since April. The organization has also provided 525 beds with cleaning supplies and 112 kits for treating cholera. In partnership with UNICEF, WHO has established 2,924 diarrhea treatment beds as well as several oral dehydration therapy areas.

“We urge the Yemeni authorities – and all those in the region and elsewhere who can play a role – to find a political solution to this conflict that has already caused so much suffering. The people of Yemen cannot bear it much longer – they need peace to rebuild their lives and their country,“ Dr Tedros said.[5] 

According to World Health Organization, the right strategy and funding could eliminate the disease within a few years as the great news is that the world has access to safe, effective and affordable vaccines, a possibility which was unlikely before 2011. By vaccinating the population at risk and maintaining clean water, hygiene and sanitation, the disease would no longer pose a threat to global health. Such unforeseen epidemics like the Cholera outbreak in Haiti, Yemen, Bangladesh and India calls for innovative interventions to ensure quick accessibility of vaccines in limited-resource setting areas. One such example is the existence of heat-stable vaccines which holds the potential to ensure maximum coverage. The immunization gap could be bridged since they are not temperature sensitive driving down the logistics cost.

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[1] https://www.usatoday.com/story/news/2017/06/28/yemen-facing-worst-cholera-outbreak-world-health-authorities-say/436858001/

[2] https://english.aawsat.com/n-al-rasheed/news-middle-east/yemens-health-minister-efforts-address-cholera-improving

[3] http://time.com/4900830/yemen-cholera-crisis-half-million

[4] http://www.who.int/emergencies/yemen/en/   

[5] http://www.independent.co.uk/news/world/middle-east/yemen-cholera-cases-half-million-civil-war-aid-healthcare-humanitarian-a7894141.html#gallery

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Heat stable Rotavirus Vaccine: India Combats Diarrheal Deaths

By: Hilleman Laboratories on June 15, 2017

Rotavirus is a highly contagious virus, usually spread through contaminated water and food. The disease causes uncontrollable diarrhea leading to severe dehydration which can even cause death. It is the most common cause of diarrheal disease in young children throughout the world. According to the estimations of World Health Organization, nearly 215,000 children aged less than 5 years die globally from vaccine preventable rotavirus infections. The maximum number of children affected reside in low-income countries where children are malnourished and lack access to proper medical care. However, In India, it is the leading cause of moderate to severe diarrhea accounting for 40% of cases which require treatment. The vast majority of children in the country are affected by diarrhea than as compared to AIDS, malaria, and measles combined.



According to the Union Health Ministry, rotavirus diarrhea is responsible for about 78,000 deaths, 3.2 million outpatient visits and nearly 0.9 million hospitalizations every year. Therefore, in 2014, the rotavirus vaccine was included in the Universal Immunization Programme in 4 states, Himachal Pradesh, Andhra Pradesh, Haryana and Odisha and then in February 2017, the vaccine was included in Assam, Tripura, Rajasthan and Tamil Nadu. Even though the government is striving for maximum coverage where no child should die from vaccine-preventable diseases, it faces difficulties such as reaching remote areas, untrained health workforce, equipment, logistics and sub-optimal cold chain management.

The available vaccine for rotavirus vaccine loses its potency when exposed to temperatures outside the specified range which lie between 2° to 8° Celsius.As emphasized in a peer-reviewed medical journal, outdated vaccine supply, and distribution systems not only delay, but also limit the impact that vaccines have in safeguarding people’s health. Thus, understanding the global disease burden of rotavirus has on childhood mortality, Hilleman Laboratories leverages its research functions to establish a proof of concept for the development of an optimized oral heat-stable vaccine that will impact the health of millions of children in developing nations.

Hilleman Laboratories is improvising the existing oral rotavirus vaccine which will be thermostable i.e. the vaccine will be functional over a wider range of temperature thereby reducing the dependability on storage & refrigeration. This kind of Research & Development is needed to make effective vaccines that have a high efficacy percentage available in resource-limited countries so that they can be more easily used to decrease the impact of vaccine-preventable diseases. Hilleman Laboratories is using innovative technology for simple novel packaging, making it affordable and the vaccine will be lyophilized for easier administration. If the vaccine proves to be safe and immunogenic the vaccine could be brought to India, as early as 2020, aiding in bridging the gap in vaccine delivery says Dr. Davinder Gill, CEO, Hilleman Laboratories.

