Tuesday, 31 January 2017

Immunization against Measles – Rubella in India

The World Health Organization has congratulated India for launching the world’s largest immunization campaign against Measles – Rubella. The campaign targets Measles, a highly contagious disease caused by a virus. The virus is from the paramyxovirus family and it is normally passed through direct contact and through the air. It is spread by sneezing, coughing or direct contact with infected nasal or throat secretions, infecting the respiratory tract. The campaign is additionally targeting, the congenital rubella syndrome (CRS); responsible for permanent effects such as irreversible birth defects, deafness and cataracts.  

In India, Measles affect 2.5 million children annually whereas the congenital rubella infection, also known as the German Measles, affects 25,000 children born in the country. In recent years, due to consistent efforts, the mortality rate has declined by 51% from the year 2000 to 49,000 in the year of 2015.

The Union Health Ministry has launched the Measles – Rubella (MR) vaccination campaign
in Bengaluru on 5th February, proving India’s commitment to improve the country’s health by protecting children against vaccine preventable diseases. The campaign targeting two diseases will cover nearly 3.6 crore children will start from five states and union territories (UTs), namely, Karnataka, Tamil Nadu, Puducherry, Goa and Lakshadweep. 

In the nationwide campaign, the ministry will reach out to and cover 41 crore children in the age group of 9 months to 15 years,” says MoS Health Faggan Singh Kulaste.  

A specified age group will get a single shot of Measles - Rubella vaccine irrespective of the previously introduced Measles/rubella vaccine status or disease status. The Measles Rubella vaccine will be provided free of cost across states from schools as well as to health facilities. Earlier, in 1985, Measles vaccine was part of the Universal Immunization Programme (UIP), but due to the introduction of the Measles - Rubella vaccine, the monovalent vaccine (Measles) will be discontinued and replaced by the bivalent vaccine (Measles - Rubella).    

The World Health Organization has set a Sustainable Goal Target, which aims to prevent the deaths of newborns and children under five years of age by 2030. Thus, the elimination of Measles and congenital rubella syndrome by the bivalent vaccine will contribute to the achievement of the set goal.
We, at Hilleman Laboratories, believe that by not getting vaccinated you are not only putting yourself at risk but also the people around you. To ensure the effectiveness of the campaign, it’s important that throughout its duration, no individual is left behind. An important learning taken away from the polio eradication programme was to further the strengthening of surveillance for Measles- Rubella and to identify infected and vulnerable areas. The parents, caregivers, community leaders, teachers and the frontline healthcare providers are urged to become active participants and advocates for the campaign. Consistent efforts are the only way to rapidly build up immunity and thereby reducing the huge socio-economic burden on the susceptible cohort.

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Sunday, 15 January 2017

Immunizing India and its various Challenges

Immunization has played an integral role in improving children’s health and survival in India. The Ministry of Health and Family Welfare has been consistently working towards reducing the mortality rates from vaccine-preventable diseases through its Universal Immunization Programme (UIP).  Immunization doesn’t just save medical costs, but also yields indirect economic benefits like educational attainment, enhanced productivity. The unimmunized individuals are also offered protection through “herd immunity” by many vaccines.  

India has made significant progress towards reducing child deaths and has set multiple child health targets to achieve. The government of India has taken multiple steps to accelerate child survival, including strengthening the routine immunization (RI) programme of the country. Since 1990, the child mortality rates of the country have declined by 58%. So far, Vaccines have successfully eradicated smallpox and polio from the country. Measles have brought to an all- time low and tetanus has been reduced to a large extent. As of 2013, 18 states were estimated to have eliminated maternal and neonatal tetanus. Over the years, India has seen progress in expanding immunization coverage, with nationwide coverage of the third dose of the diphtheria-tetanus-pertussis (DTP) vaccine increasing to an estimated 72% in 2012 from 60% in 2003.    

The industry stands on remarkable success that exemplifies “Make in India” while the road ahead calls for strategic maneuvering and funding. The global foothold is consistently strengthened which is crucial to remain successful, however, the need of the hour is to evaluate the evolving domestic market landscape.

Vaccines have transformed public health throughout the world, for children particularly, the burden of vaccine-preventable diseases in India is still substantial and hence the usage of this powerful tool is still not optimal in our country. The Indian healthcare industry presents new vistas of growth, provided, challenges in terms of policy barriers, lack of awareness and affordability issues, are successfully tackled. Some of the challenges can be explained as -

Technical Challenges: -
Technology has been a conspicuous obstruction in the case of few emerging vaccines. Hence, this results in significantly higher product risk, higher than it has been in all previously developed vaccines.

IP Policies: - We need stringent IP policies and an ecosystem where research is prized and not just encouraged. Hence, at the end its not only a question of sustained industry competitiveness, it is a question of appropriate and active public response to a critical national need. 

Regulatory Challenges: -
Many a times procedural hold-ups delay product development and launch, which in turn have proven truly expensive – not only to the industry but to the country as such. While the industry stakeholders have now begun a constructive dialogue to wash out certain regulatory delays, the magnitude of the problem calls for a collaborative approach that is as aggressive as it can be. 

In a wake to address the regulatory issues of Indian vaccine industry, Union Health Ministry has recently announced that it will be forming an expert group to examine regulatory issues for Indian vaccine industry. "Indian vaccines manufacturers should accord prime importance to meeting domestic demand, upscale research and development related work, and also take initiatives in developing critical vaccines such as Pneumococcal conjugate vaccine (PCV) and Human Papillomavirus (HPV) vaccines" said Union Health Secretary C K Mishra. The expert group will work towards speedy resolution of issues in time-bound manner without compromising critical aspects like quality, patient safety and patient management.

More of such initiatives and planned multi-stakeholder approach is required for conquering challenges of complex emerging vaccines that lie ahead. It is critical that policymakers and regulators alike, maintain the pace in such efforts and work in full force to help India win over the next set of public health challenges.
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Hilleman Laboratories is a global vaccine research & development organization focused on making affordable vaccines using innovation to address gaps that exist in low resource settings. Hilleman Labs acts as a catalyst in bridging the gap between academic research and product development by targeting novel vaccines and increasing the efficiency of existing vaccines. Know More

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