This week, I'll share some fun vaccine facts because 🇲🇾 joined COVAX.
Fact 2: there are ~10,000 diseases but only ~1500 treatments & ~30 vaccines.
How many diseases have been 100% eradicated by vaccines? Only one: smallpox, declared in 1980. (1/6)
~10,000 diseases? It's a rough number because “disease” could mean different things.
One resource is the International Classification of Disease 10th edition (ICD-10), managed by @WHO. It has ~70K codes!
Some are hilarious, like this pic. These are not diseases, of course.
Diseases can be infectious (eg tuberculosis, malaria or HIV/AIDS) or non-infectious (eg diabetes, cancer or asthma). Another term is “communicable”. Vaccines work against communicable diseases.
3 of the top 10 global causes of death are infectious, so it's a big problem.
~1500 cures/treatments? (Cure = 100% health. Treatment = trying to achieve a cure).
Using the US FDA as a guide, it has approved 1453 “new molecular entities” in its entire existence.
NMEs are completely new drugs, i.e. many companies make paracetamol, but it’s one NME.
There are >300 infectious diseases, but only ~30 vaccines. Why? 1. Vaccines are complex & expensive. 2. Bacteria & viruses mutate. 3. Many infectious diseases are tropical, which lacks capital & research capacity.
The last reason is the most important & controversial.
Despite ~30 vaccines, we’ve only eradicated smallpox. Why? 1. Eradication is possible only if everyone gets a vaccine. 2. Some germs have non-human hosts, like horses, cows or bats, so they can return. 3. No money or political will.
A: Possibly, and data is increasing to support this policy.
A "mix-and-match" vaccines policy has increasing science behind it. The scientific term is "heterologous prime boost" (thelancet.com/journals/lance……, from Oxford).
1/4
Dua sebab penting:
🔺Saya tak mungkin tahu segala-gala ilmu & sains. Jadi, saya bergantung pada rakan sekerja yg lebih arif dlm bidang-bidang lain.
🔺Saya mungkin silap, jadi saya ingin kurangkan risiko itu.
Maka, Surat Rujukan akan menjaga kebajikan pesakit dgn lebih rapi.
2/
Mungkin saya pernah menulis beratus-ratus Surat Rujukan, spt kpd:
🔺Pakar jantung di Kuala Lumpur & Pulau Pinang
🔺Surat rujukan/sokongan utk Jabatan Kebajikan & badan zakat
🔺Rumah Seri Kenangan supaya mereka tahu keadaan fizikal seseorang warga emas yang baru sampai.
3/
A short story:
🔺A Funeral, Durians, SMEs & the Covid-19 Vaccines🔺
Had to organise a funeral (cause of death: lung cancer). Noticed dry ice being used.
Spoke with the undertaker, who told me that each dry ice brick is ~RM20, is -70 Celcius and lasts ~1-2 days.
1/5
Asked him about vaccine storage. He gave two ideas: 1. Ice-cream distributors have cold rooms reaching -20C. 2. Durian exporters to China use a freezing process reaching -80C.
Great ideas from a practical hands-on man!
2/5
This gentleman doesn’t have a degree, but he has decades of work experience & lots of common sense.
I told him that one Covid-19 vaccine requires -70C storage. He educated me that Siberia’s temperatures are “only” -60C, so human beings need to work hard to achieve -70C.
3/5
BEBENANG: Mengapa 🇲🇾 tak boleh umumkan harga vaksin?
Situasi ini amat kompleks. Kita mesti mempertimbangkan hujah & realiti utk kedua-dua belah situasi ini.
🔺Bab 1: di LUAR kawalan kerajaan (Tweet 3-9)
🔺Bab 2. di DALAM kawalan kerajaan (10-16)
🔺Bab 3: ringkasan (17-18)
1/18
Pertama sekali, sedikit pengumuman: 1. Saya seorang perunding bebas. 2. Saya tak memiliki stok apa-apa sykt di mana-mana. 3. Saya bekerja di Pharma 8 tahun (2Y sbg Medical Manager di 🇸🇬 + 6Y sbg Ethics & Compliance Director di Dubai, Shanghai & Paris, utk EEMEA & China).
2/18
BAB 1: DI LUAR KAWALAN KERAJAAN
Sykt farmaseutikal (atau pharma) mempunyai 3 pelanggan utama: 1. Kerajaan (kementerian, hospital atau insurans kerajaan) 2. Entiti swasta (hospital swasta, pengedar atau ejen) 3. Organisasi global (@UNICEF membeli 2 bilion dos vaksin/tahun).
BEBENANG: 6 SEBAB mengapa 🇲🇾 perlukan portfolio vaksin drpd pelbagai syarikat, bukan drpd satu sykt sahaja:
1. Tiada sykt yg mampu bekalkan segala keperluan vaksin 🇲🇾. Kalaupun wujud, mesti setiap negara akan bersaing, & kita masih tak mampu bersaing dgn negara kaya.
1/12
2. Bahaya kalau kita bergantung pada satu sykt saja.
Mungkin ada kluster Covid-19 di kilang mereka. Mungkin ribut taufan melanda kilang mereka.
Mungkin mereka naikkan harga sbb ada kuasa monopoli. Atau mungkin vaksin mereka tak diluluskan NPRA.
2/12
3. Virus Covid mungkin ada mutasi. Ini disebut "antigenic drift".
Jika 🇲🇾 ada satu vaksin saja, & vaksin tu tak berkesan terhadap mutasi tersebut, maka seluruh bekalan vaksin itu dah tak boleh digunakan.
Portfolio vaksin mengurangkan pendedahan kita kpd risiko mutasi.