[health-vn] Poor may lose out in swine flu vaccine production
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Thu May 7 14:20:47 EST 2009
Poor may lose out in swine flu vaccine production
Katherine Nightingale and T. V. Padma
30 April 2009 | EN | 中文
Almost all of the world's vaccine production capacity is located in just nine
The ability of developing countries to combat a swine flu pandemic could be
undermined by the fact that most major vaccine producers are based in developed
countries — and likely to have commitments to meet the needs of the populations
in those countries, a leading development organisation has warned.
Sangeeta Shashikant, a researcher at the Third World Network, points out that
almost all of the world's vaccine production capacity is located in just nine
developed countries and that the governments of these countries will have
entered into advance purchase agreements with their vaccine producers, giving
them priority in the event of a pandemic.
"If [developing countries] don't have capacity [to produce vaccines] then
they'll have to rely on the goodwill of developed countries, as well as
companies," Shashikant told SciDev.Net.
UN secretary general Ban Ki-moon said at a press conference this week (27 April)
that developing countries are especially vulnerable to the swine flu outbreak
and need protection against it. "They have been hit hard by other crises this
year: food, energy, the global economy, climate change," he said. "We must
ensure that they are not also hit disproportionately hard by a potential health
Strains of the swine flu virus taken from infected people are already being used
in a handful of labs in developed countries to create a vaccine virus — a
version of the virus that contains the correct antigens against the swine flu
strain but is not dangerous to humans. The disabled virus will be sent to
manufacturers to grow the vaccine in eggs.
But the process is time-consuming. Even if the WHO requests manufacturers to
switch from seasonal to pandemic vaccine production — a step it has not yet
taken — it could be up to six months before a vaccine is available.
Vaccine manufacturers have already been donating their H5N1 pandemic flu
vaccines to a WHO stockpile. According to Tachi Yamada — executive director of
the global health programme at the Bill and Melinda Gates Foundation —
GlaxoSmithKline has donated 50 million doses and Sanofi 60 million doses, while
Novartis has also indicated that it would take part in the scheme.
But Yamada told SciDev.Net that "this is a whole new ballgame" because H5N1 was
not the main concern in the current pandemic.
"The vaccine manufacturers are all quite aware of their role and
responsibilities in reacting to this kind of crisis, and they're all very
interested in doing the right thing," he said. "They're just waiting for
instructions on what to do."
The utmost importance
Ravini Thenabadu, a spokesperson for the WHO, told SciDev.Net that the
organisation is currently in talks with vaccine manufacturers to assess their
production capacity and the percentage of their vaccine output that could go to
She described developing country access as being of "the utmost importance" to
the WHO, and said that the organisation would fight to ensure that developing
countries received sufficient supplies of the vaccine.
When a new virus emerges the WHO coordinates a set of procedures under which
virus samples are sent to WHO collaborating centres, and may then be sent on to
companies to make vaccines and drugs that the companies are permitted to patent.
In recent years, however, critics have claimed that this provides an unfair
opportunity to such companies to profit financially from vaccine sales.
Indonesia caused controversy in 2007 when it stopped sharing bird flu samples
until a benefit-sharing mechanism had been set up (see Indonesia stops sharing
bird flu samples).
Developing countries have already been in negotiations with the WHO about a
benefit-sharing procedure to ensure that when a pandemic virus originates in a
developing country, poorer countries are guaranteed access to any vaccine
developed against the virus in question.
Suggested mechanisms include setting aside a percentage of the vaccine for
developing countries to purchase at a reduced price, creating an emergency WHO
stockpile of the vaccine and placing a portion of vaccine manufacturers' profits
into a fund for developing countries.
Until a mechanism has been established poorer countries will be exposed to the
danger of inadequate or unaffordable supplies of vaccine
But no mechanism has yet been agreed upon — leaving poorer countries exposed to
the danger of inadequate or unaffordable supplies of vaccine, says Shashikant.
Nandula Raghuram, reader in biotechnology at the Indraprastha University in
Delhi, points out that although the avian flu case offers a good example of
international research collaboration, "that cooperation does not extend to a
more liberal policy on sharing of drugs and vaccines that emerge from such
"The licenses for production and mass manufacture are given to companies which
prefer to have exclusive manufacturing rights at such times," Raghuram told
Graham Dutfield, professor of international governance at the University of
Leeds, United Kingdom, suggests that there is a need to plan for such situations
in advance. "The private sector will almost certainly need to be involved but
[the challenge is] how to reconcile the profit motivation of firms, and the
likelihood of heavy patenting activity, with the need to get vaccines where they
are most needed," he says.
To many observers, the debate over the need to secure access to vaccines in the
case of a pandemic has highlighted the lack of research and vaccine production
facilities in the developing world.
Raghuram, for example, points out that the uneven capacity for vaccine
production between developed and developing countries is particularly noticeable
in the case of newly-emerged infections, such as avian or swine flu.
"In such cases, research on new vaccines involves international collaborative
efforts with the WHO, where often scientists from developing countries do not
participate," he says.
Shashikant blames the lack of participation on the lack of research capacity in
developing countries. "The aim should be to build [developing country] capacity
for them to be able to … analyse the virus sample and give information," she says.
"Each region should have some capacity to produce drugs or vaccines when there
is a situation such as this."
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