Warning of the risks of totally depending on external sources for funding the country's universal immunisation programme (UIP), the draft National Vaccine Policy has recommended that the government take ownership of it for ensuring vaccine security and equity by creating fiscal and legislative provisions with appropriate support from external donors.
As donor countries are yet to recoup from the impact of the recent global financial crisis, the draft policy says it is important that India creates and strengthens its own mechanisms and systems for long-term sustenance of programmes for vaccine-preventable diseases.
In addition to suggesting maximum use of vaccines available globally as a public health tool for improving health, it also recommends creation of a National Immunisation Authority at the Centre, that would be supported by several cells with different functions, and a similar set-up right up to the district level.
“The ideal situation for any government is to assume ownership of their national immunisation programmes to the fullest possible extent and accordingly create fiscal and legislative space. Meeting benchmarks and enacting protective legislation are both essential conditions for sustainability,” it says.
Advocating the need for creating a Corpus Fund (vaccine fund) through innovative financing mechanism, the draft policy calls for setting up an interagency task force to assess the legal and administrative barriers to create such a fund. This fund could also be used for introduction of new vaccines and their development for emergency. It calls for flexible governing and funding mechanisms to support development in the public-private partnership mode.
The draft policy was commissioned in September last year to address the issues of strengthening the institutional framework, processes, evidence base and framework required for decision-making for new vaccine introduction, vaccine security, and regulatory guidelines.
The nine-member team was chaired by N.K. Ganguly, the former Director- General of the Indian Council of Medical Research.
The UIP in India targets 2.7 crore infants and 3 crore pregnant women annually and is one of the largest programmes in the world. The country also has a vaccine industry that caters to 43 per cent of the Expanded Programme on Immunisation and some of the new vaccines purchased by the Global Alliance for Vaccines and Immunisation (GAVI). Thirty-five per cent of the country's population buys the vaccines from the private market.
Recommending changes in the existing immunisation schedule to accommodate new vaccines, broader utilisation of some or changing the number of doses, the proposed policy draws attention to the shortage of trained manpower to manage the UIP at the Centre and State level, disease surveillance and procurement and effective vaccine management.
However, N. Raguram of the Society for Scientific Values has criticised the draft policy by saying it was not clear if this model takes disease burden into account. When the disease burden is lower than 2 per cent prevalence (and when the disease is treatable or preventable by other means), the quality of evidence emerging out of a clinical trial, in terms of the safety and efficacy of a vaccine, has no relevance in deciding whether to introduce the vaccine.
“The moot policy question is not whether the vaccine works, but whether the vaccine is necessary for all in India, and how many cases/deaths can be prevented and by vaccinating how many people. This basic logic is missing throughout this policy document,” he says.
Courtesy : The Hindu
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