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Global vaccination effort saves millions

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The lives of up to 10 million children could be saved in the next six years by joint action to boost vaccination rates in developing countries, according to the Global Alliance for Vaccines and Immunisation.

In its Mid-Term Review, presented to a meeting in Stockholm last week, the Alliance (GAVI) reported good progress in boosting immunisation rates in developing countries, with 97 million children receiving GAVI-funded vaccines in 2011 and 2012, potentially saving around 1.1 million lives.

The Alliance – which is a public-private partnership founded by the Bill and Melinda Gates Foundation, the WHO, UNICEF and the World Bank – said that developing countries were on track to immunise an extra 243 million children through GAVI-supported routine immunisation programs between 2011 and 2015, preventing almost four million future deaths.

Looking further ahead, it said expanded vaccination programs in developing countries had the potential to save 10 million lives, prevent more than 200 million cases of illness, and avert more than $US200 billion in illness-related costs by 2020.

Since 2011 the Alliance has overseen the introduction of vaccines on 98 separate occasions, including almost 30 launches of the pneumococcal vaccine and the introduction of rotavirus vaccines on 10 occasions.

Earlier this year it begun funding for the human papillomavirus vaccine and the combined measles-rubella vaccine.

But it admitted that poor infrastructure, inadequate transport networks, funding constraints and soaring demand meant the organisation was likely to fall short of the targets it had set itself for the five years ending 2015.

The lack of a well-functioning and reliable refrigerated supply system in many countries increased the risk that vaccines would be exposed to damaging temperatures before they could be used. The vast majority of vaccines need to be kept at between 2 and 8 degrees Celsius before they are administered.

The Alliance has also encountered difficulties in its efforts to build up the capacity of countries to sustain immunisation programs once GAVI support is withdrawn, though it reported that 17 countries are on track to meet co-financing requirements, and seven are expected to be in a position by 2015 to support ongoing vaccination programs without external assistance.

But the humanitarian organisation Medicins Sans Frontieres (MSF) has called on GAVI to do more to improve vaccination rates in developing countries.

Executive Director of the MSF Access Campaign, Dr Manica Balasegaram, said that although the organisation fully supported GAVI’s mission, “we think that [it] could improve its work in a number of areas so that more children can be protected from childhood killers”.

Specifically, MSF believes the Alliance needs to cut the cost of vaccination by driving a harder bargain with manufacturers and suppliers, and the give humanitarian organisations such as MSF access to these vaccines at a cheaper price (currently access is restricted to Alliance members, such as participating governments).

MSF said the cost of fully vaccinating a child had soared since 2001 from $US1.38 to $US38.80, and concern was mounting among many countries where MSF is active that “they will not be able to afford these prices once they lose GAVI support”.

The humanitarian organisation also wants GAVI to extend its vaccination programs to include children older than 12 months, and tho provide incentives for the development of vaccines – such as the MenAfriVac meningitis A vaccine – that can survive for lengthy periods without refrigeration.

It said cold chain logistics were often incredibly difficult in developing countries, where power supplies were often unreliable or virtually non-existent, and temperatures regularly exceeded 40 degrees Celsius.

“We think it’s very important for GAVI to take a close and critical look at what it can improve,” MSF Vaccines Policy Adviser Kate Elder said.   

In its update, GAVI said that the development of new vaccines against HIV and tuberculosis were still some time off, but added there was “a very real prospect” of a malaria vaccine within the next five years, while an inactivated polio vaccine would be introduced into routine immunisation programs in coming months.

Adrian Rollins

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