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Three solutions setting the pace of Immunisation - Thermostability, Affordability and Availability

By: Hilleman Laboratories on May 22, 2017

The vaccine landscape is shifting, and new opportunities, challenges, and debates have pushed vaccines to the center of global health discussions. Thanks to vaccines and systematic immunization, the polio disease saw its final death knell. It is estimated that vaccines avert about 2-3 million deaths each year in all age groups and protect 83% (107 million) of infants worldwide from vaccine preventable diseases .

Immunity is gained without the consequence of being ill and without the risk of potential life-threatening complications from the disease. However, access to vaccines has been 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 . Not just access, thermostability has been another cause for concern in case of vaccines. The World Health Organization (WHO) estimates that annually 10-50 percent of vaccines may be wasted globally because of temperature control, logistics and shipment-related issues. In low-resource settings, factors like tropical temperature, scarce resources, unreliable power, and long distances between healthcare facilities pose risks.

Innovation is the key to success!

As already discussed, a lot of factors contribute to vaccines not completely catering to those in need of it. The temperature sensitive nature of these vaccines leads to a loss in production as well as the supply chain. However, the last decade saw significant advances in developing, introducing and expanding the reach of vaccines globally. One of such measures was the ‘vaccine cold chain’ wherein vaccines are stored at refrigerated temperatures throughout the transport, storage, and handling of vaccines. The cold chain implies that the vaccine, from the time it is produced till the time it is consumed, stays in refrigerated conditions. Besides that, some companies are even researching methods to enhance the thermostability of vaccines. They have invented measures to maintain all the attributes of a vaccine even in unfavorable temperature conditions. Thermostable vaccines also help to decrease logistics cost by eliminating cold chain, which, in turn, allows for more economical pricing. As a result of this, vaccines can also be made available in remote and far-flung areas where temperatures are not naturally favorable.

Hence, it is fair to say that Thermostability, Affordability, and Availability go hand-in-hand and they hold the key to the success of immunization. The heart and soul of this field is innovation. Innovation is required to improve vaccine production as well as optimizing the supply chain. The recent wave of changes has created a tremendous opportunity for innovative technologies in this space, as companies that can help discover and deliver new vaccines could create enormous value.

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The Low Cost Meningococcal ACYWX Conjugate Vaccine: A Boon For The Developing World

By: Hilleman Laboratories on May 15, 2017

Meningitis is the inflammation of the membranes that outline your brain and spinal cord. These membranes are called meninges, therefore, giving the illness, its name - “meningitis”. While viral meningitis is the most common, bacterial meningitis is more consequential. Lack of timely treatment can cause paralysis, stroke, seizures, sepsis, and even death. The symptoms of bacterial meningitis can begin quickly, sometimes as quick as in a couple of hours. In cases of development of the disease, one experiences nausea, vomiting, sensitivity to light, confusion and a rash of purple discoloration. There are several cases of bacterial meningitis –
1.) Streptococcus pneumoniae, also called pneumococcus
2.) Neisseria meningitidis, also called meningococcus
3.) Haemophilus influenzae type B, also called Hib
4.) Listeria monocytogenes
5.) Group B streptococcus
6.) E. coli

Amongst the leading causes of bacterial meningitis is “Neisseria meningitidis”; causes pneumonia, sepsis and other such infectious manifestations. The invasive disease affects 50,000 to 1.2 million people and is responsible for 135,000 deaths annually. As in the case of other infectious diseases, the majority of disease burden lies in developing countries. This includes meningococcal countries in the African meningitis belt, regions in South-East Asia as well as in the United States of America. Meningitis is also prevalent in Europe, the Eastern Mediterranean region and in Saudi Arabia. The recorded incidence of the endemic meningococcal disease is relatively low in India but such cases have occasionally appeared in the last 100 years. The disease is deadly and is contagious in people with close contact and can spread through coughing and sneezing. A person develops bacterial meningitis when bacteria gets into the bloodstream from the sinuses, ears or other parts of the upper respiratory tract.

