Drug Action Forum, a Karnataka-based voluntary organization has strongly criticized the Central government's decision to include hepatitis B vaccination in its Universal Vaccination Programme. The DAF has also warned against the administration of every new born child with hepatitis B vaccine.
According to DAF, there is no epidemiological basis to conclude that the incidence of hepatitis B infection is 4.7 per cent of the population. Quoting different studies, they point out that the epidemiological HBsAg carrier rate works out to be 1.42 per cent and hence no need for a Universal Strategy in India. Lack of resources has also been pointed out as a reason for not encouraging universal vaccination. DAF feels that to vaccinate all newborn with hepatitis B vaccine and to implement the same which would cost Rs. 1250 million annually for the hepatitis-B vaccine alone, at the rate of Rs 50 per new born for an estimated 25 million annual births in India.
"If this is compared with the budget in the year 2000-2001 of Rs 1250 million allotted by the Government of India for its National Tuberculosis Programme and Rs.1050 million for Malaria control. Tuberculosis & Malaria are obviously major killers in India," they point out.
DAF wants the centre to take up the Selective Vaccination Strategy, in which the pregnant women be screened for HBsAg and vaccinate such newborn only if mother is positive. They feel that the cost efficacy of this Selective Vaccination Strategy, (around Rupees 5227), is much greater, than Universal Vaccination Strategy, (around Rupees 9260) for protection from HBeAg (hepatitis B eantigen). They feel that to cover all the pregnant women and their newborn in a year, the total annual cost of the programme for Universal and Selective vaccination for a cohort of 10,000 would be Rupees 5,00,000 and Rupees 1,15,000 respectively.
The DAF also wanted the government to regulate the promotional materials of the vaccine manufacturers, which according to it, "have been misleading the common man". "We would like to bring to the notice that DAF-K has corresponded with Glaxo Smith Kline Pharmaceuticals (GSK) on the issue of a misleading advertisement of hepatitis B vaccine by the company. The company has not, however, complied with the request by correcting its advertisement. That should mean that only effective regulation on the part of the Government can stop this" states Dr Gopal Dabade of DAF.
DAF-Karnataka is bringing out an English booklet written by Dr Dabade titled "Hepatitis B Vaccine - Misleading policy & promotion" on March 28, 2004. A Kannada version of the book written by Dr SL Pawar & Sharada Gopal would also be released on the occasion, it is learnt.