A century ago, state institutes of public health played an important role in the production of sera and vaccines. In The Netherlands and the Scandinavian countries they continued to do so until after World War II. Focusing in particular on The Netherlands, this chapter examines their withdrawal from vaccine production in the past 20 years. In the 1980s the Dutch government was still committed to maintaining the state’s ability to produce the vaccines needed by the national vaccination programme. A series of legal and institutional changes sought to protect the public sector vaccine producer against the threat of privatisation. These changes ultimately proved inadequate. Not only was the Institute’s ability to meet demand for new vaccines being eroded by global developments, but policy makers were increasingly convinced that vaccination practices should be harmonised with those of other European countries. The decision to sell off the Dutch state’s vaccine production facilities, taken in 2009, has to be understood in historical context. It was the outcome of globalisation processes that for two decades had worked simultaneously on both the supply and the demand sides
The case of the Netherlands
A global history
Edited by: Christine Holmberg, Stuart Blume and Paul Greenough
In this book scholars from across the globe investigate changes in ‘society’ and ‘nation’ over time through the lens of immunisation. Such an analysis unmasks the idea of vaccination as a simple health technology and makes visible the social and political complexities in which vaccination programmes are embedded. The collection of essays gives a comparative overview of immunisation at different times in widely different parts of the world and under different types of political regime. Core themes in the chapters include immunisation as an element of state formation; citizens’ articulation of seeing (or not seeing) their needs incorporated into public health practice; allegations that development aid is inappropriately steering third-world health policies; and an ideological shift that treats vaccines as marketable and profitable commodities rather than as essential tools of public health. Throughout, the authors explore relationships among vaccination, vaccine-making, and the discourses and debates on citizenship and nationhood that have accompanied mass vaccination campaigns. The thoughtful investigations of vaccination in relation to state power, concepts of national identify (and sense of solidarity) and individual citizens’ sense of obligation to self and others are completed by an afterword by eminent historian of vaccination William Muraskin. Reflecting on the well-funded global initiatives which do not correspond to the needs of poor countries, Muraskin asserts that an elite fraternity of self-selected global health leaders has undermined the United Nations system of collective health policy determination by launching global disease eradication and immunisation programmes over the last twenty years.