Several public interest groups in India have asked the World Health Organisation (WHO) to re-examine the way recommendations for introducing vaccines for national immunisation programmes all over the world are arrived at by the WHO.

Expressing doubt over the world body's recommendation to include pneumococcal vaccine for preventing pneumonia in children in the national immunization programmes, the All India Drug Action Network (AIDAN) in a letter to WHO Director-General Dr Margaret Chan said, "The WHO recommendations seem dictated by needs of increasing demand for vaccines and profits for manufacturers rather than the needs of public health." AIDAN's criticism comes in the wake of the finding that "for every four children in whom pneumonia is prevented, two children develop asthma because of the vaccine."

"We earnestly appeal to you to re-examine how recommendations are arrived at by the WHO or else repeated exposures of this nature will erode the very credibility of the WHO. AIDAN and its members restate its demand that it should review its stand on the wrong advice given towards the vaccine in question," AIDAN said. AIDAN is a network of several NGOs working to increase access and improve the rational use of essential medicine.

For some time, AIDAN and its members including the Drug Action Forum -Karnataka have been expressing concern to the WHO in this regard. After repeated reminders, the WHO replied, "We think that the introduction of pneumococcal vaccines, where merited by evidence of the disease burden, would be of tremendous benefit, saving many lives, particularly of children. WHO stands ready to assist its Member States to assess the need for the use of specific new vaccines, to aid in decision-making, prioritization and introduction, and to work on solutions for financing them. We look forward to creating a world where no person should die of a vaccine-preventable disease and to cooperating with countries and partners to realize this goal."

Finding fault with the WHO reply, AIDAN said, "AIDAN has reservations about the first sentence of this statement because a letter published in the Lancet (July 2 to 8) points out how this policy in effect siphons off money to vaccine manufacturers; the funds that are actually donated for the MDG without commensurate benefit for the children. For the pneumococcal vaccine the letter suggests that $250,000 will be spent to prevent four children getting pneumonia. Instead the four cases could have been treated by WHO protocol for $1 each."

AIDAN also cited that the journal, Vaccine, of 9 July 2009 (Mathew JL Pneumococcal vaccination in developing countries: Where does science end and commerce begin? Vaccine 27 (2009) 4247-4251) has also published a scathing indictment of the WHO recommendation on the pneumococcal vaccine and what WHO considers 'evidence of the disease burden' enough to merit vaccination.