There are 13 serogroups, but the majority of invasive meningococcal infections are caused by organisms from the A, B, C, X, Y, or W serogroups. While polyvalent conjugate vaccines targeting serogroups A, C, Y and W, are available, they are too expensive and therefore not widely used in developing countries due to affordability and accessibility issues. There are currently no low-cost polyvalent conjugate vaccines in the market that cover all five A, C, Y, W and X serogroups. Therefore, Hilleman Laboratories is currently working on a low - cost meningococcal ACYWX conjugate vaccine which provides protection against five types of serogroups. Researchers adopted a two- pronged strategy to develop low-cost combination vaccine for the treatment of invasive meningococcal disease.

“The role of the formulation in the vaccine scenario in terms of accessibility, affordability, and acceptability, besides the contribution in bridging the immunization gap in the country would also be assessed,” says Dr. Davinder Gill, CEO of Hilleman Laboratories. Developing Countries with high endemicity place an immense strain on the public healthcare system. The disease includes long-term risk of cognitive deficit, bilateral hearing loss, motor deficit, seizures, visual impairment, and loss of limbs due to tissue necrosis; the highest risks in low-income countries, where the burden of bacterial meningitis is greatest.

The novel cost Meningioccocal - ACYWX conjugate vaccine has the potential to significantly reduce costs and create new intellectual property allowing developing country manufacturers undertake more conjugate vaccine development projects. Technical success of the vaccines has been demonstrated in animal models. With accessibility and affordability issues in low-income countries, the vaccine could prove to be a boon for the developing nation.

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Hilleman Laboratories signed an MoU with NICED, ICMR to develop the first ever: Shigella Vaccine

By: Hilleman Laboratories on April 07, 2017

A Kolkata based National Institute of Cholera and Enteric Diseases (NICED), Indian Council of Medical Research (ICMR) inked an MoU with Hilleman labs, for further development and commercialization of the Shigella Vaccine and other enteric vaccines for diarrheal diseases. The agreement was signed as an effort of Hilleman Labs mission to make affordable and accessible vaccines for the developing world.   

At the signing-in, Dr. Davinder Gill, CEO, Hilleman Labs said, "Shigella is the second most fatal organism after Rotavirus that causes severe diarrhea in children with no approved vaccine available at this time. We are pleased at this opportunity to

collaborate with NICED and jointly develop Shigella vaccine for a disease whose basic pathology is not yet properly understood."

 

Dr. Shanta Dutta Director, NICED said, "Vaccines are the most, simple, powerful and cost-effective health intervention and an effective public health tool. Our association with Hilleman Labs is in alignment with NICED's mission to identify enteric infections, initiate appropriate multidisciplinary research and develop strategies for treatment, control and prevention of enteric infections."

"Till now Shigella infection was treated with antibiotics and currently there is no vaccine to prevent shigellosis. We look forward to this as a strong partnership aspiring to unlock new knowledge behind the enteric disease like shigellosis and to come up with appropriate and effective preventive tool against this disease.", she added.

Shigellosis the leading cause of mortality and morbidity in under five children with bloody diarrhea worldwide, especially affecting low income developing countries of Africa and South Asia. According to the 2015 Global Burden of Disease report, 1.3 million deaths related to diarrhea occur not only in children but adults as well across the world. Out of these, India had the highest mortality rates with 500,000 deaths in children less than 5 years of age. India’s population is severely affected by water borne diseases. Poor quality of water, hygiene and sanitation results in 30.5 million disabilities adjusted life years in India. While the Government of India is working towards improving these basic needs, the vaccine industry is contributing to public health by developing vaccines for various pathogens: Shigella, adenovirus, Campylobacter & E. coli which are identified to cause diarrhea.

Dr. Soumya Swaminathan Director General of ICMR and Secretary, Department of Health Research - Ministry of Health and Family Welfare added by saying, “India has immense potential in clinical research, drug and device manufacturing and we would like to see more of these partnerships within the country to realize the ‘Make in India' dream. We are keen that ICMR becomes more collaborative and partners with organizations in this direction and mutually expand capacities through cross-functional partnerships".   

 

In addition to understanding the role of NICED better with Hilleman Laboratories, Dr. Davinder Gill, CEO, Hilleman Laboratories said,’ The good thing about this collaboration is that we can offer our expertise in vaccine development to the work that is done at NICED and quickly accelerate the process of development of the vaccine, so that within the next year we can bring the vaccine from research stage to clinical trials.”    

