Thursday, 23 February 2017

Improving Vaccine Supply Chain System in India

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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Tuesday, 14 February 2017

History of Cholera and its burden on Developing Countries

In modern history, cholera occupies an important place as a public health challenge. It was the first pandemic of the 19th 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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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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