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Posts Tagged ‘medicine

Maternal Mortality on the Rise in the United States

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By Kathleen Huntzicker, ScB

Image by Sasin Tipchai from Pixabay

Despite leading the world in healthcare spending, the United States has the highest maternal mortality rate of any developed country. According to the Centers for Disease Control and Prevention (CDC), about two women die every day in the United States due to complications with a pregnancy or a delivery. The United States also holds the unfortunate distinction of being one of the only countries in the world with a rising maternal mortality rate – while most other countries have improved maternal health over time, the death rate of pregnant or recently-delivered American women in the United States has doubled since 1987. Growing activism has helped to raise awareness of these sobering statistics; however, the United States has yet to meaningfully curtail its rising number of deaths.

The CDC defines a pregnancy-related death as “the death of a woman while pregnant or within one year of the end of a pregnancy – from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.” Although the United States has done little to decrease the occurrence of these deaths over the past four decades, it has managed to successfully tracked pregnancy-related deaths for over 100 years. Since 1915, the National Vital Statistics System has published mortality rates for each state using data collected from death certificates. While these numbers help to illustrate gross trends over time, they can only provide limited insight into thewhat factors that might drive changes in mortality rate. Additionally, societal perceptions of what constitutes an “accidental” death have changed markedly since 1915. Just decades ago, a suicidedrug overdose following a pregnancy might have been considered an accident; however,, whereas doctors today recognize that the mental health of a woman is not independent of her pregnancy status. To provide more accurate and standardized data sets, state and local governments began forming Maternal Mortality Review Committees (MMRCs).forming Maternal Mortality Review Committees (MMRCs) with the goal of developing novel strategies to combat peri- and post-partum maternal death. BIyn 1968, 44 states andnd the District of Columbia had instituted their own versions of an MMRCs. Sadly, by 1988, this count had dropped to only 27. Upon the recommendation of the CDC, the United States then pioneered the Pregnancy Mortality Surveillance System in 1986 to collect death certificates and other related health information from all fifty states. This system was instituted in the hopes that a closer comprehensive study of all maternal deaths might fill in gaps in the current understanding of maternal mortality, allowing both lawmakers and medical professionals to better focus on the most vulnerable populations of women and to determine what types of community interventions might be most successful.

These monitoring systems have revealed that every woman does not experience the same odds of suffering a pregnancy-related death. In fact, the mortality rate for non-Hispanic black and Native American women is more than triple that of white, non-Hispanic women, with the disparity only increasing in older age groups. Additionally, recent data indicates that women who receive no prenatal care are three to four times more likelythree to four times as likely to suffer a pregnancy-related death than women who do attend prenatal doctor visits prior to delivery. Women without prenatal care represent 25% percent of all pregnant women in the United States, but 32% percent of black women and 41 %percent areof Native American women.25% of all pregnant women in the United States, but 32% of black women and 41% of Native American women. A study out of Mount Sinai School of Medicine found that maternal deaths were not consistent across hospitals, either, and that hospitals mainly serving minority women were more likely to experience a pregnancy-related death, even afterwhen controlling for the race of the patient. This suggests the racial disparities could depend not only on access to health care, but also inconsistencies in how pregnant women are treated from hospital to hospital.

One glaring example of such a medical inconsistency is the rate of cesarean sections across hospitals.medical centers. While many pregnant women might assume that their doctor’s decision to perform a c-section is dependent only on the health of the mother and child, collected statistics appear to suggest otherwise. C-section ratesRates of c-section by hospital vary drastically: a team from the University of Minnesota found that nationwide, rates for individual hospitals ranged as low as 7% percent and as high as 70 p%ercent7% and as high as 70%.. Even when treating women with low- risk pregnancies, some hospitals were more than fifteen times as likely to perform a c-section than others. These statistics are especially worrying given that c-sections can be linked to severe complications in deliveryc-sections are linked to severe complications in delivery, including hemorrhages, infection, and surgical injury. In fact, women who undergo c-sections are 80% percent more likely to experience severe complications than women who deliver vaginally. In the United States, about one in three women deliver via c-section, a rate more than 500 times higher than in the 1970s500 times higher than it was 50 years ago,, and about 50% higher than the rest of the world. With c-section rates continuing to rise, it might be reasonably expected that the rates of maternal morbidity and mortality could rise as well.

