Giving poor children a shot at life
Parents in developed countries are saying no to the vaccine many elsewhere are literally dying for
For the doctor who heads a $2-billion-plus a year international initiative to vaccinate hundreds of millions of children in the world’s poorest countries, what disease do you think is top of mind?
If you guessed Ebola, you’re ... not even in the right ballpark.
It’s measles, says Seth Berkley, the epidemiologist who heads the Geneva-based GAVI Alliance, an organization set up 15 years ago by private and public donors — Canada is a big supporter — to provide equal access in every country to new and underused vaccines for children.
Measles kills 130,000 kids each year — 10 times more than have died in 24 known Ebola outbreaks that have occurred since the disease was first identified 40 years ago.
Of course, the world — or, at least, the rich part of it — has had an effective vaccine to prevent measles for decades. The problem is that children in disadvantaged places — very poor and remote rural areas of developing countries or the worst of urban slums — can’t get the shots. And a distressingly high number of parents in developed countries — not just in Canada, but also the U.S., the U.K, Japan and many more — won’t allow it to be used on their children for fear of rumoured, although undocumented, side effects that they think pose a greater risk.
GAVI doesn’t fund vaccinations in developed countries — its work is confined to the 73 poorest ones — but Berkley follows North America’s anti-vaccination debate closely, and it worries him.
“The problem here is mostly that parents don’t remember the diseases,” he told me in an interview. “They don’t remember how quickly it can kill, even in a setting of great health care like Canada.”
Misinformation about vaccines can spread to developing countries through the Internet, he said, but most parents in poorer countries are all too familiar with the horrors of these diseases and they want their children protected.
Next to measles, the two biggest priorities for GAVI are the continuing rollouts of vaccine programs for diarrhea and pneumonia, two major child killers in places where poor public health measures are the norm and treatment options are limited. The diarrhea campaign is moving ahead more slowly than he would like, but the drive to vaccinate for pneumonia is proceeding briskly, thanks to an innovative funding strategy where drug companies are promised huge volumes of sales in return for lowering their prices dramatically.
Work is also proceeding on an Ebola vaccine, which was fasttracked for testing when the latest outbreak was reported a year ago. But Berkley sees the need for more urgency in the work being done to develop vaccines to prevent HIV/AIDS, tuberculosis and malaria, each of which is a far worse scourge.
A malaria vaccine may be getting close, and GAVI will decide whether, or how, to roll out a vaccination strategy when the results from the latest round of field tests are known. It is a tough call, he said, and the decision will depend not only on how thoroughly the vaccine protects children — early tests showed only about 50 per cent coverage — but also how long the protection lasts.
Over its 15-year history, GAVI has vaccinated 500 million children, saving an estimated seven million from death.
In the next five years, the alliance hopes (with the help of a $7.5-billion cash injection from its latest fundraising drive last year) to vaccinate 300 million more, thus saving another five million to six million children.
This is a substantial scaling up of GAVI’s work, Berkley noted, and it will include taking vaccines into some of the world’s hardest-to-reach pockets of poverty.
He lauded Canada’s support for GAVI’s mandate — praise that, in my view, is deserved as this is one of the too-few areas of international development where the federal Conservatives have improved Canada’s aid response.
Last November in Senegal, Prime Minister Stephen Harper announced $500 million over five years to support GAVI’s intensified vaccination drive.
This is in addition to the $325 million Canada provided over the previous five years.
The commitment was part of the prime minister’s push for improvements to global maternal and child health care. And it fits with his government’s general move away from aid for important, but intangible, issues such as improved governance in impoverished countries and toward countable outcomes such as the number of children vaccinated.