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The introduction of new health technologies in India

Date: Poster sessions
Source: Forum 11
Authors: Shilpa Vuthoori, Policy Associate, Public Policy, International AIDS Vaccine Initiative, USA
with Holly Wong

Abstract

Building political and financial support and strengthening health system capacity to ensure equitable access to new and future technologies, such as HIV vaccines, can be especially challenging in developing countries. Involving a range of stakeholders in decision-making can help adequately prepare for the adoption, implementation, and delivery of new innovative health technologies. The introduction of new technologies includes the formal government decision to approve the product (or service) and the implementation of programmes necessary for its distribution. To identify and assess the potential issues in introducing HIV vaccines into the Indian health-care system when they become available, a research study was conducted of five health technologies previously introduced in India.

This analysis examines the adoption histories of the Universal Immunization Programme (UIP), hepatitis B vaccine, no-scalpel vasectomy (NSV), voluntary counselling and testing for HIV (VCT) and antiretroviral therapy (ART) in India using literature reviews, national data sets, international health agency reports, and interviews with field experts. We identified key financial, political, social and programmatic factors that influence health technology introduction. Reviewing these five health technologies previously adopted in India within the context of these factors provides health-care decision-makers with valuable lessons applicable to HIV vaccines.

The findings suggest the eventual introduction of HIV vaccines may face numerous challenges and that multiple stakeholders must be involved to successfully introduce any new health technology. For example, defining public health need for ­ and evaluating the appropriateness of ­ an HIV vaccine depend on both scientific and operations/social research data. Additionally, involving both nongovernment organizations and the private sector can significantly affect the success of a vaccination programme. Other critical steps, such as obtaining financial and political support and expanding infrastructure, require participation from a variety of stakeholders including policy-makers, programme managers, funders and activists.

Encouraging stakeholders to prepare in advance could substantially ease the introduction of HIV vaccines, reduce the time lag to implementation, and result in more equitable access for the target population. Additional lessons may be gained from the practical experience of introducing other technologies such as the human papilloma virus (HPV) vaccine in India and other developing countries.