Though the statistics maymight seem grim, some policy measures appear to hold promise for improving future outcomes. California’s Maternal Quality Care Collaborative was successfulsucceeded in cutting its state’s maternal mortality rate in half, largely due to the addition of emergency delivery toolkits in over 200 hospitals across the state. The collaborative team targeted the two most preventable causes of maternal death – hemorrhages and adverse cardiovascular events –

by designing best-practice protocols for peripartum emergencies, and training hospital teams to carry them out. The CMQCC recommends that every maternity ward feature a cart with all the necessary equipment to treat an emergency hemorrhage, including sponges, clamps, and a Rusch balloon to staunch heavy uterine bleeding. These toolkits have now been implemented across eighteen states, to with much success. However, even in California, which now boasts the lowest maternal mortality rate in the country at four4 deaths per 100,000 women, racial and economic disparities unfortunately still exist, indicating that simply adding a hemorrhage cart to all hospitals cannot be the only answer to the rising maternal mortality rates in the United States.

It remains clear that the federal government, as well as state and local governments, must to do more to address the alarming rate of maternal deaths in the United States. Low-income and minority women are three to four times more likely to die as a result of pregnancy or childbirth, so it is imperative that any policy solution adequately address the vastly different standards of care that are received by American women dependent on their race, chosen hospital, or state of residence. With governmental access to increasingly larger data sets and growing public and political awareness of the issue, we can becan hopeful that the maternal mortality rate in the United States will decline in the coming years. Even so, the state of maternal health in the country is a sobering reminder of the stark health disparities that exist between races, neighborhoods, hospitals, and income levels – and, particularly in the case of maternal mortality rate, the unique health risks and dangers experienced by American women.

Written by sciencepolicyforall

February 22, 2020 at 8:50 am

Science Policy Around the Web January 7th, 2020

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By Ben Wolfson, PhD

Image by mcmurryjulie from Pixabay 

What CRISPR-Baby Prison Sentences Mean for Research

Chinese scientist He Jiankui came to prominence last year after claiming he had used CRISPR/Cas9 to genetically edit human embryos to confer resistance to HIV-1. Twin girls with the mutation were born in October of 2018, and He’s work was confirmed by Chinese investigators in February of 2019.

Now, after a trial held in secret, He has been sentenced to three years in prison for “illegal medical practice” by a Chinese court. Two of He’s colleagues were also charged and given shorter prison sentences. All three were leveled fines, and will be prevented from conducting research using human reproductive technology.

These actions set an important precedent for regulation of human gene editing, however Chinese scientists also worry that they may result in restrictions for research into genetic modification that is not as ethically dubious. They worry that it may become difficult to get approval to use gene editing tools in clinical trials, as well as making funding for these sorts of research experiments more difficult to get. 

Despite these worries, He’s imprisonment is supported by the scientific community, and represents the first big check on clinical gene editing research. Others outside of the mainstream scientific community disagree. In an Op-Ed published by Stat News, Biohacker Josiah Zayner states that as gene-editing of human embryos becomes more common, the perspective on Jiankui will shift and he will no longer be seen as having done anything wrong. 

(David Cyranoski, Scientific American)

Written by sciencepolicyforall

January 7, 2020 at 1:27 pm

Science Policy Around the Web December 20th, 2019

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By Mohor Sengupta, PhD

Image by Eveline de Bruin from Pixabay 

Trump Administration Takes First Step to Allow Drug Imports From Canada

“For the first time in history, H.H.S. and the F.D.A. are open to importation as a means to lower drug prices,” Alex M. Azar II, secretary of HHS said recently. In a step unusual for the Trump administration, it has announced that import of drugs from Canada would be made possible. Despite vehement opposition from the pharmaceutical industry, and previously from even the FDA, the government is set to implement importing of drugs from outside the U.S., once the states have come up with individual proposals for approval by the federal government. 

