Healthy vaccines ecosystem: A tough equation to solve

Professore Panos Kanavos: "The EU market is fragmented and therefore, every market is different. This is problematic and better coordination is needed. All relevant stakeholders should talk to each other and above all, avoid rivalries." [Photo by Sarantis Michalopoulos]

This article is part of our special report A ‘healthy’ vaccines ecosystem.

In an already fragmented EU market, the vaccines ecosystem is particularly complex and in order for it to be “healthy”, all relevant stakeholders should be taken into account, Professor Panos Kanavos, an associate professor at LSE, told

However, in practice, the equation is not easy to solve.

At the “Vaccine ecosystem health check” event in Gastein, Austria, experts analysed the complexity of vaccine ecosystems and explored ways to bring different stakeholders together to tackle the system’s vulnerability: A simple change can affect the entire ecosystem, considering the high-level interdependence of stakeholders.

Speaking to EURACTIV on the sidelines of the event, Kanavos said: “The processing agency aims at cost minimisation, the manufacturer wants price maximisation while the government the widest possible coverage. And then we have some families who believe in what social media say. This equation wants a masterful application”.

“The EU market is fragmented and therefore, every market is different. This is problematic and better coordination is needed. All relevant stakeholders should talk to each other and above all, avoid rivalries,” he added.

Speaking at the event, Kanavos said resilient immunisation programmes strongly contribute to the sustainability of healthcare systems, which are currently under significant pressure.

“There is room for increasing systems performance and vaccination has a key role to play in it. To achieve this, we need a sustainable supply of innovative, qualitative and affordable vaccines to meet the public health needs,” he underscored.

“We need to be able to respond to challenges that can apply pressure on the vaccine market, such as population growth and dynamics, vaccines hesitancy, regulatory burden, sub-optimal investment and non-anticipated demand from governments.”

According to Kanavos, the vaccine market is in a “black box”, as it could take 10-15 years for a vaccine to be marketed compared to medicines, which now need 8-10 years.

Kanavos added that the visibility of vaccines has been reduced and more emphasis has been placed on cancer drugs and other major diseases without paying proper attention to the vaccines and the level of policy and strategy.

“So, when one says that every child should be vaccinated for at least 10-15 vaccines, how do you measure it? Do you have a passport that says your child has X vaccines before going to school? How do you enforce it?” he wondered, adding that in order to have maximum effectiveness you need to vaccinate your entire population.

Vaccination high on EU agenda

Wolfgang Philipp from the European Commission’s DG Health said boosting information and coordination on vaccination across Europe will continue to be a top priority for the next Commission, as several multi-level actions would take place until 2022 at least.

The new EU health chief, Stella Kyriakides, is asked in her mission letter to “prioritise communication on vaccination”, combatting fake news over the issue.

EU member states adopted in late 2018 a European Commission recommendation on strengthened cooperation of all stakeholders against vaccine-preventable diseases.

The EU executive’s action came at a time when anti-vaccination campaigns are on the rise across Europe while “forgotten” diseases such as measles are re-appearing.

“It’s a strong piece of policy, in which EU member states agreed to follow up a certain line of activities. Many different stakeholders are entitled to take action, ranging from EU member states to industry, healthcare workers, civil society as well as EU bodies, such as the European Commission and the European Centre for Disease Prevention and Control (ECDC),” he said.

“The activities are being implemented in full speed,” he added.

Asked if all these actions could be better coordinated under an EU-wide platform, he insisted on having parallel initiatives.

Regarding the EU bodies, Philipp said they’d focus on the information aspects as well as on the cooperation of national immunisation technical advisors.

Focus on pharmacists

However, reaching out to all parts of the population and raising awareness of the need for vaccination is not an easy task. Analysts suggest that pharmacists could play a greater role as they are in direct or even first contact of people.

For Antonio Gaudioso, secretary-general at Active Citizenship Network, the primary objective is to have well-informed citizens as well as the best possible access vaccines. The only way for this to happen, different actors, such as pharmacists, need to step in the process.

“They are so close to the people in their everyday life. In Italy, for instance, nearly four million people have access to a pharmacist. So, it is a fantastic point of intervention in terms of trust with the people,” Gaudioso told EURACTIV.

He added that in particular cases, pharmacists could also take a more active role in vaccination, as this will inevitably result in “measurable” outcomes.

He said the local authorities in the region of Toscana, Italy, have decided to increase access to vaccines by empowering general practitioners, who will focus on immunisation of adults. Italy is one of the EU countries where the anti-vaccination sentiment has been quite strong

“It’s the first time that this is happening to that extent in Italy,” he said, adding though that the Italian legislation needed to be amended in order to enable also pharmacists to vaccinate. .

[Edited by Zoran Radosavljevic]

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