This could become a reality if anti-thiomersal activists are successful .
The United Nations Environment Programme (UNEP) is developing a treaty on the production, importation, and export of mercury-added products. Thiomersal (also known as thimerosal, mercurothiolate, and sodium 2-ethylmercuriothio-benzoate) is a key preservative used in most multi-dose vaccines and it contains a mercury-based ingredient, ethylmercury. Although data from many studies show no convincing evidence of harm caused by the low doses of thiomersal in vaccines, all mercury-added pharmaceutical products, including vaccines, are currently included in a draft list of products to be banned under the treaty, if adopted as written. Banning thiomersal in vaccines would almost certainly limit the availability of affordable vaccines and result in a significant adverse public health impact. To our knowledge, the health community has not been involved in the formulation of this treaty, which is under the auspices of environmental entities.
Additional information is included below and attached.
We are asking participants in this forum to respond in two ways:
(1) Educate country environmental representatives to UNEP of the potential impact such a ban would have on their respective countries. This can be done directly (using contact information provided here) or indirectly by engaging with ministries of health or other influential health officials who can reach UNEP country representatives. A one-page overview of the situation is attached as well as a brief by WHO.
(2) Share with this group the potential impact a ban on thiomersal would have on the work that you do, or more broadly.
Please contact Erin Fry, Government Affairs Officer at PATH, [email protected], with additional information or questions.
About the UNEP Mercury Negotiations & Thiomersal
• In 2009, UNEP decided to develop a binding agreement on mercury, including the production, import, or export of mercury-added products, to be completed in 2013.
• Negotiations are taking place over five International Negotiating Committee (INC) meetings.
• In the second INC meeting, the issue of thiomersal in multi-dose vaccines was raised by a US anti-thiomersal activist group.
• In response to the second discussion draft of the treaty, the African Region stated, “The use of mercury in pharmaceutical products where alternatives exist should also be prohibited. Existing stocks should not be sold to the developing world.”
• The third discussion draft released in preparation for the October/November 2011 negotiation includes “pharmaceutical products” on a list of all mercury-added products that would be banned.
• Countries (and some regions) replied with comments to the third discussion draft; the US suggested that pharmaceutical products should not be on the list to ban; those from the Latin American and Caribbean regions and the European Union, suggested more broadly that affordability should be considered along with periodic scientific reviews of evidence.
• To date, the only non-governmental organization (NGO) response posted related to vaccines is from an anti-thiomersal group and is a “Summary of Supportive Science Regarding Thimerosal.”
• It appears as though the voice of the health community has not adequately been present in these negotiations.
• We understand that WHO will be presenting and submitting materials at the third INC, and is supportive of the health community engaging with country-level INC delegates on the issue.
UNEP-Mercury-Treaty----Vaccine-Issue-Overview.pdf
WHO and UNEP recently released this brief, which includes additional information on the topic.UNEP-Health-Advance.docx
I have some quick responses to this mail.
First no ban should be advocated unless we have an alternates already in place for those who would be affected by this ban. For example, nerve tissue vaccine was banned in India citing some rare reactions but later the poor were left to die as they could not afford to purchase the new safer cell culture vaccine. So capacity of governments, especially third world governments need to be assessed for purchase of newer vaccines without preservatives, before any ban is in place or immunization programme would get a real jolt.
Secondly, we should try to explore alternate routes of vaccine administration like intradermal route, whereas even if there is a preservative, but the amount used is small or negligible.
Thirdly we should try to make vaccines that donot use any preservatives like some Rabies vaccines do.
And finally we need to focus on the areas that are still deprived of basic vaccines, whether with or without any preservatives.
Moreover murcury laden spygomanometres are all around spilling murcury in the hospitals, why that is not not catching anyone's eye?
Thanks,
Dr. Omesh Kumar Bharti, Himachal, India
I hope this discussion will be open. If developed countries have stopped using thiomrsal/ mercury in vaccines- it should be possible for GAVI to consider promoting the vaccines that are now used in for better off families. "Cheap" vaccines are those which are used widely and bought in large quantities. If supply goes up, prices of mercury-free vaccines will fall.
An old debate- where Siddha practitioners state that mercury has therapeutic effects in certain medicines is well known in India. If some one starts pushing for thiomersal, they will revive that debate on Siddha medicines as well . I do not know if mercury in Siddha medicines is considered safe by those who feel it is "cheap" in vaccines.
Thank you for your thoughts on this topic, and for providing an example from India. I believe the underlying question here is whether the scientific evidence points toward the need for a ban at all. Over the past ten years, reputable scientific bodies have evaluated the safety of thiomersal. The World Health Organization’s (WHO’s) Global Advisory Committee on Vaccine Safety concludes that existing thiomersal-containing vaccines are safe and that any risks are unproven. Similar conclusions have been drawn by the US Institute of Medicine, the American Academy of Pediatrics, the UK Committee on Safety of Medicines, and the European Medicines Agency
.
It is beyond the scope of this discussion to focus on other products that might be banned under this treaty. I recommend consulting the UNEP Mercury Intergovernmental Negotiating Committee website at: http://www.unep.org/hazardoussubstances/Mercury/Negotiations/INC3/tabid/3469/Default.aspx
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