The proposed implementation is still a long way off. The pharmaceutical industry’s main lobbying group, the Pharmaceutical Research and Manufacturers of America, are not happy with the recent turn of events. “At a time when there are pragmatic policy solutions being considered to lower costs for seniors at the pharmacy counter and increase competition in the market, it is disappointing the administration once again put politics over patients,” the group’s president and chief executive, Stephen J. Ubl, said in a statement.

Because a proposal such as this has never been implemented before, the Trump administration is unsure of the costs it would incur. Until the states submit their individual plans of how to go about implementing these imports, estimates of consumer or taxpayer savings cannot be made. However, it is amply clear that consumers of highly priced drugs will be happy with the move. In recent years, public outrage over high prices of prescription drugs has mounted steadily and lowering drug prices by importing them would meet a key campaign promise of the administration.

A 2003 law sets limits on the types of drugs that can be imported, and by that law, most of the expensive drugs, including insulin, biologics and injectable drugs, are excluded from this proposal.  

(By Katie Thomas, New York Times)

Written by sciencepolicyforall

December 20, 2019 at 3:57 pm

Science Policy Around the Web November 26th, 2019

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By: Andrew H. Beaven, PhD

Source: CDC

How Best To Use The Few New Drugs To Treat Antibiotic-Resistant Germs

Bacteria have existed for 3.5–4 billion years, and their survival demonstrates remarkable environmental plasticity. One consequence of their plasticity is that bacteria are able to rapidly become resistant to antibacterial drugs (drugs meant to help humans and animals stave off infection).

Combatting antibiotic drug resistant bacteria (so-called “superbugs”) has been pinpointed as a major, modern global health concern. A new Centers for Disease Control and Prevention (CDC) report published November 14, 2019 estimates that more than 2.8 million treatment-resistant infections and 35,000 annual deaths occur in the U.S. alone. Notably, the development of new antibiotics has lagged, therefore, scientists are recommending new methods to use old drugs. These include: limiting doses for healthy people and allow the body to do its work; flooding the body with multiple drug types at once; or sequentially changing drug types every 12 to 24 hours.

Given all we know about this global health concern, why is the market not being flooded with new antibiotics? Largely, because it is not lucrative for pharmaceutical companies to chase a moving target. Additionally, antibiotics are only used for short-term ailments (as opposed to those used for chronic illness) and many antibiotics remain unused in an effort to minimize new drug resistance. To help promote new antibiotic research, U.S. Senators Bob Casey (D-PA) and Johnny Isakson (R–GA) introduced the Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms Act of 2019 (DISARM Act of 2019; S.1712) to the Senate on June 4, 2019. The goal of the act is to strengthen American antimicrobial research and improve the development pipeline. While the act was called “essential and timely” by the President of the Infectious Diseases Society of America, it has not passed the Senate at time of publication.

(Richard Harris, NPR)

As SpaceX Launches 60 Starlink Satellites, Scientists See Threat to ‘Astronomy Itself’

On November 11, 2019, the private American aerospace company SpaceX, founded by Elon Musk in 2002, launched its second Starlink satellite payload rocket into outer space. Starlink is a prodigious project that aims to provide “high speed internet access across the globe,” specifically allowing internet access to “locations where access has been unreliable, expensive, or completely unavailable.” The Starlink webpage states that they will provide near-global internet coverage by 2021 through their satellite constellation (a network in which satellites work together to provide continuous coverage).

Even with the relatively few Starlink satellites currently in place, astronomers have already noted significant impact on their work. The primary point of concern is that the satellites are very bright, and astronomers say that even if the satellites are darkened, they will have a profound effect on Earth-based astronomy. Additionally, astronomers worry that Starlink will pollute radio wavelengths used to probe deep space and permanently pollute low-orbit space with “space junk.” SpaceX says they are attempting to minimize the effects Starlink has on the scientific community and that the project is moving ahead. Indeed, Mr. Musk has requested the Federal Communications Commission to allow 30,000 more satellites than 12,000 that were already approved. If successful, SpaceX would have eight times more satellites in low-Earth orbit than currently in orbit.

