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Opinion

In favor of a national vaccination plan

Brazil should contribute more actively to develop immunization

Vaccines have been recognized for a long time as one of the measures of greatest cost/benefit in health. Thus, the advantage of their development no longer needs any justification. After the fundamental discovery of Pasteur, various vaccines against numerous pathogens were developed, mainly those against bacteria and viruses. After a long period of sparse appearance of new vaccines, there has recently been a new period of growth in the area. This resurgence is due, among other factors, to the development of technology and to an increase in the understanding of pathogenesis.

The greater part of the basic understanding that triggered this advance took place in the public sector, universities and institutes. However, the process of vaccine development that gets to the public has been carried out by the pharmaceutical industry. This aspect restricts the spectrum of new vaccines available, since it is limited by the characteristics of the market and the possibility of financial return on the investment done. Recently, the Institute of Medicine in the United States, carried out a survey on the priority of vaccines for North Americans during the 21st century. The choice took into consideration the illnesses that would be primarily of domestic importance.

In1985, the developed countries made use of, as routine manner, seven vaccines in their immunization schemes, while the developing countries used six. During the year 2000, the poorer countries started to make use of seven vaccines and the richer countries twelve. These aspects reflect the need for national plans that take into consideration the reality of each country or region.It is necessary to consider the objectives of the Global Alliance for Vaccines and Immunization (Gavi). The initiative aims to guarantee the wide use of existing vaccines and to stimulate their development against the illnesses responsible for the greatest mortality rate in the under developed countries.

The Gavi is directing its priorities towards countries poorer than Brazil, which doesn’t guarantee that our panorama of needs will be contemplated. Even more, Brazil has the conditions to contribute in a more active manner for improving the current situation. The expressive growth of the country in the production of knowledge and in the formation of researchers is a guarantee that it could play a prominent role in this sector. Today, Brazil is not playing the role laid out for it, for various reasons. The absence of a program giving incentive towards basic knowledge in the illnesses of interest, and for the development of technology in vaccinology are some f them. The clinical research groups, on the whole, attend to an agenda dictated by the all powerful international industry, be it for the shortage of internal demand, or for the lack of stimulus and coordination by government agencies.

A plan for the development of vaccines for Brazil is possible and necessary. However, it will be essential to keep an eye on the protection of intellectual and industrial property, and the orientating mechanisms of these actions need to be spread out and made easier. The formation of multidisciplinary teams, as well as adequate equipment in the testing units – in experimental models or through clinical testing –, needs to be stimulated. Nonetheless, more important than isolated initiatives for the correction of errors, is the necessity for the integration of all of the measures. Without a global plan that takes into consideration all aspects, we will be embarking on yet another useless effort.

Professor of Pathology, Director of the Medical School of the Federal University of Bahia and a permanent member of the Brazilian Academy of Sciences.

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