Sreelatha Menon: Wrong dose

Under influence of big drug firms, India will have immunisation for diseases with low prevalence

Under the influence of big drug firms, India seems to be embarking on immunisation for diseases whose prevalance here is almost negligible.

This week, Unicef released another report giving a grim reminder of over a million neo-natal deaths in the country and more than half-a-million mothers dying at child birth.

This raises the question if the immunisation programme in the country is designed to stop these deaths or if it is the result of the push of drug companies wanting to sell their vaccines.

This month, Bangladesh introduced the Hib vaccine against Haemophilus influenzae type b bacteria as part of universal immunisation. India is to follow suit.

Hib pneumonia kills 70,000 children in India, according to estimates by funding agencies and associates. The World Health Organisation (WHO) says there is no local surveillance data available and that should not delay the vaccine. But a WHO-sponsored study, conducted in Vellore, showed that the bacteria was hard to find in the country. The report was published last year, ten years after the study was conducted.

In the study, done for over two years at a cost of millions of rupees, only seven children per 100,000 were found having the bacteria. But the government is still going ahead with the vaccine with pressure from the WHO and funds being made available by the Global Alliance on Vaccines and Immunisation (GAVI), which is a partnership of NGOs like Gates Foundation, UN bodies, vaccine companies and research agencies. Both in case of Bangladesh and Nepal, the governments have been bailed out by GAVI grants.

One of the whistle-blowers in the case has been Dr Jacob Puliyel, head of paediatrics at St Stephen’s Hospital in New Delhi, who says the figures on Hib deaths are rubbish and the disease is not prevalent in the country.

He says his studies have showed the occurrence of the bacteria to be as rare as seven in 100,000 children, something confirmed by the WHO study, he says. But they did not publish the report till last year and that too after much hue and cry.

His findings, published in peer-reviewed journals, have been that the Indian children are protected by E coli in the body. He says the WHO is now using a study done in Bangladesh to push the vaccine. But Puliyel has punched holes in that also by arguing that the children in the study belonged to well-to-do families.

He says in countries where children are dying of hunger and poverty, GAVI and WHO are busy funding research to establish harm caused by diseases which local doctors scarcely come across. South Asian countries like Bangladesh, Nepal, Sri Lanka, and now India, have been persuaded to accept the grant of GAVI so that they only have to pay 20 US cents per dose instead of $5.60. There is no assurance that the grant will continue forever.

The government has already accepted the grant. While there is no fear of side effects, the loss is mainly economic. It will entail an annual commitment for 75 million doses to 25 million children and with no assurance of grant continuing after two years, the government will be saddled with bills worth millions, said Puliyel.

Which raises the question as to what can save the babies if immunisation is not supported by scientific data.

Unicef, a partner of GAVI, provides answers in its latest report: Education and nutrition alone can ensure healthy babies in India, where annually, six million are born with low weight, putting their survival at risk.