Other companies, such as, Amazon, Telesat, and OneWeb, are following close behind launching similar satellite constellations. Using outer space for private gain yields an important, unanswered question – who can profit from outer space? Megan Donahue, president of the American Astronomical Society acknowledges that “international space law is pretty wide open,” and that it for now the public must trust corporate good will. Currently, a set of United Nations treaties and principles as well as resolutions have laid out guidelines on the peaceful usage of space, but few exact rules are in place.

(Shannon Hall, The New York Times

Written by sciencepolicyforall

November 26, 2019 at 3:14 pm

Should Vaccines be Mandatory?

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By: Juan I. Moliva, Ph.D.

Image by Angelo Esslinger from Pixabay 

The anti-vaccination movement has been gaining traction across the United States (U.S.) and the world. According to the Centers for Disease Control and Prevention (CDC), the number of measles cases in the first five months of 2019 surpassed the total number of cases per year for the past 25 years, with the number of children unvaccinated for preventable diseases quadrupling since 2001. The CDC also found an increase in the number of vaccine exemptions for kindergarteners across the U.S. While the numbers vary across the country mostly due to laws set in place by each state, in Mississippi, one of three states that do not grant exemptions due to religious or philosophical reasons, the rate of kindergartners with an exemption to one or more required vaccine was 0.1%. Compare that to Oregon, a state that grants exemptions to vaccines due to religious or philosophical reasons, where the rate of vaccine exemptions for kindergarteners is at 7.6%. As the number of individuals choosing not to get vaccinated or choosing not to vaccinate their children continues to increase, the debate as to whether vaccines should be mandatory has taken front stage.

Simply stated, a vaccine is a weakened or killed version of a pathogen that is delivered to the body with the sole goal of stimulating an immune response to protect you against the disease you are being vaccinated against. How is this accomplished? Your immune system has a subset of cells with “memory” that remember the pathogen and if you are later exposed to the pathogen these “memory” cells will eliminate the pathogen before it can make you sick. In the U.S. and most of the world, the general scientific consensus on vaccines is that they are safe and critical for maintaining healthy communities. The U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) strongly defended the case for vaccines. Chairman Lamar Alexander (R-TN) said, “The science is sound: Vaccines save lives – the lives of those who receive vaccines and the lives of those who are too young or vulnerable to be immunized.” Like any medication or medical procedure, vaccines do not come without risk, but the advantages vastly outnumber any disadvantages.

Not only do vaccines protect your body from dangerous pathogens, they also protect the community via a concept known as herd immunity. When a high enough percentage of the population is immune, pathogens have a harder time spreading. We rely on this principle to protect those who cannot receive a vaccine. However, vaccine opponents continue to argue that mandating vaccines is a slippery slope towards losing body autonomy. I have spent the last eight years studying vaccines, from basic research to pre-clinical testing through clinical trials and licensing. I have recently come to embrace the belief that the sole exemption for a vaccine that has been proven to be effective is a medical one – the case where you cannot receive a vaccine because your body responds negatively to the vaccine; this includes a weakened immune system that can be caused by chemotherapy or radiotherapy, a congenital condition that leads to an impaired immune system, or a history of serious adverse events related to vaccination such as an allergic reaction to one or more components in the vaccine.

The case against anti-vaxxers surrounds the choices they make on behalf of their children and how those choices affect their children and those in the community. If parents started claiming religious or philosophical exemptions against child safety seats or against buckling their children while driving, would we be arguing in their favor? Seatbelts and safety seats have been proven to save lives by preventing ejection from the vehicle after impact. Vaccines have been medically proven to save lives by preventing death or disability from infectious pathogens after exposure. While we expect not to be involved in a car accident, we rely on seatbelts in case we do. Vaccines work the same way; we do not want to be exposed to deadly pathogens but being vaccinated against these pathogens helps ensure we do not get sick if we do. Childrenare incapable of deciding if they want to be vaccinated as some vaccine regimens are initiated within the first year of life, thus their welfare is entrusted upon their parents. 

