After MiD DAY exposed the vaccine scam, blame game begins. Price of life-saving drugs went through the roof in last two years

Vaccine scam follow up: The plot sickens

After MiD DAY exposed the vaccine scam, blame game begins. Price of life-saving drugs went through the roof in last two years

Who is responsible for the shortage of life-saving vaccines in the country? Was it the Union Health Ministry,

Public Sector Undertakings (PSUs) responsible for manufacturing the drugs or the private sector, which is being blamed for the rising prices of these essential medicines?

As per the information supplied by the Union Health Ministry in response to the RTI plea, prices of vaccines for DPT, BCG and other life threatening diseases have gone up by at least 100 per cent in the last two years.
"But before 2008 there was only a 10 per cent annual rise in the prices. While closing down the PSUs engaged in manufacturing the vaccines, the health ministry forgot to control the prices of the drugs produced by the private players brought in as replacement," said Dr Babu KV, the RTI applicant.

Burden of rules
At the same time the government added a few extra regulations which ultimately led to an increase in the cost of production of vaccines, Dr Babu added, who filed a series of RTI pleas after the union government decided to abruptly close the three nodal vaccine manufacturers -- Central Research Institute, Kasauli, Himachal Pradesh, Pasteur Institute, Kunnur, Kerala and BCG Vaccine Lab in Chennai - in 2008.

"Prices of all essential vaccines rose by a minimum 100 per cent but in the case of tetanus injections the cost went up by 300 per cent," said Dr Babu, a senior ophthalmologist and a central council member of the Indian Medical Association (IMA).

In 2007-08 while a vial of BCG vaccine cost Rs 13 the next year it went up to Rs 27.85 per unit. In case of DPT, the prices rose from Rs 11.80 per unit to Rs 23.49 per unit but the maximum rise was registered in the case of tetanus injections where the prices shot up from Rs 6.20 per vial to Rs 17.61 per vial.

"There has never been such high increase in the prices of the vaccines. Keeping in mind the cost of production there was an annual increase of 10 per cent only but this time they went through the roof taking such essential medicines out of reach of a large section of the population," he added.

Blame game
The RTI, apart from ruffling feathers in the union government and vaccine manufacturers, has led to a blame game between the players.
The Serum Institute of India, which was contracted after the three PSUs were closed down in 2008, denied any shortcoming on its part and claimed that it has always met the targets within the stipulated time.

"There has never been any delay on our part. In fact all of our vaccines were delivered right on time. The problem in delivery schedule by other agencies has appeared because government of India decided to go for the lowest bid. But on the other hand it should have awarded the contract to the companies which had the capacity to deliver on time," said SK Bahl, Director, Serum Institute of India.

He agreed with Dr Babu that the extra regulations by the government of India also led to a rise in the prices of vaccines. "Till the time government's PSUs were manufacturing the vaccines the cost of packing was Rs 1.5 per unit but as soon as the contracts were shifted to private organisations health ministry made it compulsory for the manufacturers to introduce international quality packaging which further increased the cost," said Bahl. The overall increase in the cost only due to packaging was Rs 0.50 per unit (total cost of Rs 2 per unit) which added 20 per cent to the cost of vaccines.

Ironically, between 2008-10, the health ministry incurred an extra cost of Rs 39.5 crore (a 70 per cent hike) by purchasing vaccines from private bodies. "Some of the renowned private manufacturers had promised vaccines at lower prices. But every now and then an extra regulation related to packaging and other parameters was added which were missing when the vaccines were produced by the government itself. The result was a steep rise in prices," a health ministry official said on condition of anonymity.u00a0

Bahl further provided the order and supply figures of some government organisations like Pasteur Institute which missed all its deadlines. According to him, the deadlines were missed because of faulty government policy to award contract to the lowest bidder without verifying its capacity to produce and ability to deliver on time.

"During 2007-2008, Pasteur Institute, Coonor was given the order for 1000 lakh doses of tetanus injections and 600 lakh doses of DPT. Not a single dose was supplied by Pasteur Institute which also led to a shortage of vaccines in 2008-2009, as buffer stocks had been exhausted. Also the orders were placed in July 2008, which ideally should have been done by Jan' 2008 to enable timely supplies starting April 2008," he said.
But the story does not end here.

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