Aşı: Kutsalın metalaşması
Küçük Resim Yok
Tarih
2012
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Dergi Başlığı
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Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Her yıl 2.5 milyondan fazla yaşamı kurtaran aşı, en önemli medikal ürün olma özelliğini günümüzde de korumaktadır. Bununla beraber duraklama dönemine girmeye başlayan ilaç pazarının yerini almaya aday gözükmektedir. Özel sektörün gösterdiği bu ilginin açıklamasını yapmak için aşı üretiminin sadece, bilimsel ve teknolojik bir konu olmayıp, sosyal, ekonomik ve politik bir konu olduğu gerçeğini hep anımsayarak aşının geçirdiği değişime bakmakta yarar olacaktır. Aşının öyküsü dört dönem üzerinden izlenebilir; heroik evre (1930'lar ve öncesi), gelişme ve farklılaşma evresi (1940-1980), özelleştirme evresi (1970-1990) ve üreticilerin birleşme evresi- kamu özel ortaklıkları (1990 sonrası). Heroik dönemde çiçek, kuduz, tifo, kolera, veba, difteri, tetanos, boğmaca ve sarıhumma aşıları uygulanmaya başlamıştır. Ardından 20. yüzyıl ortalarında yeni aşılar, yeni teknolojilere ve yeni yasal düzenlemelerle gelişme ve farklılaşma dönemi yaşanmıştır. Bu evrede yerel düzeyde pek çok aşı üreticisi bulunmaktaydı. Üçüncü dönemde çiçek, polio eradikasyon programlarını, 1974'te başlatılan Genişletilmiş Bağışıklama Programını (EPI - Expanded Programme on Immunization) görüyoruz. Bu program nedeniyle olan talep artışı, aşının bulunamaz olması ve aşı fiyatlarının yükselmesine yol açtı. Ardından aşı üreten kamu kurumlarının, özelleştirildiği evre gelmiştir. Dördüncü evre, 1990 yılında UNICEF, DSÖ, BM Kalkınma Programı (UNDP) Dünya Bankası (DB)ve Rockefeller Vakfı tarafından Çocukların Aşılanması Girişimi , (CVI-Children's Vaccine Initiative), 2000'de DSÖ, UNICEF, Dünya Bankası, ulusal hükümetler, uluslararası kalkınma bankaları, hükümet dışı kuruluşlar, Bill ve Melinda Gates Vakfı, aşı endüstrisinin temsilcilerinden oluşan Aşı ve Bağışıklama için Küresel İşbirliği (GAVI-Global Alliance for Vaccines and Immunization) kurulmasıyla şekillendi. Ancak 1999 yılında UNICEF rutin aşılama programları için bile DBT ve BCG aşısı bulamaz oldu. Bu yıllarda benzer sıkıntı OPV için de yaşandı. 1998- 2001 yıllarında geleneksel aşıları üreten 14 üreticiden onu üretime son verdi. 1970'lerde bağışıklama UNICEF gibi bağışçıların ve alıcı hükümetlerin kontrolündeyken, 1980'lerde özel sektör GAVI gibi küresel ortaklıklar aracılığıyla bağışçılarla yakınlaştı ve ardından bağışıklama hizmetlerinin baş aktörü oldu. 2010 yılında beş büyük şirket Sanofi-Pasteur, Merck & Co., GSK, Wyeth ve Novartis aşı pazarının %83.9'unu kontrol etmekteydi. Sanofi-Aventis ve GSK liderlik için yarışmaya devam etmekte. Pazar dinamikleri göz önüne alındığında, günümüzde pediyatrik aşılar pazara egemenken, ileride yetişkin, terapötik ve influenza aşılarının bu egemenliği ele geçireceği, kanser, bağımlılık, biyoterör etkenlerine karşı aşılama çalışmalarına ağırlık verileceği beklenmektedir. Ancak Ar-Ge çalışmalarının maliyetinin giderek artması, çalışmaların başarıyla sonuçlanma olasılığının %10'lara inmesi, patent yasası kar oranlarını artırmak için aşı fiyatlarının çok yüksek olacağının ipuçlarıdır.
