Author: Jacob M Puliyel, M.D.
Head of Paediatrics
St Stephens HospitalDelhi, India
Date: 10 July 2007
I was quoted in the Hib vaccine news story from 4 July (see Hib vaccine could save thousands in Asia), but perhaps due to constraints of column space, I feel justice was not done to what I said.
My main argument against the research findings from Bangladesh is
not that it does not make economic sense, but that the study is
seriously flawed. The visible enthusiasm of the sponsors of the study
must not be allowed to cloud scientific objectivity.
In the study, cases of pneumonia were compared with a control group without pneumonia.
Because more children in the control group received the Hib vaccine,
the researchers considered the vaccine to prevent pneumonia.
But closer reading of the paper suggests that the Hib vaccination status in the control children was only coincidental.
The control children were significantly richer, lived in better
houses and their mothers were better educated. With their greater
affluence, more children in the control group probably wore branded
T-shirts, but we would not expect Nike or Reebok to suggest that
wearing their apparel is protective against pneumonia.
Where starvation and cholera kill thousands of children each year,
international agencies such as the GAVI Alliance, USAID and the WHO are
busy spending millions on dubious research to emphasise the harm from a
disease that local doctors hardly ever come across. All this so that
vaccine manufacturers can fill their coffers. This situation can only
be described as scandalous.
It is unfortunate that five resource poor countries ― Afghanistan,
Bangladesh, Bhutan, Pakistan and Sri Lanka ― have been persuaded to
undertake the expensive intervention on the basis of flawed research. Lois
Privor-Dumm says in your report that Bangladesh is eligible for funding
for the Hib vaccine from the GAVI Alliance, so they will only have to
pay 20 US cents per dose instead of US$5.60 per dose. He failed to
mention that there is no long-term assurance of continued GAVI funding,
or that funding will be withdrawn soon after universal vaccination
becomes government policy.