Although the Influenza A (H1N1) virus (swine flu), has so far killed 16 people(in Mexico only) and infected 615 people in 15 countries (the World Health Organisation (WHO) figures)as of today, and caused a global panic and media attention, statistics reveal that hundreds of people died and millions were infected in India since 2000 with epidemics such as Chikungunya, Japanese Encephalitis (JE), Meningococcal disease, Dengue fever, Plague and Cholera.
However, most of these outbreaks in India have not attracted the same level of interest in the global healthcare industry. Pharma companies are yet to even develop drugs for diseases such as chikungunya and JE, note industry experts.
According to WHO’s India statistics, 151 districts in 9 states of Andhra Pradesh, Tamil Nadu, Karnataka, Maharashtra, Gujarat, Madhya Pradesh, Kerala, Delhi and Andhra Pradesh were affected by chikungunya and dengue fever, spread by Aedes albopictus mosquitos in 2006. More than 1.25 million suspected cases were reported from the country from February to October 2006.
Neither the multinational drug companies, nor any of the Indian drug companies are yet to develop an effective drug for this disease. During the outbreak, doctors had to prescribe paracetamol and other antibiotics to check the viral infection. Nicholas Piramal India, which planned to form a joint venture drug discovery research programme with the French pharmaceutical company, Laboratories Pierre Fabre backed out from the project due to procedural delays.
"We dropped the drug research plans for chikungunya, since the drug controller general of India (DCGI) delayed to sanction the project. It is almost six months' since we applied," Swati Piramal, director- strategic alliances, NPIL, told Business Standard in November, last year.
Pierre Fabre had developed effective medicines to prevent the disease outbreak which happened in Re-Union islands, a French colony, about three years ago and in some other tropical countries.
In July -August period of 2005, 1,145 cases of Japanese Encephalitis(JE) or brain fever cases were reported from 14 districts of Uttar Pradesh. Of this, one fourth or 296 people had died. Another 90 cases were reported from Bihar. The disease was caused by Culex tritaeniorhynchus and Culex vishnui group of mosquitos, the vectors of JE. Only two months ago the U.S. Food and Drug Administration approved Ixiaro, a new generation vaccine manufactured by a UK based biotech company Intercell, that can effectively prevent this disease.
Another fatal disease that infect India repeatedly is the meningococcal disease. In 2005, about 405 cases were reported in Delhi and suburbs and of this, 48 had died. Meningococcal disease is endemic in Delhi and outbreaks of Meningococcal Meningitis in and around Delhi were reported in 1966 and 1985. During 1966, 616 cases of meningitis were reported with case-fatality rate of 20.9 per cent.
The outbreak in 1985 was bigger in magnitude, both in terms of cases and the geographical area affected, with 6133 cases with 799 deaths.
Vaccines are currently available against four of the five strains of this disease, and a vaccine against the B strain is in development.
Menactra, Menomune of Sanofi-Aventis, Mencevax of GlaxoSmithKline and NmVac of JN-International Medical Corporation are commonly used vaccines. Indian companies such as Serum Institute are also developing vaccines for this disease.
Antibiotics such as ciprofloxacin is normally used by doctors to prevent the disease.
