Poliomyelitis is highly infectious disease caused by poliovirus. It is also known as polio or infantile paralysis. The virus belongs to genus Enterovirus which is a type of single-stranded RNA virus. There are three serotypes of poliovirus: P1, P2 and P3 and development of immunity to one serotype does not produce significant immunity to the other serotypes. The virus is transmitted primarily via the faecal-oral route, by ingesting contaminated food or water and less commonly through oral-oral route. Those who are infected may spread the disease for up to 6 weeks even if no symptoms are present. Poliovirus colonizes the gastrointestinal tract, specifically intestine and oropharynx and after about a week, it invades local lymphoid tissue and enters bloodstream, and then may infect cells of the central nervous system. Replication of poliovirus in motor neurons of the anterior horn and brain stem results in destruction of cell and thus causes the typical manifestations of poliomyelitis. This is projected to favour a significant growth for polio vaccines market over the forecast period.
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Symptoms of Poliomyelitis:
Polio mainly affects children under 5 years of age. Up to 70% of all the infections in children are without any symptoms and about 25-30% of infections in children causes’ nonspecific illness without clinical or laboratory evidence of central nervous system invasion. This has created a gesture for the organizations to focus on the vaccines options for making prophylactic approach towards the prevention of the disorder, which in turn is expected to fuel the polio vaccines market in the near future.
Polio vaccines market relies on the fact that around 1% of polio cases can develop into paralytic polio which causes paralysis in the spinal cord (spinal polio), brainstem (bulbar polio), or both (bulbospinal polio).According to WHO, 1 in 200 infections leads to irreversible paralysis. Among those paralysed, 5% to 10% die when their breathing muscles become immobilized. The statistics regarding the prevalence of the disorder is expected to be one of the crucial factor that is to fuel the market of polio vaccines.
In a report, WHO has reported that Polio cases have decreased by over 99% since 1988, from an estimated 350 000 cases then, to 74 reported cases in 2015. The reduction is the result of the global effort to eradicate the disease. Of the 3 serotypes, P2 was eradicated in 1999 and number of cases of P3 has decreased significantly.
America has been declared polio free in 1994. In 2004, polio was declared to be eliminated from Australia, China and other 37 Pacific countries. Since 2011, there has been no cases of wild polio infections in India. This factor is projected to hinder the polio vaccines market in the near future.
There are only 3 countries left in which wild polio infections still persist; Afghanistan, Nigeria, and Pakistan, which are somehow the reason for significant growth in the polio vaccines market in the near future.
Indigenous wild poliovirus type 2 has not been detected since 1999. In 2015, the World Health Assembly agreed that all Member States which currently use OPV should prepare for the global withdrawal of the type 2 component of OPV in April 2016. According to WHO, member countries are required to introduce at least 1 dose of the IPV into routine immunization schedule.
Sanofi Pasteur and Bilthoven Biologicals/ Serum Institute of India are the 2 companies which was awarded in 2014 by UNICEF for the supply of IPV in 1, 5 and 10 dose vials, and long term supply agreements were established through to 2018.
Since 2000, UNICEF OPV procurement has averaged 1.8 Bn doses annually. GPEI launched the “End Game Strategic Plan 2013-2018” at the World Health Assembly in May 2013. This comprehensive strategy focuses on eliminating both wild and vaccine-derived polio incidence through routine immunisation programs thereby gradually replacing OPV use with IPV vaccine. This in turn is expected to favour the growth in polio vaccines industry in the near future.
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According to UNICEF report, Bio Farma (Indonesia), GlaxoSmithKline (GSK) (UK) and Sanofi Pasteur (France) are the only OPV bulk manufacturers. Novartis (Switzerland) has stopped their manufacture of OPV.
Other players of polio vaccine market are: Merck & Co, Bibcol, Pfizer, Beijing Tiantan Biological, Bio-Med, Panacea Biotec Ltd, Adithya Vaccine Pharma, Sinovac Biotech Ltd, IPOLand Aventis Pasteur.