In the U.S. we have laws about providing proper nutrition, schooling, clothing, cleanliness, shelter, and many more that protect children’s welfare. Providing vaccines on time should be included as a basic necessity and be treated no different than other child welfare offenses. If an unvaccinated child contracts a preventable disease and is significantly affected to the point of disability or even death, the parent(s) should be directly responsible. A guardian refusing to vaccinate their medically eligible child should be treated like what it is: child endangerment. Take for example the recent case of a six-year-old in Oregon that nearly died of tetanus after sustaining a cut while playing outdoors. The child’s parents had refused to vaccinate the child with DTaP, a safe vaccine intended to protect against tetanus. The boy was held in an intensive care unit for 47 days, undergoing multiple intravenous infusions to alleviate the high fever, hypertension, and tachycardia caused by the infection. All at the cost of over $800,000 for a disease that could have been easily prevented with vaccination. Despite the episode, the boy’s parents continue to refuse the vaccine.

Although bipartisan support exists for vaccination at the federal level, it is unlikely federal law eliminating philosophical and/or religious exemptions would come to pass as public health policy is traditionally left to the states. State legislatures are beginning to introduce laws that will help limit the increase in numbers of preventable disease cases due to lack of vaccination. New York state recently passed legislation forbidding religious and non-medical exceptions to vaccines. After signing the bill, Governor Cuomo (D-NY) said, “While I understand and respect freedom of religion, our first job is to protect the public health.” Washington state, plagued by surging number of measles cases, also recently banned personal and philosophical exemptions to the MMR vaccine, which protects against measles, mumps, and rubella. Merely going to a public park or a grocery store can place unvaccinated children or immunocompromised individuals at risk of contracting a preventable disease. Such was the case of a six-year old boy with leukemia that died of measles after being exposed by his intentionally unvaccinated siblings. Senator Bill Cassidy (R-LA), a former physician, stressed: “If you are such a believer in liberty that you do not wish to be vaccinated, there should be a consequence and that should be that you cannot infect other people.” While I agree that autonomy over one’s body is important, the government has the right to require a reasonable level of vaccination for all citizens as a matter of public health. 

In the U.S. where freedom and personal liberty are valued above all else, mandatory vaccination would have a lengthy and challenging uphill battle. Additionally, data suggests that mandatory vaccination does not necessarily increase vaccination coverage. Instead, the U.S. could increase vaccinations via financial incentives similar to the system in place in Australia whereby parents receive monetary compensation when their children meet vaccination requirements. However, the most successful approach might be akin to the one the CDC implemented over sixty years ago to encourage stricter vaccination requirements by the states. By providing educational support, the CDC engaged parents, policymakers, and state and local health officials at every level to increase vaccination coverage. Education is one of the most effective ways to counter vaccination noncompliance. Specifically, educating people on the alternatives to vaccines – the morbidity and the mortality associated with lack of vaccination – was shown to be the most effective strategy. Educating why vaccines are so crucial is the most powerful weapon to combat vaccine non-compliance. 

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Written by sciencepolicyforall

August 14, 2019 at 10:00 am

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Science Policy Around the Web August 9th, 2019

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By Ben Wolfson PhD

Image by OpenClipart-Vectors from Pixabay 

Scientists are making human-monkey hybrids in China

In a new report first published by Spanish newspaper El Pais, it was revealed that an international team of scientists lead by Dr. Juan Carlos Izpisúa have created human-monkey chimeras, with the end goal of growing human organs in monkeys for transplant.

Chimeras are organisms with cells coming from multiple genetically distinct individuals. Chimeras are commonly used for biomedical research, such as mice bred to express genes from other species, or immunocompromised animal models in which foreign tumors are introduced to facilitate cancer research.

While these uses are commonplace, the ethical ramifications of human-animal chimera creation are significant. If chimeras are created at early developmental stages, it is difficult to control the destiny of each individuals’ cells, meaning that human cells could end up in the nervous system or brain, potentially resulting in human-like behaviors. Due to these considerations, the National Institutes of Health have banned the use of federal funds to create human-monkey embryos, and the scientific community has instituted an unofficial “red-line” to cut off chimeric embryo growth at 14 days.

