Once the emergency of the Covid pandemic has passed, which left many consequences with respect to the EU-directed centralized purchasing policies of millions of doses of vaccines – often left in warehouses – Italy’s procurement strategy seems to have changed.
No to the EU contract for the purchase of the preventive vaccine
While New infectious challenges loom on the horizon, such as avian flu and Dengue, just to give two examples, a first sign of a possible turning point is that our country is not among those who have decided, through Hera – the EU Authority for the preparation and response to health emergencies (Hera) of the Commission – to enter into the joint procurement framework contract for the supply of up to 665 thousand doses of Seqirus pre-pandemic vaccine, with the option for a further 40 million doses for all 4 years covered by the contract. An initiative aimed at having medical countermeasures to prevent avian influenza (the vaccine in question protects against that caused by the H5 strains of the influenza A virus).
The reasons for the choice
15 EU member states have said yes. Why not Italy? A first hypothesis is that we will go and buy the vaccines when needed, but above all the paradigm shift on this front is the desire to go and negotiate directly with the pharmaceutical companies, without intermediate steps. Objective: minimize waste. Seqirus is the only preventive vaccine against zoonotic avian influenza authorized in the EU today. However, Italy is not exposed, neither on the avian nor on the dengue front. As regards specifically avian flu, for example, the previous Government, with another Prevention directorate of the Ministry of Health, had opted for GSK’s pre-pandemic vaccine against the H5N1 avian influenza virus.
Lopalco: “Short-sighted ideological choice”
“A short-sighted” and “ideological” choice made by Italy. This is the opinion of Pier Luigi Lopalco, professor of Epidemiology at the University of Salento.
“Italy makes this choice – explains the epidemiologist to Adnkronos Salute – once again outside the international forum for preparing for pandemic events. It is a choice that isolates Italian public health.”
Rezza: “It’s crucial to have strategy”
“It is true that if a country remains outside” the European agreement for the pre-pandemic vaccine against avian influenza, “it is not necessarily wrong or a disaster. However – warns Giovanni Rezza, extraordinary professor of Hygiene at Vita University – Health San Raffaele of Milan – we need to be sure that, when we need them, we can obtain vaccines. You need to have a ready strategy. Joining these European initiatives can be advantageous. Of course it is not mandatory. But if you decide not to join I want to hope that it is because there is already a ready strategy. It is a matter of strategy, not an ideological matter.”
Rezza highlights that “the other large European countries must also be looked at: Italy is not the only one not to have signed, for example Germany and Spain are also not on the list of members, while France is”, he highlights to Adnkronos Health. The EU initiative is aimed at having medical countermeasures to prevent avian influenza (the vaccine in question protects against that caused by the H5 strains of the influenza A virus). “There are two pre-pandemic vaccines – explains Rezza – One is that of GSK, the other is this one from Seqirus”. Italy’s option “is for the GSK vaccine because in the past there had been another European agreement and Italy returned. It is for a vaccine that would be made available – possibly adapted to a pandemic strain – at the moment should a pandemic break out. This one from Seqirus is still based on H5N1, like the one from GSK, but is already authorized for use for example in people at risk, such as farmers who have direct contact with animals. Italy is already in the other one, but that vaccine cannot be used“.
“It is true – continues Rezza – that individual bargaining can be done with the industry, bilaterally. This should be done when it is needed and could take more time. So, if perhaps we had exposed operators, why there are many outbreaks, we would not have had the vaccine available immediately. And it’s always better to already have it, perhaps in a small number of doses. Then there is a consideration linked to the price that can be obtained in a bilateral negotiation. Third reflection concerns the fact that this new authority, Hera, which includes all the European countries, has acted as guarantor for European agreement. Of course it is generally useful to participate in initiatives in a setting like this. It is not an ideological question, I repeat, but linked to the fact that many times there are compensation mechanisms that can be useful.”
Hera, explains the former DG Prevention of the Ministry of Health, “contracts for all European countries and facilitates the task. It should not be seen as a loss of national sovereignty, but as something advantageous from a practical point of view. It is clear that to do ‘preparedness'”, preparation in view of possible future threats, “you need to commit money to tools that you hope not to have to use later. This is a given. And you certainly shouldn’t throw money away either a plan and perhaps being within a “centralized” contract with a minimum of doses available because this means being able to quickly have more vaccines if needed.”
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