Marine Martirosyan
Vahe Sarukhanyan 

In a follow-up to our article regarding the donation of 60,000 seasonal influenza vaccines to Armenia from the U.S. based Task Force for Global Health, we will now take a look at the details of the memo of understanding between donor and recipient.

These details are interesting and raise a number of issues.

Hetq sent Armenia’s Ministry of Health questions regarding this document and the answers are also subject to scrutiny. In particular, we wanted to know the exact date when Minister of Health Armen Muradyan and Task Force Executive VP Thomas Rosenberger signed the memo. The ministry wrote back that the memo covered a one-time donation and was signed based on a government decision issued on October 30, 2014.

However, in the section of the memo of understanding (MOU) regarding its effective time frame, no dates have been entered. It only states that the MOU may be terminated at any time by either party with prior written notice of at least 30 days. Thus, the ministry didn’t provide a clear response to our question. This is strange.

The MOU spells out the obligations of the parties. While the Task Force’s Center for Vaccine Equity (CVE) was obligated to provide the vaccines supplied by Green Cross, the ministry had to comply with a number of conditions. Below are the most interesting.

Is  this point an attempt to safeguard the intellectual property rights of the vaccine, or does the donor seek to conceal the true composition of the vaccines, despite the fact that the World Health Organization (WHO) has publicized what the vaccines contain? The MOU states that Armenian law is to be applied in this matter. The RA “Law on Drugs”, which also covers immunizations, states that these too are subject to official registration. Before any drug can be registered they must be laboratory tested by The Scientific Centre of Drug and Medical Technology Expertise.

The ministry informed us that the influenza vaccines underwent a document and partial laboratory exam, as well as a visual inspection, after reaching Armenia.

In our previous article we had written that although Armenia is located in the northern hemisphere and that the flu season here stretches from September to May, the ministry received vaccines intended for the southern hemisphere’s March-November flu season. The ministry said the components of both vaccines are identical. The WHO has come up with the same recommended compositions for northern and southern hemisphere flu vaccines.

According to the health ministry, the vaccines supplied to Armenia were manufactured by Green Cross, a South Korean bio-pharmaceutical company. The flu vaccines are marketed under the name “GC FLU® inactivated”.

Green Cross Hwasun Plant were the flu vaccines are produced

The number of vaccines is kept a secret 

At first glance it may seem that these points are there to facilitate data collection and analysis. Nevertheless it remains a mystery why would the donor be interested to know, in particular, about the exact location of remaining vaccine stocks? It’s not hard to guess that those who drafted and signed the MOU would say argue the above. However, who can guarantee that the information collected by the supplier, and its possible distribution to unknown third parties isn’t just another link in the overall testing procedure.

We asked the ministry how many individuals had been vaccinated as of January 23 of this year. According to the MOU, the ministry was obligated to provide the number to the donor a long time ago. But the ministry gave us no number, just that the vaccines were given to corresponding risk groups.

The ministry cannot provide exact numbers because it has a problem using up the vaccines. A Hetq source within Armenia’s Ministry of Defense claims that the department has refused to use the vaccine. Of note is the fact that in the government’s decision to accept the vaccines it states that cases of acute respiratory viruses within the military have risen sharply. Then too, Armenia’s military forces perhaps make up the largest risk group. Essentially, there is a clear dispute between specialists at the ministries of health and defense regarding the vaccines. In this case, it is interesting to know what number the health ministry gave the Americans regarding the numbers of those vaccinated.

A gift in the form of a package of requirements

Thus, if the CVE does not take back the vaccines, the ministry, even after refusing them, must use up the amount already supplied. The ministry told us that all 60,000 vaccines have been shipped.

What were our government officials thinking when they supported such a memo? What exactly is its true objective – preventing flu cases or testing the vaccines?

Simply put, if any one gets sick or dies from taking this vaccine, Armenia’s Ministry of Health will be held fully accountable. Any compensation will come out of the state budget – out of the pockets of average taxpayers.

It seems that the top brass over at the ministry of health have completely misunderstood the Hippocratic Oath and overriding principle of health workers – first do no harm.