To avoid legal issues, Izpisúa’s team (based in the US and Spain) conducted research in China, where no legal limitations currently exist. In previous work producing human-pig and human-sheep chimeric embryos, Izpisúa reported that only 1 in 10,000 cells were human. While the results of his human-monkey research remain confidential as they await publication, a colleague stated that “the results are very promising“.

(Antonio Regalado, MIT Technology Review)

 

Written by sciencepolicyforall

August 9, 2019 at 3:38 pm

Disparity in the Global Supply and Demand for Vaccines Against Rotavirus

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By: Lawrence Wang

Image by Arek Socha from Pixabay 

Vaccines are extremely important for individual and global health. These life-saving biologics are especially important for children in developing countries, who suffer disproportionately from vaccine-preventable infectious diseases. One of these infectious diseases is rotavirus, which causes severe diarrhea and kills around 200,000 young children and babies per year1. Effective vaccines against rotavirus are responsible for saving countless lives and reducing suffering around the world.

In November 2018, the major pharmaceutical company Merck canceled a long-term commitment it made with GAVI (The Global Alliance for Vaccines and Immunization) to provide its rotavirus vaccine, RotaTeq, to four countries in West Africa (Burkina Faso, Cote d’Ivoire, Mali, and Sao Tome) for $3.50 a dose. Simultaneously, Merck increased RotaTeq shipments to China where a course sells for $40, nearly 12 times more than in West Africa2. Merck reported that the reason for this termination was “supply constraints” and an “unprecedented increase in global demand” for Rotateq3. Vaccines that were earmarked for West Africa were instead diverted to China, where they would protect millions of Chinese children while leaving millions of West African children vulnerable.

This situation exemplifies the disparity in the global supply of, and demand for, vaccines. Many vaccines are produced by large pharmaceutical companies like Merck that are based in wealthy nations (e.g., Merck’s headquarters are in New Jersey, USA). In general, developed countries have more agency in purchasing and providing vaccines for their citizens at higher prices. Developing countries, on the other hand, usually lack the money to pay for vaccines and are consequently reliant on free or subsidized vaccines. Profit-driven companies such as Merck are thus incentivized to sell their limited supply of vaccines to countries that can afford to pay more.

GAVI and UNICEF (United Nations Children’s Fund) are organizations that work to address disparities in vaccine access between industrialized and developing countries by buying and delivering vaccines to poor countries around the world4,5. However, they still rely on pharmaceutical companies to produce the vaccines that they distribute. When Merck notified GAVI and UNICEF that it would stop supplying discounted RotaTeq doses to the four West African nations, their only recourse to address the unexpected vaccine supply shortage was to help the affected countries switch to anot­­her rotavirus vaccine produced by a different company2.

This potentially problematic situation was avoided by a multilateral collaboration between aid organizations, governments, and manufacturers. Specifically, other pharmaceutical companies like GlaxoSmithKline (GSK), Serum Institute of India, and Bharat Biotech stepped in to fill the dearth left by Merck by pledging to supply their rotavirus vaccines (Rotarix, Rotavac, and Rotasiil) to the four West African countries. These countries are expected to switch to these alternative vaccines (which are actually cheaper than Merck’s) in 2020 after their supplies of RotaTeq run out6.

While this story ostensibly has a happy ending, it also highlights inherent problems in the way vaccines are supplied to the world, specifically poorer nations. These nations are reliant on aid organizations like GAVI and UNICEF to provide them with free or discounted vaccines, which are in turn dependent on profit-driven pharmaceutical companies to produce and supply the vaccines. Why can’t these multinational pharmaceutical companies, which have vast resources at their disposal, just produce more vaccines when there is a shortage?

The answer to this question is multifactorial. Firstly, vaccine production is complicated and only multinational pharmaceutical companies have the sufficient expertise, infrastructure, and manpower to produce high-quality vaccines that are safe and effective at scale. Thus, even these companies need advanced warning to produce millions of vaccine doses. Secondly, the prices for vaccines have been increasing in recent years, mostly due to high fixed overhead costs and exclusive licensing practices that preclude competition7. Thirdly, vaccines represent only about 2-3% of big pharma’s trillion-dollar production portfolio and are not the most profitable part of their portfolios8. Thus, pharmaceutical companies have little incentive to pick up the slack. How, then, can the costs of vaccines be reduced and who is supposed to step up to make vaccines when big pharmaceutical companies fall short of their obligations?

