Indian Vaccines help curb cholera outbreak in Haiti and Africa

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Indian Vaccines help curb cholera outbreak in Haiti and Africa ​

Affordable option, easier to produce and transport

Cholera cases in Haiti, the Caribbean country in North America, were lower by 75 per cent in the first three months of 2014, as compared to the same period last year.

What helped curb the spread of the disease was an oral cholera vaccine, Shanchol, developed by Hyderabad-based Shantha Biotechnics, among other medications.

Given the promising results in Haiti, the idea of using cholera vaccines to counter the menace has received a boost. For some time now, health officials have been hesitant to embrace the new cholera vaccine in outbreak situations.

Recent trials
“The vaccines are considered too expensive. Health workers are of the opinion that it could require multiple doses.

“There is the logistics barrier, as also the belief that it provides limited protection.

“However, the recent vaccine trials have suggested that the campaigns are worth considering,” said an official at the Delhi office of Medecins Sans Frontieres (MSF), an international medical humanitarian organisation.

MSF set out to test the short-term effectiveness of two doses of Shanchol, made by Shantha Biotechnics, a subsidiary of Sanofi, for the first time in the Haiti outbreak.

The only World Health Organisation pre-qualified oral cholera vaccine is the double dose Swedish vaccine called Dukoral, which was also used.

Affordable option

The MSF official said the agency was tracking Shanchol's performance, “since it is much cheaper and has a low storage volume, which are important factors to make it easier to deploy across a wide area during a similar outbreak.”

He added that the World Health Organisation was stockpiling Shanchol for use in emergencies, “because it is a more affordable option, and is easier to produce and transport.”

Successful campaign

Early last year, Haiti started vaccinating its population with the vaccine made in India.

The first phase of the campaign targeted 50,000 people in Port-au-Prince, while another 50,000 were vaccinated in the Artibonite River valley.

A Boston-based non-government organisation, Partners in Health, had bought 2 lakh doses from Shantha Biotechnics.

Vaccine from India helps curb cholera cases in Haiti | Business Line
Vaccine from India helps curb cholera cases in Haiti

Indian vaccines cost less than half of its western alternatives! ​

The study was done by Epicentre, the research arm of Doctors Without Borders, and the Health Ministry of Guinea, during a large 2012 outbreak there. More than 316,000 doses were given out, and about 75 percent of the residents of cholera-affected areas got two doses, which is good coverage for an outbreak already underway.

Two vaccines have been stockpiled by the World Health Organization since 2013. But the older vaccine, Dukoral, made by a subsidiary of Johnson & Johnson, was invented mostly for the wealthy travel market.

Dukoral costs over $5 a dose and must be given with a glass of alkaline soda as a buffer against stomach acid. Carrying soda and clean cups slows vaccinators down.

Shanchol, which costs less than $2, comes in a vial smaller than an energy shot. It was developed with support from the Bill and Melinda Gates Foundation, and its maker, Shantha Biotechnics, has said that large orders could push the price below $1 a dose.

http://www.nytimes.com/2014/06/24/science/cholera-vaccine-africa.html?_r=0

 

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Indian firms among emerging world's vaccine heroes: Bill Gates

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Billionaire philanthropist Bill Gates has showered rich praise on companies from emerging nations, including India, for donning the role of 'hidden vaccine heroes' and driving down their cost to about $1 per dose in the global fight to protect kids from deadly diseases.

Gates , who is to attend the World Economic Forum 's Annual Meeting, on Tuesday said there is reason to be optimistic than ever about the future progress using vaccines to give all children a healthy start to life.

"You have probably never heard of many of the pharmaceutical companies-Serum Institute of India, Bharat Biotech, Biological E, China National Biotec Group, and Bio-Manguinhos, to name just a few-that have become some of our most valuable partners in global health," Gates said in WEF blog.

"By harnessing the same innovative spirit that transformed emerging markets into manufacturing hubs for everything... these companies have become leaders in supplying the world with high quality, low-cost vaccines," he noted.

Gates, the founder of Microsoft, is co-chair of the Bill and Melinda Gates Foundation.

The increased competition and new manufacturing approaches created by these firms have made it possible to protect a child against eight major diseases. These include tetanus, polio and tuberculosis.