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Why you should care about Water,Sanitation and Hygiene

By: Hilleman Laboratories on March 22, 2017

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Realizing The Potential of Public Private Partnerships in Developing Effective Vaccines For Disease-Endemic Countries

By: Hilleman Laboratories on March 06, 2017

Immunization is the most cost effective tool for preventing death among children less than 5 years of age. Vaccines for leading global diseases - Diarrheal diseases, acute respiratory infection and Tuberculosis are largely unavailable in developing countries. However, the overall cost for completely vaccinating a child has increased in the last 30 years. (WHO SEAR, 2010) Introducing vaccines in developing countries, carries its own set of limitations- cost, affordability and sustainability, cold chain, adverse effects, safety, short and long-term issues.

The advent in technology presents itself as a paradox. Equipped with a deeper understanding of the genomics and access to sophisticated research tools, science now has the potential to target diseases like never before. Despite the advances, critical gap between industrialized and developing countries remain. Although, Private sectors have capitalized new technological capabilities for creating new drugs and vaccinations aimed at chronic diseases affecting the industrialized countries, the same have not been exploited to treat infectious diseases plaguing the developing countries. A number of distinct factors make it difficult to attract the necessary investments in research and development of these diseases. Factors like low market returns, distribution challenges in developing countries and most importantly, lack of awareness of these diseases in developed countries. Unless diseases such as malaria, tuberculosis and acquired immunodeficiency syndrome (AIDS) account for millions of deaths, threatening the economic stability of the nation, there are limited number of drugs and vaccines available to treat the diseases of the developing countries.

To address the critical gap, Public Private Partnership’s represent an important approach. The Public Health sector for example - WHO, UNICEF or any non-governmental organization offers its expertise and combines it with the private sector where financial resources and market experience aid in meeting the developing countries health needs while also fulfilling the corporate social and fiscal responsibility objective. Understanding the need for vaccine developments in disease endemic countries, Hilleman Laboratories took an innovative approach, by collaborating with National Institute of Enteric Diseases (NICED), Indian Council of Medical Research (ICMR) in Kolkata to develop a vaccine against Shigellosis, which cause severe diarrheal diseases.

“Hilleman Laboratories will lead the vaccine development efforts, and that’s really where our expertise is whereas NICED is a center of excellence monitoring diseases in India where they will be contributing to various aspects of clinical research, clinical & pre- clinical trials, regulatory submissions” says Dr. Davinder Gill, CEO, Hilleman Laboratories. The combined efforts between Hilleman labs and NICED, ICMR offering their expertise will bring this collaboration to a successful completion contributing the make in India initiative.

“India has immense potential in clinical research, drug and device manufacturing” says
Dr. Soumya Swaminathan, Director General, Institute of Medical Research.

The Public Private Partnerships offers several opportunities for Indian Pharma companies such as low cost of innovation, quality chemical capabilities where the cost of drug discovery is 80-90% cheaper as compare to other countries. In order to move past the significant barriers to give rise to more such partnerships, the government must create an environment for innovation and entrepreneurship, strong patent protection and predictable regulatory mechanisms.

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Improving Vaccine Supply Chain System in India

By: Hilleman Laboratories on February 23, 2017

The Ministry of Health and Family Welfare through its Universal Immunization Program has taken numerous initiatives to maximize the vaccines coverages in India. Since 2005, the strengthening support provided by National Rural Health Mission (NRHM), shows an increasing trend in immunization coverage and quality but still, critical gaps remain in the vaccine logistics management system in the country.


According to the report released by the Confederation of Indian Industries, India still fares poorly as compared to other countries as far as expenditure and vaccines coverage is concerned. In terms of full immunization coverage, Brazil and Mexico’s portfolio is far superior as that of China and India. The astonishing fact – 70% of the world’s unvaccinated children live in only 10 countries, 52% of which live in just 3 countries: India, Nigeria and the Democratic Republic of Congo.


India covers 2.7 crore children under the immunization program, whereas 14.5 lakh still don’t receive vaccination. Vaccines are efficacious against prevalent areas, making it easier to overlook their success. For example, between the year 2000 and 2015, the measles vaccine alone saved 17 million lives, as reported by the World Health Organization (WHO). Despite the availability of safe and effective vaccines, the coverage of immunization against the six main vaccine-preventable diseases is still variable across different regions of the country. In 2015, one in every 5 children was unable to receive the needed routine vaccination. In an attempt to improve the immunization numbers, especially countries consisting of few vaccine manufacturers face extreme difficulty due to weak health-care systems, inadequate and poor infrastructure, interrupted links in the cold chain system and even issues related to technical capacities of staff.

