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Indigenous HPV vaccine, the rhetoric and the reality
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Context
The recent push for universal HPV vaccination in India raises questions about its necessity, timing, and pricing. This discourse comes amidst declining cervical cancer trends globally and the introduction of the indigenous HPV vaccine 'Cervavac' by the Serum Institute of India (SII).
Controversies Surrounding HPV Vaccination:
- Causality debate: The direct causal link between HPV and cervical cancer is not conclusively proven, with only a few strains out of 200 associated with precancerous lesions.
- Declining trends: Population Based Cancer Registries (PBCR) and International Agency for Research on Cancer (IARC) acknowledge decreasing cervical cancer prevalence regardless of vaccine coverage.
- Ethical concerns: Universal vaccination of pre-puberty girls raises moral questions in Indian society and may perpetuate patriarchal notions.
Development and Pricing of Indigenous HPV Vaccine:
- Delayed development: Nearly two decades gap between patented HPV vaccines in the Global North and India's 'indigenous' Cervavac, despite similar rDNA techniques.
- Funding and infrastructure: Cervavac development received $7 million from the Bill & Melinda Gates Foundation and utilized infrastructure supported by the Indian government.
- Pricing concerns: Despite public funding and shared infrastructure, Cervavac's market price (?2,000 per dose) remains high, raising questions about the pricing strategy.
Impact of Global Patent Regimes on Vaccine Development:
- Shift in innovation landscape: Changes in U.S. patent laws and their global adoption through TRIPS agreement transformed vaccine development from public to private sector.
- Indian scenario: India's transition from process patents to product patents delayed the development of generic versions of patented vaccines.
- Competition issues: Despite multiple domestic players announcing HPV vaccine development, Cervavac remains the sole indigenous option, limiting price competition.
UPSC Mains Questions:
Q. Evaluate the ethical and public health implications of universal HPV vaccination in India. How does this policy align with the country's socio-cultural context and existing health priorities?
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