Depth: Uncovering the Black Curtain of Interests in Vaccine Purchase

Two days ago, the public health system fried the pan again.

According to media reports, the Commission for Discipline Inspection of Guangyuan City in Sichuan Province recently investigated and dealt with a corruption case in the city’s disease control system. The case involved six counties and districts under the jurisdiction of Guangyuan City, Cangxi, Wangcang, Jiange, Lizhou, Zhaohua and Chaotian, with a total of more than 30 people involved, 6 of whom were transferred to judicial organs for handling, involving a total amount of more than 5.1 million yuan.

Speaking of this case, it is inevitable that people will think of Zheng Xiaoyu, former director of the State Food and Drug Administration, who was investigated for corruption, bribery, dereliction of duty and dereliction of duty many years ago.

After all, government agencies and units should bear the responsibility of what in vaccine management? Why are there always all kinds of moths involved in the purchase of vaccines? Why is corruption common in vaccine management agencies?

This starts with our country’s vaccine management system.

Who is in charge of the vaccine now?

To answer this question, we must first understand the classification of vaccines in our country.

At present, vaccines in our country are mainly divided into two types, which can be simply called [type I vaccine] and [type II vaccine].

A type of seedling:

It is provided to citizens free of charge by the government. At present, the first-class vaccines in our country mainly include hepatitis B vaccine, BCG vaccine, live attenuated oral poliomyelitis vaccine, etc.

This kind of vaccine, because it is provided free of charge, is borne by the provincial and municipal governments, they are budgeted by the provincial governments, bidding procurement. The procurement manufacturer is different, the price will have a little difference, but the difference is not big, after the procurement is completed, unified distribution to the vaccination points.

The second type of seedlings:

It refers to vaccines that citizens receive voluntarily and at their own expense. This kind of vaccine is no longer purchased centrally by the government, but by each vaccination point. The pricing of this kind of vaccine is also relatively free, usually according to market rules.

Substitute seedling:

In addition to Class I and Class II vaccines, there is also a special variety, which we can call [substitute vaccine] for the time being. It refers to imported vaccines that prevent the same diseases as [Class I vaccine].

Just mentioned, a class of vaccines mainly have hepatitis B vaccine, BCG vaccine, oral poliomyelitis attenuated live vaccine and so on. In the process of government procurement, domestic vaccines are usually preferred. For the same disease, if economic capacity permits, imported vaccines can be selected at one’s own expense. This kind of imported vaccine at one’s own expense is what we call [substitute vaccine].

Sometimes, the safety of domestic vaccines for certain diseases is indeed lower than that of imported vaccines. For example, the safety of domestic oral poliomyelitis attenuated live vaccine (OPV) is lower than that of imported inactivated poliomyelitis vaccine (IPV).

However, there is no need to be superstitious. At present, there are many high-quality vaccines in our country, and the quality is no worse than that of imported vaccines. For example, hepatitis B vaccine, which is provided free of charge in our country, has reached the world’s advanced level in quality and is not necessarily a better choice.

Well, after reading the above introduction, do you know who is in charge of the vaccine?

In short:

    The first type of Miao government is in charge and free of charge. The second type of seedlings are managed by local purchasing points and need to be vaccinated at their own expense. The [substitute seedlings] that are free from the two types of seedlings are also inoculated at their own expense.

Vaccine procurement [oil and water]?

There is no [oil and water] for formal procurement management operations.

If it is necessary to say [that is, there are many procurement irregularities], then it can be said that the current procurement management for Class II vaccines is not rigorous enough, and the [oil and water] for vaccine procurement mainly comes from Class II vaccines.

The first type of seedlings are purchased by the Government through public bidding. Because of the accident, all links are now transparent and open, so there is almost no way to receive kickbacks and bribes.

However, the second type of vaccine is different. As mentioned above, the second type of vaccine is priced by the market, that is, a small vaccination point can choose different vaccines from different manufacturers, and the selling price can of course be determined by itself. This will easily lead to various irregularities and even covert operations.

It is not uncommon to receive kickbacks and accept bribes. For example, in 2013, in a bribery incident investigated and dealt with by the state, drug dealers bribed personnel in all aspects, from functional departments such as industry and commerce, prices and human society to primary hospitals and doctors, in order to sell their own drugs.

According to media reports, drugs with an original price of 15 yuan actually sold for 207 yuan in China due to the cost of [opening joints].

The purchase and sale of vaccines are actually the same. China has a large population and a huge amount of vaccines are used.

Only Guangyuan County mentioned above has purchased 60 million doses of vaccines since 2008. We may as well calculate how much vaccine can be used in the country.

However, this is only a case that has been investigated and dealt with. In the face of such high profits and fierce market competition, how many drug manufacturers and salespeople do not use this method in order to survive?

In addition, because the second type of vaccines can be purchased and priced by themselves, it is not excluded that many managers with purchasing and pricing rights actively raise the price of vaccines to earn the difference in order to earn high income.

Is [Vaccine Bribery] Unavoidable?

Of course it can be avoided.

Everyone should have confidence that corruption in vaccine purchasing can be avoided.

Strengthen the leadership and monitoring of vaccine purchasing units;

Standardize the purchase process, public bidding and purchasing process, implement unified online bidding and purchasing of vaccines, unified vaccine purchasing and settlement procedures, and implement two-line management of revenue and expenditure;

Strengthen special control efforts, crack down on commercial bribery, and further correct unhealthy practices in the field of vaccine purchase and sale;

We will strengthen the construction of the supervision and inspection system and improve the long-term mechanism for honest medical practice.