By investing in vaccine development, India can create lasting health and economic benefits for its citizens. In fact, vaccines are one of the most cost-effective public health interventions.
By Virander Singh Chauhan
The last two months have seen a constant and disturbing flow of news from the Democratic Republic of the Congo about the resurgence of Ebola. The current outbreak, which has now been declared a public health emergency of international concern, has already claimed nearly 2,500 lives. The situation has captured worldwide attention, with public health experts, scientists and health workers racing to contain the disease.
A serious and highly contagious virus, Ebola is fatal for approximately half of the people it infects. While experts worry that the worst is yet to come, the current outbreak still pales in comparison to the 2014-16 epidemic, which spread to 10 countries—including four outside of Africa—and resulted in over 28,000 suspected cases and 11,000 deaths.
Luckily, healthcare responders today have a tool that may help prevent outbreaks of such magnitude in the future: an investigational Ebola vaccine. Although Ebola vaccines have been in development for several years, during the 2014-16 crisis, in an unprecedented move, the World Health Organisation (WHO) and partners began using the vaccine in clinical trials in the most affected areas in West Africa.
Now, this yet-to-be-licensed vaccine is being put to work once again—this time, to provide protection to a larger group, including thousands of healthcare workers. This is a huge achievement and the results are promising, with preliminary research finding that the candidate vaccine is safe and highly efficacious, and that the innovative vaccination approaches used in the trial were effective in helping prevent further spread. The Ebola crisis has also inspired the creation of important multi-partner initiatives, such as the Coalition for Epidemic Preparedness Innovations, a global alliance dedicated to developing vaccines against emerging infectious diseases.
But there is a lesson here. Immunisation is a powerful tool, with tremendous potential to help us prevent illness and death from emerging infections and common killers alike. Investing in and accelerating vaccine development during an outbreak is not enough. We must consistently prioritise developing, licensing and introducing vaccines, and ensure they reach those who need them the most. This is especially true of a country like India, which has a high burden of infectious diseases that can spread rapidly given the density of population.
By investing in vaccine development, India can create lasting health and economic benefits for its citizens. In fact, vaccines are one of the most cost-effective public health interventions. A 2016 study of 94 lower-income countries found that, for every dollar invested in vaccination, more than 16 dollars are expected to be saved in healthcare costs, lost wages and lost productivity due to illness and death.
Already, there is a significant and exciting progress to develop indigenous vaccines. India is home to mature and successful vaccine production companies, highly respected worldwide. Many vaccines in India’s Universal Immunisation Programme (UIP) are manufactured by Indian companies.
Over the last two years, three vaccines produced in India received the WHO’s prequalification—two rotavirus vaccines currently used in India’s UIP, and the world’s first typhoid conjugate vaccine. In fact, there are many vaccine candidates in the pipeline for other serious, but often deprioritised, diseases such as Zika virus, Nipah virus and malaria.
Of course, developing vaccines is not enough—we also need to ensure that they reach the people who need them the most. India’s UIP—the largest programme of its kind in the world—aims to reach more than 25 million infants with vaccines against 12 important diseases each year. Since its launch in 2014, the government’s immunisation scheme, Mission Indradhanush, has vaccinated over 33 million children across the country. Additionally, the government and its partners have developed innovations to help reach every child, such as the Electronic Vaccine Intelligence Network (eVIN), which provides real-time information on vaccine stocks in 371 districts.
Progress has continued with the introduction of pneumococcal conjugate vaccine (PCV) to help prevent a leading cause of pneumonia. One recent study estimates that PCV introduction has the potential to prevent more than 2 million hospitalisations, 400,000 deaths, and $50 million in healthcare costs in just 10 years. However, ensuring that this critical vaccine reaches every child will require enhanced funding commitments by the government.
Vaccine research and development, introduction and scale-up requires considerable time, government prioritisation, investment and multi-sectoral partnerships. Above all, it requires a sense of urgency. We cannot afford to wait for the next crisis to invest in vaccine development now. We must learn from Ebola and invest early and often in getting promising vaccine candidates through clinical trials and ready for use in communities, and in scaling up access to existing vaccines like PCV and rotavirus vaccine to ensure that they reach those who need them the most. Only if we invest the time and effort today, can we ensure healthy lives for generations to come.
(The author, a Padma Shri, is a genetic engineer and academic who has been instrumental in developing a vaccine for malaria)