Vaccine requirements compete with basic needs of poor people

doi:10.1136/bmj.39563.588762.BE

BMJ 2008;336:975 (3 May), doi:10.1136/bmj.39563.588762.BE

Letters

Global access to vaccines

Vaccine requirements compete with basic needs of poor people

The first 150 words of the full text of this article appear below.

Chokshi and Kesselheim make a strong case for developing countriesto invest in an evidence base for developing and appropriatelyusing newer vaccines.¹ However, an infrastructure of the requiredresearch and information systems is entirely absent in developingcountries and its creation would require the complete revampingof current public health systems. Those who promote vaccinesas the most cost effective interventions for poor people nevertake into account the costs of erecting the health systems todeliver them and monitor their efficacy and safety.

The authors quote Amartya Sen to show the opportunities thatopen up for poor people in developing countries from modernhealth systems with delivery of vaccines. However, these peoplehave competing needs for food, shelter, water, sanitation, andeducation. In reality, vaccines compete with these other needs.One example is that the widely prevalent malnutrition in childrenin India results from lack of health education . . . [Full text of this article]

Onkar Mittal, national convener

¹ Centre for Health Policy Dialogue, New Delhi 110049, India

o_mittal@rediffmail.com