SARS, H5N1... These emerging iruses threatening code names ha e made pre ention an undisputed star and boost accines market. But the ear o se ere acute respiratory syndrome and a ian in luenza pandemic sometimes masks the importance o certain bacterial and iral in ections deemed tri ial. Or it is belie ed, wrongly, missing. The case o measles is iconic. This disease su ers rom insu icient co erage or risk o epidemic, including in the majority o de eloped countries. Pro essor Didier Houssin, Director General o the Health Ministry, con irmed: three years, "the rance de eloped a plan aimed at the Elimination o measles and congenital rubella syndrome on the horizon...". "2010". A response to the approach ad ocated in Europe by the world Organization o the health and operation which says a lot on the way to go.
To stop the mo ement o the measles irus, more than 95 o children aged two years should be accinated at least one dose o MMR (measles - mumps - rubella) on the two necessary against 87 currently. A simple statistical recall to measure health issues. According to who, more than a million deaths are still a oided each year in the world with the measles accine. Another striking: the rate o BCG co erage, protecting rom tuberculosis, which is more mandatory in rance since July 2007, has dropped 99 in 2003 or school children in kindergarten to approximately 60 in the high-risk in ants aged two to twenty-three months, according to estimates ery recent and still partial to the Institute or sanitary Watch (IN S). TB cases reappear in the world, despite the act that BCG is the more administered accine on the planet.
In luenza: the rance late
Mean that, or health pro essionals, the watchword is clear: redouble their igilance. All urge the population and the medical pro ession to ollow the recommendations made by independent experts in the national accination schedule. In the 2008 Edition, published April 21, pertussis igure so prominently. Some epidemiologists are concerned about the resurgence o this disease that a ects 3.6 indi iduals on 100.000 inhabitants in rance. While who has set an incidence less than 1 case per 100,000. "The public authorities should communicate with the public." "It is the indi idual but also collecti e interest", points out Bertrand Alexandre, Chairman o the Committee the Leem (drug companies) accines. "The lack o in ormation can result in reluctance to accinate or maintain concerns un ounded," said Marianne Morini, consultant to the O ice o ad ice Alcimed.
E en massi e campaigns o communication are insu icient but still. This is the case or acs accination: 65 only o the targeted population, i.e. the elderly more than sixty- i e years, patients with long-term or chronic illness and immunocompromised people, acquired the accination re lex. "The rance is behind other European countries." "The who recommends a rate o immunization o 75 o the exposed persons", note Ral Krenning, Director o commercial operations o the Sol ay group, which accines is ocused on seasonal lu.
Hepatitis B: regain con idence
It must be recognized that accine protection has been wounded by the contro ersy that raged in rance, on the sa ety o hepatitis B accine. The charges relating to his in ol ement in some cases o multiple sclerosis ha e caused the brutal the accination program in 1998. These suspicions were swept earlier this year by a study coordinated by Pro essor Marc Tardieu, Kremlin-BicÍtre Hospital in Paris. Las, this in ection, including immunization co erage remains low blow (30 to 40), is still responsible or 1,000 deaths a year in rance, about a million people in the world. Howe er this accine, which was the irst to target a human carcinogenic iruses, pre ents se ere disease complications are the li er cancer or cirrhosis. "It is particularly urgent to initiate a campaign o accination against hepatitis B". "It ne er was or ten years, while the identi ied cases ha e multiplied", alert Senator Paul White, in his parliamentary report entitled " accines: con ince and inno ate to better protect", released last October. "The irst step will be course to regain the trust o general practitioners and paediatricians", recognizes Didier Houssin. To acilitate the immunization o in ants and reduce the number o injections, the hexa alent accine, hepatitis B, diphtheria, tetanus, poliomyelitis, pertussis and Haemophilus in luenzae b, combining is reimbursed by social since 17 securityMarch 2008. But it isn't that o a prime.
