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Vaccines Summit 2020: Bringing to widespread public use latest technologies and innovations in vaccines and immunization: a point of view from a developing country, Mozambique- Helder Fernando Brigido Martins- Public Health Planning and Management, Uganda Helder Fernando Brígido Martins Public Health Planning and Management, Uganda
Despite the generalized consensus that most effective technologies are useless if not widely used, between the discovery of the various effective vaccines and their widespread use it has always elapsed a long time. The discovery of vaccines has led to the near eradication of several important diseases and has had a tremendous impact on health for a relatively low cost. However, most vaccines in use today were developed by techniques that were pioneered more than 100 years ago and do not represent the full potential of the field. The introduction of genetic engineering has fueled rapid advances in vaccine technology and is now leading to the entry of new products in the marketplace. In the past, options for the utilization of vaccines in the area of managed care had been quite limited because of the historically straightforward application of immunizations. The growing number and type of vaccine targets, coupled with novel, more effective formulations, adjuvants, and routes of delivery for vaccines, will undoubtedly create new challenges. Although progress in vaccine technology has the potential to prevent illness and reduce the economic burden of diseases in the long term, thereby improving outcomes, ongoing problems remain in the short term In the past, among others, two main factors have justified this long gap of time: widespread use of vaccines implies a complex managerial and logistic delivery system; and the introduction of new vaccines imply costs. Money is not always available, particularly in developing countries. In 1974, the EPI program approved by WHO and recommended to be implemented all over the world, was a gigantic step forward to create the managerial and logistic system to deliver vaccines. At same time, a new era of vaccine promotion started, to raise conscience of vaccines as one of the most cost/effective measures in public health. However, even after the EPI was widely adopted all over the world, there has been always a considerable period, between the discovery of new vaccines and their introduction in EPI national programs. In recent years, a lot of progress had been made in vaccine research and development and a great number of new vaccines were approved for public use and some are still on the pipeline. However, the time between the approval of a vaccine for public use and its effective widespread use is still much more than the desirable and there still are a lot of underutilized vaccines. To complicate the situation, in the last 10 to 20 years, an unexplainable anti-vaccine lobby has been very active, involving many Medical Doctors, to discourage the general public to use vaccines. On the other side, the paradigm of the original EPI program was based on vaccines for children and women in the fertile age. This was understandable, because, at the time, the important task was to address priority problems. In the last 20 to 30 years, the conscience of the health professionals has moved to realize that there are also very useful and effective vaccines for teenagers, elderly people and adults that should not remain underutilized. Consequently, the EPI paradigm has changed, to include a much bigger number of vaccines. With well-established EPI Programs in almost all countries of the world, the managerial and logistic delivery system problems are solved (or at least, they are not very constringent any more) and the financial constraints to bring to widespread public use an increasing number of vaccines became the main issue, but not the only one. While recognizing that the HHS activities described throughout this report are only one pillar of the USG efforts to strengthen global immunization programs and reduce the global burden of VPDs, the NVAC believes HHS has a vital role to play in the global efforts to make the Decade of Vaccines vision a reality. The recommendations and supporting rationale are intended to raise awareness of ongoing HHS efforts in the context of broader global initiatives, to build political and public support around these activities, and to ensure that these efforts will enhance USG efforts to continue to move the global immunization agenda forward. In turn, the recommendations and efforts outlined in the NVAC report will help better communicate HHS's accomplishments and resource gaps to decision makers and the public. The recommendations should serve as a potential roadmap for better coordination and tracking of HHS global immunization efforts. The continued participation of HHS in the six priority areas identified by NVAC will make certain that global immunization remains at the forefront of HHS global health priorities Therefore, nowadays, the great challenge is how to reduce the time gap between the approval of a vaccine for public use and its effective widespread use. In this paper, the author uses his wide technical and managerial skills and experience to present suggestion on how to minimize this problem.
This work is partly presented at 32nd International Conference on Vaccines and Immunization March 21-22, 2020 held at Rome, Italy