CHARITABLE HEALTH GIFT: $600,000 IN FLU VACCINES TO ARMENIA
23:30, March 31, 2015
Marine Martirosyan
Vahe Sarukhanyan
On October 30 of last year the Armenian government adopted a law to
accept a donation from The Center for Vaccine Equity (CVE), a division
of the U.S. based Task Force for Global Health.
The donation was in the form of 60,000 seasonal influenza vaccines. A
memo of understanding on how the vaccines were to be provided was
signed by the CVE and Armenia’s Ministry of Health. The memo regarding
the free medicine contains a number of interesting clauses that casts
suspicion on this charitable donation.
First, we should note that the ministry’s website surprisingly contains
no new information on the memo. Last fall, the press in Armenia only
covered the issue in passing and used news supplied by the ministry’s
website as their main source. So let’s now try and understand why
the government decided to accept the donation of medicine and what
those drugs actually are.
It was Sergey Khachatryan, the Deputy Minister of Health, who proposed
the initiative to the executive branch. It was the health ministry
that drafted the documents, including the memorandum and arguments
supporting it. The ministry noted that a campaign against seasonal flu
hadn’t been included in the government’s National Vaccination Agenda.
“Due to an increase in influenza illness in the past few years,
an epidemic risk situation has been registered in the country and
the health of vulnerable groups is at risk,” read the ministry’s
argument in favor of the initiative. Vulnerable groups, as cited
by the ministry, include the military, health workers, children in
orphanages and their staffs, and old age homes.
Of interest is that the health ministry did not specify the years
when cases of influenza had increased in the country. According
to the annual logs of the ministry, influenza cases from 2009-2013
significantly dropped in comparison to the 1990s or the early 2000s.
In the bar chart below we show the figures for influenza both in
absolute and relative numbers (per 100,000 individuals). There were
no registered cases in 2012.
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In the health ministry’s argument in favor of the initiative we read:
“Throughout the entire world, as in Armenia, numerous influenza
cases are registered yearly, due to the various type sand sub-types
of influenza, which show up in at risk and age groups with different
levels of intensity, which increases the burden placed on the health
sector. Statistics from epidemiological analyses prove that two peak
periods of illness are registered in the country – from September
to October and the following February, which continues till the end
of April.
The most effective preventative measure against seasonal influenza,
taking into account its airborne transmission mechanism, is
vaccination. In accordance with proposals of the World Health
Organization, it is necessary to give preventative vaccinations to
vulnerable groups on the advent of each season given that such groups
often display complications from flu, including death.”
Pneumonia Mortality Rates at Hospitals (Individuals aged 0-14 and
over 14)
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The health ministry’s argument in favor of the initiative continues:
“In recent years, no primary preventative measures against influenza
have been taken in Armenia. As a result, the at-risk season is regarded
as a period for increased flu and related respiratory illnesses. This
negatively impacts on attendance by students and staff alike at
the country’s schools and on wide segments of society, oftentimes
resulting in serious cases. This was the case in the military during
last year’s flu season.
Frontline preventative measures against the flu haven’t been
comprehensively implemented in Armenia, mainly due to a lack of funds.
In some years only a tiny number of vaccinations have been carried out,
and not all vulnerable groups were included.
The non-profit Task Force for Health’s Center for Vaccine Equity is
proposing a donation of flu vaccines, something which is of urgent
necessity for the country. Given the vagaries of the international
vaccine market, coupled with the intensification of seasonal influenza,
there is a great disparity between the supply and demand for vaccines.”
Armenia’s Ministry of Health says the value of the vaccines is US$
600,000. Thus, the cost of one is $10.
The memo was signed by Minister of Health Armen Muradyan and Thomas
Rosenberg, Executive Vice President of the Task Force.
What vaccines did Armenia receive?
Armenia received flu vaccines designed for the southern hemisphere. As
we all know, the peak flu season lasts from fall to spring. Since
this period is different in the two hemispheres of the globe (In the
northern hemisphere from September-May; in the southern hemisphere
from March to November), the World Health Organization has come up
with two formulas for manufacturing flu vaccines and two application
stages. And despite the fact that Armenia is located in the northern
hemisphere and the flu cases, according to the ministry of health,
peak during September to May, Armenia was given vaccines designed
for the southern hemisphere.
In any event, the vaccines for both hemispheres don’t differ all that
much. They both cover H1N1 – a subtype of the virus of influenza A –
most commonly known as ‘swine flu’, influenza A virus subtypeH3N2,
and Type B viruses. We should note that Flu types A and B can turn into
epidemics and pandemics, which isn’t the case with Type C influenza. In
other words, the vaccines prepared with these elements are logically
designed to prevent epidemics and pandemics.
Who is donating the vaccines to Armenia?
As we noted at the start of the article, the Center for Vaccine Equity
(CVE) has allocated the vaccines to the ministry of health.
The CVE is part of the The Task Force for Global Health(TFGH) a
nonprofit, public health organization, based in Atlanta, Georgia.
It was founded as the Task Force for Child Survival in 1984. The
Task Force was initially tapped to serve as a Secretariat for
a consortium of global health organizations: UNICEF, WHO, The
Rockefeller Foundation, The United Nations Development Programme,
and the World Bank.
It later changed its direction as neutral convener and collaborator,
and began to get involved in global health projects. The TFGH
implements a variety of health-related programs and immunization and
vaccines is just one of them. This is the purview of the Center for
Vaccine Equality established in 2011. According to Forbes magazine,
TFGH was the third largest non-profit in terms of private donor
projects.
TFGH was co-founded by global health pioneer and former Center for
Disease Control (CDC) Director, Dr. William Foege and two of his former
CDC colleagues, Carol Walters and Bill Watson. It’s no accident that
the CDC and Emory College are partners of the TFGH. Emory is where the
Food Fortification Initiative (FFI) is located, an international group
that advocates the enrichment of wheat, maize flour and rice. Such
an enrichment plan is being debated for Armenia.
TFGH obtained the vaccines from Green Cross International via the
non-profit Global Health Solutions (GHS).
Hetq sent a list of questions to the health ministry on March 25 on
this issue. To date, we haven’t heard back from them. In the future we
will take a detailed look at the memorandum and its interesting facets.
(To be continued)
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