Pharmaceutical companies appear to be the natural partners o public authorities to promote accination. But they cannot take the initiati e, taking into account their commercial interests. How out o this dilemma To make a ailable o icial in ormation on accines, Paul White proposes the creation o an Internet portal bringing together all o the data alidated by the health authorities, on the model created or the pre ention o obesity. A re lection is ongoing in this regard in the General Directorate o health (DGS).
These questions and these ears can hide an obser ation: in a context conduci e to the pre ention, accines market, which weighs that 2 o world pharmaceutical sales, is ne er as well worn. "This is a sector changing that addresses a ery important phase o de elopment with a growth rate o 15, twice that o pharmacy," said Eric Halioua, expert in the li e sciences o the strategy consulting irm Arthur d. Little. On this basis, it is expected to generate approximately $ 26 billion in 2011, compared to 15.6 billion in 2007. This wealth is concentrated in the hands o a hand ul o key laboratories conducted by Sano i Pasteur, subsidiary o Sano i-A entis. In the wake o the rench group lurks the British GlaxoSmithKline, ollowed by American Merck and Wyeth. At them our, they share approximately 80 o the world market.
Pro itability impro ed
The itality o the industry eeds launch new accines that ha e pro ile blockbusters, i.e. a potential sales greater than $ 1 billion. "This concept was so ar in the pharmaceutical industry." "Today, ery inno ati e accines are sold at much higher prices, thereby impro ing pro itability or laboratories", notes Eric Halioua. Like the accine Pre enar American Wyeth in ection pneumococcal disease, such as meningitis, which has generated re enues o 2.4 billion in 2007 on a global scale. Also promising opportunities open to Gardasil, marketed by Merck and Sano i Pasteur MSD in Europe in the United States. It is not strictly speaking an anti-cancer accine, but a ter against hepatitis B, it is the second to target a human carcinogen irus. Pre enti e action is directed against the our types o human papilloma irus (HP ) most commonly in ol ed in precancerous lesions and cancer o the cer ix. Howe er, its protecti e e ect is ine ecti e in approximately 30 o cases and it cannot be a substitute or testing.
AIDS: un ul illed expectations
To these undeniable successes, the brutal judgment o the clinical de elopment o the " accine candidate" Merck AIDS, six months ago, douchť hopes in the medium term. Despite this setback, "many industrialists continue research in this area, argues Bertrand Alexander, Director o the accines di ision o GlaxoSmithKline. We are still in the preliminary phases o human trials, because we are ighting against a complex irus scienti ically, which mutates permanently. "Is there a runway to accelerate the process "Should be that the public authorities, who ha e supported research on AIDS, in est more in prototype industrial de elopment", suggests Pro essor Claude Leclerc, Director o the immune regulation and accinology o the Pasteur Institute. "In order to eri y the predictions rom the preclinical tests on animals, it seems to me necessary to quickly and in parallel se eral clinical studies o small-scale", explains - it. His eyes, this is not in the industrial logic o laboratories to support this early, ery risky step in economic terms, o the de elopment o academic research rom accine candidates.
Until the best days in the ight against AIDS, some ocus on preparation or a possible a ian lu pandemic. Habs expertise in mind: "our H5N1 accine is the irst to obtain the appro al o the ood and Drug Administration in the United States, last year, said Wayne Pisano, President and CEO o Sano i Pasteur. We ha e the largest capacity o a pre-pandemic accine and we continue to in est to meet the needs at the global le el. "The rench laboratory has thus to uel the pandemic stock o the U.S. Department o health, with the deli ery o a second batch o H5N1 accine with a new strain o a ian in luenza, which corresponds to the equi alent o 38.5 million doses. On the other hand, ri al GlaxoSmithKline was the irst to obtain, May 19, the green light rom the European Commission to market its pre-pandemic H5N1 accine in the 27 EU member countries.
E en i it is better to pre ent healing, the accines or the uture will also therapeutic irtues (read below). Rein orcement o Biologics and existing therapies, they will be a day to a oid a recurrence o still incurable cancers.