Study injects scepticism into Hepatitis-B drive

September 10: The latest fad of politicians - the anti Hepatitis B campaigns, is creating a fear psychosis amongst the populace. The unive...

September 10: The latest fad of politicians – the anti Hepatitis B campaigns, is creating a fear psychosis amongst the populace. The universal vaccination for all mooted by a section of politicians is misleading as only 1.42 per cent of the population of India can be affected, indicates an indepth study conducted by Pune-based doctors Ashok Kale and Anant Phadke.

Ninety per cent of this percentage eliminate the virus from their body by their own immune system. Only an estimated 1.5 per cent of the general population are Hepatitis-B carriers and their life-time risk of dying due to the consequences of the disease is less than 0.1 per cent.

In their study the two doctors conclude, “It may be pointed out that in India Hepatitis-B infection is not a priority. The universal vaccination programme will not eradicate Hepatitis-B in the forseable future. In India the average life expectancy is 70 years. As the life-time risk of dying due to the consequences is minimal, we need not aim at eradicating the infection but should aim at drastically reducing the HBeAg pool.”

According to information available with The Indian Express the Brihanmumbai Municipal Corporation has made it mandatory for every student in all its schools to pay Rs 25 towards the vaccination charges.

“There should be a public debate on this issue. On what data are the politicians basing their programme? The 4.7 per cent incidence which these politicians have been talking about was first presented by Smith Kline and Beecham at a seminar two years ago. They based their research on a target group and not the general population. Politicians are cheating the people, a public interest litigation can be filed against them. They are creating fear in the minds of the people. There is no unanimity amongst paediatricians about the need for universal vaccination,” says Dr Arun Bal, president, Association for Consumer Action on Safety and Health..

Though this vaccination has not been included in the list of essential vaccinations by the Central Government, it is still spending an estimated Rs 250 crore annually on the Hepatitis B vaccination. The Union budget for control of tuberculosis is Rs 194 crore and the budget for all other vaccinations together is less than the requirement for the universal immunisation for Hepatitis B.

According to Dr Suhas Pingle, president of the Bombay West Suburban branch of the Indian Medical Academy, selective vaccination is preferable to universal vaccination. “Mumbai is obviously being taken up as a pilot project. There is need to discuss the merits of universal versus selective vaccination, the cost factor and the mode of vaccination, whether intra muscular or intra dermal. The magnitude is not as high as the politicians make it out to be,” says Dr Pingle.

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The universal vaccination strategy is six times more expensive than the selective strategy. To cover all the pregnant women and their newborns in a year, the total cost of the programme in India for universal and selective vaccination would be Rs 2500 million and Rs 424 million, indicates the Kale-Phadke study.

When contacted member of Parliament Kirit Somaiya, president of Yuvak Pratisthan which has embarked on an ambitious Hepatitis-B free Mumbai programme refused to answer the question on the terms of reference for his programme. His organisation is providing the Rs 270 per dose vaccine at a mere Rs 25 per dose. An angry Mr Somaiya refused to speak on the data base and details on which committee recommended the universal vaccination programme.