One potential solution to reduce the cost of vaccine production is for smaller pharmaceutical companies to produce generic vaccines. Generics are alternative versions of patented drugs and vaccines that are supposed to work just as well as the original formulation. In fact, India has become one of the world’s leading producers of generics and is a major source of vaccines and drugs for Africa. The issue with this solution is that the generics manufacturing industry is fraught with regulatory issues such as poor quality control and lack of oversight9. Africa is most starkly affected by these issues because manufacturers ship their lowest-quality drugs to the continent. Some of these products are completely counterfeit, with no active ingredients, while others have only a fraction of the active ingredients listed10. Without fixing quality control and oversight of generics manufacturing, this is not a viable long-term solution to provide vaccines to poor countries.

Another potential solution to increase vaccine coverage in Africa specifically would be to empower the continent to manufacture its own vaccines. Though Africa is home to nearly 17% of the world’s population, it produces less than 1% of the world’s vaccines and spends millions purchasing vaccines from foreign entities. For instance, African governments imported $900 million worth of basic vaccines for children in 201411. GAVI and UNICEF could partner with pharmaceutical companies to spearhead capacity building in specific African countries so they could produce their own vaccines, instead of making them dependent on vaccines from third parties. Apart from providing vaccines, this strategy would potentially build local biomedical capacity, provide jobs, and incentivize highly educated African expatriates to return to their home countries12.

Unfortunately, global vaccine stakeholders are hesitant to invest in building vaccine production capacity in Africa. For instance, profit-driven pharmaceutical companies tend to invest in healthy markets that will yield stable returns on their investments. Before investing in building a manufacturing facility, these companies must first ensure that the vaccines they produce will be bought for a certain price at a certain time12. Besides, It will be an uphill battle if Africa cannot produce vaccines more cheaply than other countries like India, which has already optimized infrastructure for producing vast quantities of vaccines cheaply13. Overall, there are many economic barriers that prevent Africa from developing its own vaccine manufacturing infrastructure.

In conclusion, the recent story revolving around providing rotavirus vaccine for West African countries exemplifies the complex challenges in supplying vaccines for the world, especially developing countries that contain some of the world’s most vulnerable populations. Despite the relatively vast resources that global organizations and companies like GAVI, Merck, GSK, and UNICEF have at their disposal, the demand for life-saving vaccines continues to outstrip the supply of vaccines. The bottom line is that vaccines are a vital component to the health of people and nations, and access to these medicines ought to be a universal human right.

  1. https://www.who.int/immunization/diseases/rotavirus/en/
  2. https://www.npr.org/sections/goatsandsoda/2018/11/01/655844287
  3. https://www.fiercepharma.com/pharma/amid-china-launch-merck-cites-supply-limits-plan-to-scale-down-rotateq-shipments-africa
  4. https://www.gavi.org/
  5. https://www.unicef.org/
  6. https://www.npr.org/sections/goatsandsoda/2019/05/31/726863111/it-looked-as-though-millions-of-babies-would-miss-out-on-a-lifesaving-vaccine
  7. https://www.who.int/immunization/programmes_systems/procurement/market/en/
  8. https://www.theatlantic.com/business/archive/2015/02/vaccines-are-profitable-so-what/385214/
  9. https://www.statnews.com/2019/07/22/indian-pharmaceutical-industry-drug-quality-charges/
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4105729/
  11. https://www.dw.com/en/africa-wants-to-manufacture-its-own-vaccines/a-46151389
  12. https://www.frontiersin.org/articles/10.3389/fpubh.2019.00056/full
  13. https://www.thehindu.com/sci-tech/health/trusting-the-science/article25861183.ece

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Written by sciencepolicyforall

August 7, 2019 at 2:45 pm