IFFI, GAVI, GSK and Benevolence.

Acronyms abound in the world of Medicine and Health care and these few have been in the news of late due to the statement from Andrew Witty, (current salary £2.3million) CEO of GlaxoSmithKline, that they are going to make available to the Global Alliance for Vaccines and Immunisation, their Rotovirus vaccine at  'cost price'. That is said to be £1.50 ($2.50) a dose, but they already receive 'advance market commitments' (cash up front) to develop vaccines for GAVI, so the benevolence assumed is somewhat less than the statement suggests.

My feeling is that this has little to nothing to do with the charity of 'Big Pharma' but is more likely to be linked to the need to rebuild the business of GSK, after the appalling Avandia debacle, which has wiped the last quarter profits in 2010. Witty has a plan to 'save' GSK from the decline in markets, brought about by 'Pharmas' inability to come up with any really useful drugs for some time, and the expiry of patents on some of its money spinners this year and next.

So, whilst forcing back a tear, I will move on to the infection that they are trying to prevent; Rotovirus. It is a disease of childhood generally, a type of Gastroenteritis, that responds well to simple hydration therapy and most children will have had it at least once before five. It is alleged that up to half a million deaths could be prevented by the use of a vaccine for the Type A virus, which is the one responsible for 90% of cases. These deaths mainly occur in emerging nations and this may because of poor hygiene but studies have shown that the rate of infection varies little between nations so this seems unlikely. The death rate is very low, at about 1 in 73,000 cases, provided the child is kept hydrated. This vaccine is not generally available in the UK, as a childhood vaccine.

The early vaccines used were shown to be effective but Wyeth's Rotashield, was withdrawn in 1999 after it was shown to cause serious bowel obstructions in 1 in 12000 cases. GSK produced Rotarix in 2006 which is the type being offered at this much reduced cost. This too was withdrawn in 2010 after batches were shown to be contaminated with a porcine virus but re licensed when GSK successfully persuaded the FDA that this content was 'harmless' (sic). But these problems did highlight the view held by many, that some vaccinations employed in pediatrics, are needless intrusions into the formative immune system of young children often on somewhat dubious medical grounds. We seem to feel that children should be saved from the possibility of almost any infection and are ready to dose them with myriad vaccines at very early ages, in a pursuit of this rather dubious goal. Often having an infection, so long as it is not serious or life threatening, is a better way of providing immunity than undertaking multiple vaccination protocols.

I, as many will perceive, am not a lobbyist for GSK, or indeed any of 'Big Pharma'. They have consistently failed to place patient safety at the forefront of their operations and it is said that little more than half of the supporting trials that should go on after approval, to ensure efficacy and safety, go unreported and little publicity is afforded to any information that shows a new drug to be worse than an older one. 'Picking' and 'cherry' are the words that spring to mind, or perhaps 'publication bias' would better describe it.

I would also like to throw some light upon the vehicle chosen to deliver the beneficence of the West into the Third World. IFFI (should that be 'iffy'?) is the International Finance Facility for Immunisation and is the funding vehicle for GAVI. Funds from donors are channeled into IFFI, which raises bond issues which are backed by the countries who have pledged future funding. It's a sort of Public Private Partnership, with Goldman Sachs, Deutche Bank and HSBC amongst others selling bonds which yield a return for investors. GAVI  then uses the income stream to pay 'Pharma' for it's products and research to allegedly save people from the ravages of disease in far off countries, we used to colonise. To be frank I find the structure somewhat puzzling to fathom, but Bill Gates is one of the funders, so it's has to be OK then (sic).

A conference, fronted by (call me Dave) Cameron is taking place in London on the 13th June, where he is expected to promise additional funding for GAVI. GSK and no doubt Andrew Witty will be there, although GSK's place on the GAVI board is now being handed over to Johnson & Johnson's Swiss subsiduary. Why they ever had one in the first place amazes me. Maybe that's why the bulk of the money from IFFI goes to Western 'Big Pharma', whilst the emergent drugs industry, in poorer nations, who allege they can make and sell most of the products utilised by GAVI at much lower prices, never get a look-in. All sounds like some elaborate Government sponsored 'Ponzi' scheme to me. Pretty much like the 'Private Finance Initiative' or 'Independent Sector Treatment Centres'. I notice the US will not back these 'bonds', nor are they allowed to be sold in the US, nor do they seem to contribute to the fund. Although most of the money in the fund, finds its way there anyway, because that's where 'Big Pharma' lives.

Why does misery always have to generate a profit?