Chapter 12PREVENTION BETTER THAN CURE?ISSUES OF CONCERN IN THE PRICING AND MARKETING OF VACCINESIN INDIA
- Anurag Bhargava, Yogesh Jain
Microbes are nothing... the terrain everything.--Louis Pasteur
How do you foresee the future of the drug industry?
Drug industries can grow in India faster than anywhereelse because of the sheer number of patients here.We can't be proud of this, but that's a fact.
–An interview with Dr. Anji Reddy of Dr. Reddy’s Laboratories in the
India offers good ‘growth’ prospects for the pharmaceutical industry because of the sheer number of patients – the largest number of patients with TB in the world, the secondlargest number of HIV infected, and a total number of patients with diabetes andhypertension which would be bigger than the population of many large European nations.When it comes to the question of vaccines, the ‘prospects’ are even better. Drugs aremeant for the diseased only to be used when they fall sick, but vaccines are for thehealthy who can be injected anytime. With a population of one billion, India offers a verylarge market for those in the business of making vaccines.
Vaccines are one of the key public health interventions for prevention of disease.Traditionally they have been developed and used for those diseases that are lifethreatening, or cause significant disease in a large number of people, or are notpreventable easily by specific public health interventions in the absence of significantimprovements in socio-economic indicators. Thus the classical vaccines against smallpoxtetanus, diphtheria, poliomyelitis, pertussis, measles, etc., could achieve if implementeduniversally the eradication or control of these diseases, even without significantimprovements in the socio-economic status of the societies that they were used in. Lately there has been the development and promotion of vaccines against diseases thatare not necessarily life threatening may not affect large numbers of people andimportantly could be controlled effectively by public health intervention, which arefeasible, and cost effective. The vaccine against chicken pox and the vaccine againsthepatitis A are cases in point. These vaccines do fulfill needs of particular individuals,and patients, and thereby represent an advance in medicine. However they cannot be saidto be tools of public health, because in the former instance chicken pox with its benigncourse is not a public health problem, while in the case of hepatitis A, a more cost-effective measure would be provision of safe drinking water.