Lessons Learned from the Japanese Encephalitis Vaccine Introduction in India That Supported the Introduction of Ivermectin–Diethylcarbamazine–Albendazole for Lymphatic Filariasis Elimination

Abstract

We used the introduction of the Japanese encephalitis (JE) vaccine in India as an example to understand more fully the process of introducing any new clinical product in India. We discuss the key decision-making points as well as the many activities involved in introducing a new clinical product in India’s public health program. We write from our experience in supporting the government of India to introduce new products successfully—namely, vaccines—to India’s health system. In India, the process begins with identifying the public health problem (e.g., an outbreak of JE), deciding to take action, prioritizing where action is needed, securing a supply and price of the intervention (the vaccine; in this case, the live, attenuated SA 14-14-2 vaccine), and determining how to ensure effective rollout of the intervention (the vaccination program). Reflecting on the experience of the JE vaccination program helped to inform the introduction of the triple-drug therapy of ivermectin, diethylcarbamazine, and albendazole in India as a new treatment protocol for lymphatic filariasis.

Strength in struggle: unravelling the journey of national vector borne disease control programme India: a comprehensive SWOT analysis

“…However, JAIVAC-1 is still in the experimental phase, and its efficacy had not been conclusively determined through extensive clinical trials. 24 Operational research Given India's vast size and diverse landscapes, tailoring strategies and treatment policies to specific settings is crucial. Utilizing micro-stratification and local data enables the development of context-specific interventions, especially in regions with varying epidemiology, ecological habitats, and health infrastructure.…”

Towards Accelerating Tool Development for Global Health

“…Considering triple-drug therapy for LF, Julie Jacobson 2 lays out ways to bend timelines to accelerate programs from proof-of-concept to implementation into community-wide drug administration programs in endemic countries; Gary Weil et al present the challenges of assessing the efficacy and tolerability of new ivermectin, diethylcarbamazine, and albendazole regimens for LF both in clinical trials 3 and in community settings 4 ; Jonathan King et al 5 discuss the importance of engaging the WHO early in designing the acceleration process; and details surrounding the field implementation and monitoring challenges of ivermectin, diethylcarbamazine, and albendazole introduction are addressed by Bhupendra Tripathi et al 6 for India and by Merelesita Rainima-Qaniuci et al 7 for Pacific island countries. The final three subject articles in the Supplement emphasize the similarity of approaches for accelerating the timeline when introducing a vaccine for Japanese encephalitis to India (Raj Ghosh et al 8 ), re-tooling and introducing a new point-of-care diagnostic (filariasis test strip) for LF by Anastasia Pantelias et al, 9 and the remarkable story from Olaf Valverde et al 10 of developing and introducing fexinidazole for human African trypanosomiasis. Last, Julie Jacobson and Alan Brooks 11 draw on the metaphor of creating a symphony orchestra to emphasize the essentialness of mutually beneficial partnerships and enlightened leadership to create an environment in which programs for developing new medicines, tools, and strategies to improve global health can progress as rapidly and efficiently as possible.…”

Reflections on “Orchestrating for Impact”: Harmonizing across Stakeholders to Accelerate Global Health Gains

“…We document the experiences of four recent global health partnerships that have accelerated achievement of their global health targets significantly, [1][2][3][4] and thereby provided an emerging profile of the needs and demands for developing a new product and/or strategy and integrating it successfully into health systems. This profile includes not only the steps of the process, but also how the work is done and which types of partnerships are required.…”