Clinical Infectious Diseases
http://www.journals.uchicago.edu/toc/cid/current

EDITORIAL COMMENTARY: Reaching MDG 4 in India: A Role for Rotavirus Vaccine?
Edmund Anthony S. Nelson and Damian G. Walker
Clin Infect Dis. (2011) 52(2): 178-179 doi:10.1093/cid/ciq095

Abstract
A new health intervention can be either more or less expensive than existing intervention(s) (usually more). It can also be more or less effective (again, usually more). Thus, improving the health of a population usually costs more money (for governments, taxpayers, and/or individuals). Occasionally, the situation arises when a new and better intervention costs less and is cost-saving. In this case, the decision should be to introduce the intervention, and a failure to do so would require a very detailed explanation.

The economic evaluation by Esposito et al of the introduction of rotavirus vaccine to India’s National Immunization Programme reports that if the Government of India applies to the GAVI Alliance and is approved to receive funds to support its introduction, it could pay the heavily discounted copay price of US$ .15 per dose (US$ .30 for a 2-dose course); at such a price per dose, it would be in the fortunate position of saving both lives and money. Of importance, however, the contribution of the Government of India to the cost of the vaccine would be expected to steadily increase over time until the full cost was borne by the government; thus, the potential cost-saving scenario would not last forever. Nevertheless, even at higher prices, purchasing the rotavirus vaccine would be considered to still be a very sound investment. What is the likely eventual …