According to Gates, Serum Institute produces a higher volume of vaccines than any other company in the world and has played a key role in cutting costs and boosting volumes.

The philanthropist mentioned about the progress with the life-saving pentavalent vaccine, which protects a child against diphtheria, tetanus, whooping cough, hepatitis B, and haemophilus influenza type b (Hib) all in one dose.

"When the GAVI Alliance first introduced it in 2001, there was one supplier and the cost was $3.50 per dose.

"As demand for the vaccine grew, GAVI encouraged other suppliers to enter the market, and the price tumbled. Now there are five suppliers, and Biological E, an Indian pharmaceutical company, announced earlier this year that it would offer the vaccine for just $1.19 per dose," he said.

Referring to various initiatives in emerging markets including India, Brazil and China, Gates said that India's Department of Biotechnology and Bharat Biotech announced plans this year to release a new vaccine against rotavirus which kills hundreds of thousands of children for $1 per dose.

Despite all the progress, more must be done to target the 22 million children, mainly in the poorest countries, who do not have access to lifesaving vaccines, Gates said.

Indian firms among emerging world's vaccine heroes: Bill Gates - Business Today

 

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India Develops Inexpensive Vaccine for Battle With Cholera
SEAN MCLAIN

A suspected cholera patient at a hospital in the eastern village of Tikiri, Orissa, during a 2007 outbreak of cholera in the state.
Agence France-Presse/Getty Images​

• Merck MRK -0.24% & Co. and the Wellcome Trust charity — said Tuesday that it has created an inexpensive vaccine that can survive without refrigeration in the far-flung tropical villages where it is most needed.
  
  Cholera kills over a hundred thousand people, mostly young children, and infects millions every year.
  
  “Cholera is a huge public health burden,” said Hilleman Chief Executive Davinder Gill. “The disease is endemic in over 50 countries across the world but it especially huge in the subcontinent and especially in the Bengal delta.”
  
  The vaccine is a dry power, capable of surviving temperatures of 45 degrees Celsius and is produced in a way which dramatically reduces the cost of manufacturing. One dose of the vaccine should eventually cost “significantly less than one U.S. dollar,” Mr. Gill said. He hopes to start clinical trials next year.
  
  Cholera infections are caused by drinking water infected with the bacteria. If left untreated, cholera bacteria cause severe diarrhea, dehydration and sometimes death. Diarrhea kills 800,000 children under the age of five every year, according to Unicef. Aquarter of those deaths are in India.
  
  While there are already other vaccines to ward off the bacterial infection, they are often in short supply and poorly suited for use in impoverished areas of the world where the disease is most prevalent.
  
  The two vaccines used today, Dukoral and Shanchol, are not widely enough used to be effective in helping eradicate the disease.
  
  Dukoral is too expensive for most poor countries, costing between $4 and $9 per dose, according to data from the World Health Organization. It is complicated to deliver, requiring a large amount of water, a problem in cholera-stricken areas with limited access to clean water. The vaccine also has to be refrigerated or it ceases to be effective after a few weeks in storage.
  
  Shanchol costs around $1.85 a dose, according to WHO data, but it also requires refrigeration.
  
  The need for a cold storage chain makes these vaccines less than ideal to fight cholera outbreaks, which usually follow natural disasters like the 2010 earthquake in Haiti. Because of the prices and need for refrigeration, demand for the vaccines has been limited considering the global size of the problem.
  
  “All of us in public health said we needed a cholera vaccine, but until (the companies) actually see the orders it was kind of a vicious circle of low demand leading to low supply,” said David Sack, a professor at Johns Hopkins Bloomberg School of Public Health who has been studying how to fight cholera since 1975.
  
  The maker of Shanchol, pharmaceutical giant Sanofi SA, said that while it is working on creating a dedicated manufacturing facility for its vaccine, the demand from cholera-affected countries remains limited.
  
  To have a chance at eradicating cholera, the world needs around 100 million doses of a cholera vaccine at around 50 cents a dose, said Dr. Sack.
  
  “Now, we have three million doses at the cost of $1.85 per dose — and currently we need two doses,” he said. “It’s a problem.”
  Indian Firm Develops Inexpensive Vaccine for Battle With Cholera - India Real Time - WSJ