Domestic vaccine supply gap takes heavy toll
Policy on indigenous vaccine production lacking; most demand met through imports.
PHOTO: REUTERS
ISLAMABAD:
Vaccine supply issues in Pakistan are hitting hard in the absence of a comprehensive government policy on indigenous production.
Most public sector requirements are presently met through imports through multinational suppliers.
The National Institute of Health (NIH), despite its mandate to supply vaccines according to the needs of the country, is barely able to provide a fraction of national requirements.
Pakistan has recently made some advances in the field of technology and trained human resources, but indigenous vaccine production is still nominal.
According to an estimate, the country will have to spend around $600 million on the Extended Programme on Immunisation (EPI) and polio vaccination from 2016 to 2018.
In Pakistan, 80 per cent of the vaccine market is in the public sector. EPI vaccines worth Rs28 billion are required for the period from 2015 to 2020, whereas polio vaccines for the next three years would cost Rs30 billion.
“It is crucial to focus on indigenous production, but substantial investments are required for research and development and for production. Besides technical knowledge, technology transfer also presents great difficulties,” a source at NIH told The Express Tribune on the condition of anonymity.
At least 18 countries produce 51 different vaccines for their domestic requirements, but only a handful export and supply other countries.
Health experts have called vaccines important tools in disease prevention, while noting that ensuring affordable availability represents a challenge for health systems.
Multinational manufacturers which traditionally supplied a large proportion of vaccines to the EPI are now diverting their business to more profitable products.
The shift has created a void which is being filled by manufacturers from developing countries.
Over 60 per cent of BCG vaccines — used against tuberculosis — and over 80 per cent of all measles vaccines produced globally are manufactured in India and Indonesia.
These factors have great implications for policy makers in the country.
The 2005 earthquake exposed Pakistan’s vulnerability to critical requirements for lifesaving vaccinations such as anti-tetanus serum.
Vaccines can be produced in Pakistan either through shared manufacturing, ready-to-fill materials, concentrate, or from raw materials such as seed bacteria and seed viruses.
“The country currently produces enough snake antivenom and anti-allergens to meet its total requirements, while 70 to 80 per cent of rabies vaccine requirements are also met through indigenous production. For EPI, only five per cent of the requirement is produced locally,” NIH Biological Production Division chief Anwar Begum told The Express Tribune.
She said that a Rs497.7 million project under the Public Sector Development Programme was being implemented to enhance snake antivenom production capacity and that a high-tech laboratory, fully compliant with international standards and capable of meeting the county’s requirements, was under construction.
Demand is around 100,000 vials per year, she added.
The project would be completed by 2017, Begum said.
She said that the NIH was the sole producer of vaccines in the public sector.
However, there is a strong need to upgrade, improve and strengthen the old outdated manufacturing units in accordance with the current “good manufacturing practices” and “laboratory practices” as defined by the Federal Drug Rules and World Health Organisation (WHO), the official said.
Published in The Express Tribune, June 18th, 2016.
Vaccine supply issues in Pakistan are hitting hard in the absence of a comprehensive government policy on indigenous production.
Most public sector requirements are presently met through imports through multinational suppliers.
The National Institute of Health (NIH), despite its mandate to supply vaccines according to the needs of the country, is barely able to provide a fraction of national requirements.
Pakistan has recently made some advances in the field of technology and trained human resources, but indigenous vaccine production is still nominal.
According to an estimate, the country will have to spend around $600 million on the Extended Programme on Immunisation (EPI) and polio vaccination from 2016 to 2018.
In Pakistan, 80 per cent of the vaccine market is in the public sector. EPI vaccines worth Rs28 billion are required for the period from 2015 to 2020, whereas polio vaccines for the next three years would cost Rs30 billion.
“It is crucial to focus on indigenous production, but substantial investments are required for research and development and for production. Besides technical knowledge, technology transfer also presents great difficulties,” a source at NIH told The Express Tribune on the condition of anonymity.
At least 18 countries produce 51 different vaccines for their domestic requirements, but only a handful export and supply other countries.
Health experts have called vaccines important tools in disease prevention, while noting that ensuring affordable availability represents a challenge for health systems.
Multinational manufacturers which traditionally supplied a large proportion of vaccines to the EPI are now diverting their business to more profitable products.
The shift has created a void which is being filled by manufacturers from developing countries.
Over 60 per cent of BCG vaccines — used against tuberculosis — and over 80 per cent of all measles vaccines produced globally are manufactured in India and Indonesia.
These factors have great implications for policy makers in the country.
The 2005 earthquake exposed Pakistan’s vulnerability to critical requirements for lifesaving vaccinations such as anti-tetanus serum.
Vaccines can be produced in Pakistan either through shared manufacturing, ready-to-fill materials, concentrate, or from raw materials such as seed bacteria and seed viruses.
“The country currently produces enough snake antivenom and anti-allergens to meet its total requirements, while 70 to 80 per cent of rabies vaccine requirements are also met through indigenous production. For EPI, only five per cent of the requirement is produced locally,” NIH Biological Production Division chief Anwar Begum told The Express Tribune.
She said that a Rs497.7 million project under the Public Sector Development Programme was being implemented to enhance snake antivenom production capacity and that a high-tech laboratory, fully compliant with international standards and capable of meeting the county’s requirements, was under construction.
Demand is around 100,000 vials per year, she added.
The project would be completed by 2017, Begum said.
She said that the NIH was the sole producer of vaccines in the public sector.
However, there is a strong need to upgrade, improve and strengthen the old outdated manufacturing units in accordance with the current “good manufacturing practices” and “laboratory practices” as defined by the Federal Drug Rules and World Health Organisation (WHO), the official said.
Published in The Express Tribune, June 18th, 2016.