doi:10.1038/nindia.2008.78 Published online 17 January 2008
The Indian government has admitted that the sub-continent's healthcare system suffers from the wide time gap between development of vaccines for third world pathogens and their delivery to the masses. India's science and technology minister Kapil Sibal was critical of this 'systemic anomaly' when he inaugurated a state-of-the-art vaccine centre at New Delhi's International Centre for Genetic Engineering and Biotechnology (ICGEB) on January 14.
"There is a problem of delivery… we can't reach the target population in time. Our systems are simply not in place," Sibal, known to be characteristically vocal about loopholes in the 'system' said. The minister pointed out that for the last 30 years, only one per cent of the global pharmaceutical products had been aimed at the developing world despite the fact that China and India make up for one third of the world's population.
"We are just at one end of the spectrum — that of developing a vaccine. Do we have the system to deliver and manufacture it? Do we have the wherewithal for capacity building to put the vaccines in the market?" he said questioning his own administrative machinery as he addressed an eminent group of virologists, geneticists and biotechnologists.
Governments in the developing world, including his own, must wake up to this reality, he said. At the same time, the newly-inaugurated ICGEB-Emory Vaccine Center, a joint effort of ICGEB and the Atlanta-based Emory Vaccine Center, should look at diseases of the poor rather than lifestyle diseases. "The idea is to have the best science at the lowest possible cost. We have seen it in the case of the Hepatitis-B vaccine. When we imported it, our people bought it for Rs 908. Now that we make it here, we get it for Rs 18. It works for us now!"
The idea is to have the best science at the lowest possible cost.
Timely delivery of vaccines could save thousands of lives, he said. "Latest WHO figures show that over 2.6 million lives were saved by vaccines since 2000. This is a huge number."
Another challenge, Sibal said, was to develop high quality human resource dedicated to vaccine development.
Rafi Ahmed of the Emory Vaccine Center and Virander Chauhan, Director of ICGEB, felt scientists from different geographical regions working in the project need to keep in mind that pathogens have no boundaries. "This project brings to the table common problems for scientists on how to alleviate the burden of infectious diseases in the developing world," Chauhan said. Ahmed was particularly concerned about the epidemics of dengue in India every few years. "This is a pathogen that requires some focus and intensive collaborative studies," he said.
Chetan Chitnis, head of the malaria group at ICGEB, told Nature India that his team was looking at phase-1 trials for a P.falciparum vaccine in collaboration with a Mumbai hospital. "It takes a lot of time. We will begin the trials very soon but we know for a fact that the final product won't be out before five years." Navin Khanna of the centre's mammalian biology group shared his views. "There are far too less people deployed for vaccine research in developing countries. That is a massive impediment"
The ICGEB-Emory Vaccine Centre is hoping to do basic research in molecular pathogenesis, immune responses, identification of vaccine candidates and immune correlates of protection. It will also conduct pre-clinical animal studies, phase-1 trials and at developing capacity to perform phase-2 and phase-3 trials of vaccines for HIV, hepatitis B and E, SARS, dengue, tuberculosis and malaria diseases prevalent in the subcontinent.