jeudi 30 avril 2009
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POST 01424E: INTRODUCE NEW VACCINES BUT WHAT ABOUT ACCESSIBILITY TO OLDER ESSENTIAL VACCINES? 30 APRIL 2009 ****************************************** Dear Moderator, I saw the mail for RFP for newer vaccines but what about accessibility to older essential vaccines in the developing countries. Countries like Bangladesh are still using the nerve tissue vaccine (NTV) instead of CCV for rabies prophylaxis. Is there some plan for that also and also to enhance the access to BCG, DPT, Measles and MMR, etc.? Even in India the coverage for EPI is only 50%, but many are bent upon the introduction of newer vaccines. Thanks and regards, Omesh Bharti M.B.B.S., D.H.M., M.A.E. (Epidemiology) Directorate of Health Services Himachal Pradesh, Shimla
il y a environ 14 ans
·
#1396
In regards to Post 01424E, it should be not be an 'either/or' but rather how to "introduce new vaccines while ensuring and sustaining availability and financing of older essential vaccines as well as the new vaccines". For many countries, the challenge is twofold: - to increase or sustain financing for current vaccines within their health budgets and - to advocate and ensure long-term financing for the more expensive, newer vaccines (and program operational and cold chain costs), particularly as GAVI funds phase out. Considerations need to include burden of disease, cost saving and benefit analysis, storage capacity and needs, strength of the current system for ensuring high routine coverage every year, program and operational needs, and sustained financing for vaccines, transport, cold chain, fuel, etc. This was recently discussed at the East and Southern Africa Regional EPI Managers' Meeting in Mombasa, Kenya in March. The attached presentation may be a useful reference for adaptation by countries on how to communicate and advocate for new vaccines. Thanks and best regards, Lora ________ ##text##
il y a environ 14 ans
·
#1399
Dear Sir, It was nice to get responses from those who are to take decisions regarding the vaccine policy of India . I still fear that we at the decision level need to work more to make vaccines accessible like posting more health workers, making their service conditions better and so on. In India half of the sub centres do not have staff; then who is going to vaccinate? Further, one fourth of them are located at a distance of more than 10 km from the nearest habitation. Who would go (all this distance) to get vaccinated? These are the issues that need solution. Also diseases like Rabies kill more than 20,000 patients every year in India , most of them school-going kids, but we do not have free antirabies vaccine/serum available in the hospitals, for want of money. How to save these children is a question? There have been many studies by the national institute of epidemiology Chennai and other public health institutes on why people do not get their children vaccinated, and we need to thoroughly go through the reasons and ensure a Functional Vaccine Delivery Mechanism (FVDM) as such , so that even if we wish to introduce a new vaccine it is well utilized. Another problem is that the states like Himachal, that had very high coverage have actually gone down after the introduction of a new vaccine Hepatitis-B. So introducing newer vaccines where coverage is good is not a universal recipe to follow. The biggest fallacy is that we do cost effective estimates keeping in view the 80% utilization of the vaccine but we do not reach a half mark in actual practice because we donot have a FVDM. FVDM may need functional sub-centre with full staff, cold chain and less distance of the sub centre besides a mechanism to keep mothers reminded of the next due date. Thanks and regards, Dr Omesh Bharti. M.B.B.S.,D.H.M.,M.A.E.(Epidemiology) Directorate of Health Services, Himachal Pradesh, Shimla, +91 9418120302 [email protected], [email protected] ________
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