Shortage of anti-Rabies vaccine jeopardises lives

KARACHI: Pakistan is rapidly running short of the Anti-Rabies Vaccine (ARV), which is mostly imported from India these days, due to ongoing tension between two South Asian nations as one of the leading Indian biotech firms has reduced its production while their government is denying visas to Pakistan officials and importers to deal with other vaccine manufacturers.

Every day, as many as 100 people including women and children are bitten by dogs in Karachi alone while it is estimated that over a 1000 people are given Anti-Rabies Vaccine (ARV) shots as well as immunoglobulin to prevent from Rabies, a viral disease that is 100 percent fatal and the affected person faces a painful death if not provided timely care. “We are rapidly running short of ARV and our supplier says that the 'Indian vaccine Indirab,' which is produced by the Indian biotech giant Bharat Biotech is not being sold to Pakistan due to a variety of reasons”, Executive Director of Jinnah Postgraduate Medical Center (JPMC) Dr. Seemin Jamali told The News on Tuesday.

The JPMC’s dog bite center is one of the largest centers in Pakistan, where daily around 100 persons including fresh and old victims of the dog bite are given ARV shots as well as Immunoglobulin to prevent them from contracting Rabies. After realizing shortage of the ARV, Dr. Jamali said asked her staff to collect as much vaccine from the open market as possible because majority of dog bite victims visit JPMC. But cautions that though she has arranged that for the time being but in the long run, if the vaccine is not made available, it could turn into a serious problem for the people.

She claimed that the suppliers offered them the Chinese vaccine but she refused as that was recently "recalled globally" and she is not willing to risk the lives of patients with the unproven vaccine. “Indirab, is known for being very effective and we are using it for years now. Switching to any unproven vaccine could jeopardize the lives of the people”, she said adding that incidents of dog bite are alarmingly high in Karachi as number of stray dog is increasing with each passing day. Dr. Jamali is of the opinion that Pakistani pharmaceutical industry and research institutions should come up with locally-produced vaccines to end the dependence on imported vaccines and medicines, especially those from India.

Dr. Nasim Salahuddin, head of infectious diseases at Indus Hospital Karachi also confirmed that their supplier had also expressed inability to supply them with the Anti-Rabies Vaccine due to multiple reasons including strained relations between India and Pakistan and warned that many people would die a painful death in Pakistan if vaccine is not made available within the next few days. “During the last one and half months over 80 people were injured and needed to be vaccinated. The dog bite cases are on the rise and if no preventive measures are taken, it would emerge as a serious public health emergency in Karachi.

While Pakistan is facing a health emergency, the Customs Department officials are allegedly extorting heavy bribes from the importers at airport which is one of the major reasons of shortage of imported vaccines and medicines, Dr. Nasim Salahuddin said while quoting some importers. Dr Salahuddin said the government must check corruption of the border-control officers to ensure there is no shortage of the life-saving drugs.

Meanwhile, vaccines importers from Bharat Biotech, which is the largest supplier of Anti-Rabies Vaccine to Pakistan, say the strained relations between two states, reduction in vaccine production by the firm, preferential sale of vaccine to countries which pay more and a ban on export of the vaccine are some of the reasons behind ARV shortage in Pakistan.

“Earlier, several multinational pharmaceutical firms were importing ARV but when they didn’t get the prices increased by the Drug Regulatory Authority of Pakistan (DRAP), they stopped supply to Pakistan”, an importer said on condition of anonymity. The importer maintained that they wanted to negotiate with the Bharat Biotech to continue supplying the ARV vaccine but the Indian authorities are not issuing visas to them, adding they are also in contact with other vaccine manufacturers in India but the strained relations between both the countries are a hurdles in the import of medicines and vaccines from India.