SUSTAINABLE HEALTH CARE THROUGH VACCINATION (I)

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From Smallpox to Measles to Polio and other health threats, vaccines have proven to stand out as the most reliable solutions to deadly diseases. Since the 1796 breakthrough for Smallpox, courtesy of Edward Jenner, the world has always sought the development of vaccines as the ‘saviour’ of human kind against stubborn public health threats.

 

Despite the fact that vaccines have helped to prevent the outburst of once dreaded diseases, the long search for suitable vaccines to immune against some staunch diseases, especially the Human Immune Deficiency Virus (HIV) reveals that huge difficulties abound in developing effective vaccines. Between 2014 and 2016, the outbreaks of Ebola Virus Disease, Lassa Virus disease, and the recent Zika Virus Disease have drastically increased the need for effective vaccines to prevent lingering public diseases. This has in turn driven several researchers to a tireless search for potent vaccines.

 

Until January 2016 when Liberia was declared Ebola free and all chains of transmission were confirmed ended in Africa, no official vaccine had been presented. Likewise, the search for effective vaccines to Lassa lingers in the world of public health especially in Nigeria, where it recently broke out. The same goes for Zika, with all the efforts experienced researchers are channeling into getting a potent vaccine, no breakthrough has been made yet. The disturbing yet obvious fact is that, it could take years before effective vaccines will be available for these diseases. The danger these delays pose is the potential for it to become increasingly difficult to discover vaccines for diseases such as Ebola and Lassa as they become less ravaging.

Presently, there are less discussions unlike in the past; getting victims and survivors to conduct trials for potential vaccine will likely become difficult as vaccine discovery becomes prolonged just as sustaining health care especially in a vulnerable continent such as Africa will remain threatened if something is not done urgently to avoid a reoccurrence of these outbreaks or an outburst of new diseases.

 

Vaccines strengthen the immune system against potential viruses in vulnerable environments; they are the most effective weapons against public health threats. Immunizing dwellers of a susceptible community prevents an outburst even when such diseases surface however, the present worry is, why has it been difficult to sustain vaccine development, especially in Africa?

 

Several factors affect the development and presentation of potent vaccines yet, for a vaccine to be acceptable, certain criteria have to be fulfilled including;

  • Overtime effectiveness, even after the disease has become rare;
  • Sustained availability;
  • Achievement of wide spread use.

Apart from scientific reasons such as variability, lack of ideal animal model, retrovirus nature of virus, as in the case of HIV (status of HIV Vaccine Research and Development, Koff W. 2014), several non-scientific but avoidable challenges are associated with developing timely and acceptable vaccines, which if tackled, vaccine innovation and production can be fast-tracked:

 

Funding: Although vaccines are highly cost effective, the processes involved in vaccine production require huge investments; from the research stages to administering stages yet, it offers low return on investment. To develop a single vaccine could require up to one billion dollars and because of this, only few affluent companies possess what it takes to invest in vaccine production although there are several independent start-up companies and individuals who may have good ideas. Currently, only four (4) pharmaceutical companies (GlaxoSmithKline (GSK), Merck, Pfizer, and Sanofi Paseur) officially concentrate on vaccine development. Despite the vulnerability of Africa to diseases and the recent public health outbreaks, no African company can boast of solely producing an internationally acceptable vaccine.

 

African countries rarely invest hugely in health, making health projects highly underfunded in comparison to developed regions of the world.  World Health Organization (WHO) reports that as at 2010, the average total health expenditure in African countries stood at $135 per capita which is only a small fraction of the 3,150 spent on health in an average high income country (The Africa Health Monitor, 2013), the situation has not considerably improved till now. Although African countries mostly rely on private donors, yet these donations are not consistent and cannot be sufficient in making up for the needed funding for vaccine productions.

 

  • Weak preparation and response to current and emerging diseases:Over the years, Africans have proven to be naturally unprepared for eventualities although vulnerable to several. Just as countries on the continent are somewhat lackadaisical about a lot of sectors; education, natural disasters, they also lag behind in responding to health challenges. One of the reasons for the wild spread of the Ebola virus was the lack of quick response; for instance, it was over 3months before the cause was identified in Guinea. Furthermore, there are no well-managed centres for managing special diseases in many countries in Africa, which brings to the fore the dearth of response resources in the region. Whereas developed countries tend to prepare for unforeseen diseases through research, infrastructural placements, and funding, African nations usually wait till they are hit before they act.

 

  • Lack of research infrastructure, required skills and new technology: One of the major challenges to development in most African countries is the lack of adequate infrastructure. Health facilities are insufficient in most cases while scientific research facilities are also a challenge to developing vaccines. WHO confirms that the greatest obstacles to vaccine productions in less developed nations are the lack of sufficient finance, poor infrastructure and insufficient technical expertise. State of the art facilities have no doubt been instrumental to the discoveries of a few scientific discoveries including existing vaccines. Lots of the time, specifically built facilities are required for the production of vaccines before such vaccines can be licensed.

 

It is also important to note that developing vaccines can be complex and does not come easy; getting breakthroughs in any discovery can only be achieved through advanced technology. As diseases emerge, new technologies are also required to attend to these diseases. Therefore, a continent as Africa with less sophisticated technological advancement, especially new technologies, is at a disadvantage in developing viable vaccines. Moreover, delicate research such as vaccine production often require special skills, expertise and the combination of multi-disciplinary teams, which are lacking in the African region. Africa faces shortage of trained health personnel; the same is the case for medical researchers.

 

  • Intellectual Property Protection /Litigation issues:One of the reasons there are few actors in the vaccine manufacturing industry is that the industry is highly regulated because contents of vaccines are usually protected by different intellectual property rights. Moreover, Patent filing is usually daunting, even in developed nations and awareness/information on patenting and licensing are usually few or unavailable in developing countries. These processes can be discouraging for budding manufacturers; a challenge of intellectual property is what prospective manufacturers, especially Africans will not likely want to engage in.

 

To be Continued next week…

 

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