Vaccine, saving more than 2.5 million lives every year, maintains it's vital medical characteristics today, as well. Nonetheless, it also seems to be an applicant to replace medicine market which gradually enters into it's recession period. In order to explain the interest of the private sector it is important to keep in mind the fact that the vaccines are not only scientific and technological, but also social, economic and political matter. The story of vaccine can be observed over four periods; heroic era (1930's ), growth and divergence era (1940 to 1980), privatization era (from 1970 to1990) and producers merging era- public private partnership (form 1990's to modern-day). In heroic period, the vaccines such as smallpox, rabies, typhoid, plague, diphtheria, tetanus, pertussis and yellow fever were initiated to be performed. Following this, growth and divergence period was gone through with new vaccines in the midst of 20th century and new technologies and new legal regulations. In this phase, there were innumerable vaccine producers at local level. We see the eradication programmes of smallpox and polio and Expanded Programme on Immunization (EPI) started in 1974 in the third era. The increase in demand due to this programme and vaccine's unfindable feature led the costs of vaccinations to raise. Then the era in which privatization of the vaccine producing public institutions has occured. The fourth era was shaped by Children's Vaccine Initiative (CVI) thanks to UNICEF, WHO, UN Development Programme (UNDP), World Bank (WB) and Rockefeller Foundation in 1990, and establishment of some institutions including WHO, UNICEF, World Bank, national governments, international development banks, non-governmental organizations, Bill and Melinda Gates Foundation and Global Alliance for Vaccines and Immunization (GAVI) consisting of representatives of vaccine industry in 2000. However, UNICEF was not able to find DTP and BCG vaccines for routine vaccination programmes in 1999. In these years, a similar problem was experienced for OPV, too. Ten producers out of 14 that generated traditional vaccines discontinued their production in 1998-2001. While the vaccination was under the control of donators like UNICEF and recipient governments in 1970's, global associations such as private sector GAVI got close to their contributors and then became the leading actor in vaccination services in 1980's. Five major companies composed of Sanofi-Pasteur, Merck & Co., GSK, Wyeth and Novartis were controlling the 83.9 %of the vaccine market. Sanofi Aventis and GSK still continue to compete for leadership in this sector. Regarding market dynamics, paediatric vaccines are currently dominant in the market, however in the future, adult, therapeutic and influenza vaccines will be superior and vaccination programmes such as cancer, addiction and against the bio-terror factors are expected to be focused. Nevertheless, patent law prices will be very high for profit maximization since cost of research-development studies is on the increase and the likelihood of completion of studies with success drops at 10 %.
Vaccine, saving more than 2.5 million lives every year, maintains it's vital medical characteristics today, as well. Nonetheless, it also seems to be an applicant to replace medicine market which gradually enters into it's recession period. In order to explain the interest of the private sector it is important to keep in mind the fact that the vaccines are not only scientific and technological, but also social, economic and political matter. The story of vaccine can be observed over four periods; heroic era (1930's ), growth and divergence era (1940 to 1980), privatization era (from 1970 to1990) and producers merging era- public private partnership (form 1990's to modern-day). In heroic period, the vaccines such as smallpox, rabies, typhoid, plague, diphtheria, tetanus, pertussis and yellow fever were initiated to be performed. Following this, growth and divergence period was gone through with new vaccines in the midst of 20th century and new technologies and new legal regulations. In this phase, there were innumerable vaccine producers at local level. We see the eradication programmes of smallpox and polio and Expanded Programme on Immunization (EPI) started in 1974 in the third era. The increase in demand due to this programme and vaccine's unfindable feature led the costs of vaccinations to raise. Then the era in which privatization of the vaccine producing public institutions has occured. The fourth era was shaped by Children's Vaccine Initiative (CVI) thanks to UNICEF, WHO, UN Development Programme (UNDP), World Bank (WB) and Rockefeller Foundation in 1990, and establishment of some institutions including WHO, UNICEF, World Bank, national governments, international development banks, non-governmental organizations, Bill and Melinda Gates Foundation and Global Alliance for Vaccines and Immunization (GAVI) consisting of representatives of vaccine industry in 2000. However, UNICEF was not able to find DTP and BCG vaccines for routine vaccination programmes in 1999. In these years, a similar problem was experienced for OPV, too. Ten producers out of 14 that generated traditional vaccines discontinued their production in 1998-2001. While the vaccination was under the control of donators like UNICEF and recipient governments in 1970's, global associations such as private sector GAVI got close to their contributors and then became the leading actor in vaccination services in 1980's. Five major companies composed of Sanofi-Pasteur, Merck & Co., GSK, Wyeth and Novartis were controlling the 83.9 %of the vaccine market. Sanofi Aventis and GSK still continue to compete for leadership in this sector. Regarding market dynamics, paediatric vaccines are currently dominant in the market, however in the future, adult, therapeutic and influenza vaccines will be superior and vaccination programmes such as cancer, addiction and against the bio-terror factors are expected to be focused. Nevertheless, patent law prices will be very high for profit maximization since cost of research-development studies is on the increase and the likelihood of completion of studies with success drops at 10 %.
Açıklama
Anahtar Kelimeler
Sağlık Politikaları ve Hizmetleri
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Cilt
27
Sayı
1