While on a contrasting scenario, the facts state that India is amongst the largest vaccine manufacturers in the world. Despite that, the country is unable to provide maximum vaccine coverage. Why?


It is because districts in India face challenges related to vaccine coverage, equipment breakdowns, overstocking and stock- outs, storage issues during transportation and a discontinuous cold chain. The purpose of ensuring effective delivery becomes moot when the final destination in rural health clinics has issues with electricity. The complication is worsened when there are power outages for extended hours at a time, the vaccines requiring refrigeration are damaged.

India is solely responsible for wasting 25% of the vaccines due to the paucity of the cold chain. Therefore, the Ministry of Health and Family Welfare has planned over 27,000 cold chain points for storing the distribution of vaccines. In order to maximize the reach of vaccines, the Ministry in collaboration with United Nations Development Programme (UNDP) rolled out Electronic Vaccine Intelligence Network (eVIN) across 12 states in India.


Due to these supply chain challenges, Hilleman Laboratories recognized the needs of the changing world and took the opportunity to introduce thermostable vaccines which drive down the logistics cost by eliminating the cold chain. Thermostable vaccines reduce the risk of ineffective vaccines and thereby, maximize the impact on public health. In order to expand the immunization coverage, Hilleman Laboratories is currently advancing technologies that aid in maintaining the quality attributes of the vaccines.

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History of Cholera and its burden on Developing Countries

By: Hilleman Laboratories on February 14, 2017

In modern history, cholera occupies an important place as a public health challenge. It was the first pandemic of the 19^th century. It’s an infectious and life-threatening diarrheal disease which is endemic in many Asian and African countries. Initially originated in the swamps of Bangladesh, it spread across the world from its reservoir which is part of the Ganges River Delta. The existent brackish waters were the birthplace of vibrio cholerae, a bacterium that infects the waters and when ingested emits a toxin so virulent that all the human body’s fluids are forced to flush out.  Deprived of electrolytes, people begin to die of shock and organ failure, sporadically, within six hours of the first abdominal rumbling. 

History of Cholera and its burden on Developing Countries 

Since 1871, pandemics of cholera has affected millions. As per researchers at World Health Organization, cholera contributes to 1.3 to 4 million cases each year. (WHO, 2016) The increase in access to safe drinking water and sanitation facilities has eliminated the transmission in high-income countries. However, the causative agent, Vibrio cholerae continues to affect millions of people in less developed countries where, unfortunately, clean water and sanitation infrastructure is not available in abundance. 

Over the last 25 years, major cholera epidemics have seen to originate in coastal areas. Currently, the regions of cholera endeminity include the coasts surrounding the Bay of Bengal, both Bangladesh and the Indian subcontinent. In these geographical regions, the patterns of the frequency of the disease show a similar trend that are explained by same physical or environmental drivers. The diarrheal disease, caused by bacteria that lives in water and faeces, is not spread by contact with an infected person. A large number of the population is infected due to drinking this contaminated water. Experts suggest an occurrence of 4,50,000 - 1,000,000 cases of cholera in Bangladesh each year, whereas Data from population-based diarrhea surveillance in an endemic area of Kolkata, India, revealed a cholera incidence of 2.2 cases per 1000 person-years.  

For effective aversion of cholera transmission, it’s imperative the afflicted countries are provided with safe drinking water through a well-maintained water and sanitary infrastructure. Oral cholera vaccines are additional ways to control the disease but should be used in conjunction with improvements in water & sanitation. Even though the disease is preventable and can be controlled despite the existence of a vaccine, many countries still remain affected.

“HILLCHOLTM  - This low-cost Cholera vaccine can be used to create a healthy stockpile to be used in epidemic situations.”  Says Dr Tarun Sharma, Associate Director, R&D, Hilleman Laboratories

Representing a significant healthcare burden globally, Hilleman Laboratories is awarded global patents for Oral Cholera Vaccine (OCV) in offices including USA, European Union, Australia, China, Canada and South Africa. Mass vaccination would be made a reality in cholera endemic zones due to ease of manufacturing and low cost. Hilleman Labs single-strain vaccine with process and manufacturing optimisation significantly reduces the cost of the vaccine production, thus, aiding in improving vaccine affordability and accessibility.

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