Progress & Challenges 2004
VACCINES are among the greatest public health tools ever invented. The discovery that a simple series of injections or drops could provide nearly failsafe lifelong protection against deadly or disabling diseases transformed the field of preventative health. Millions of lives are saved every year because of vaccines.
Yet decades after the widespread adoption of vaccines, much of the affluent world has become complacent. The virtual disappearance of diseases that once terrorized populations and communities leads some to forget that this fragile peace depends upon continued universal vaccination.
|Any way you look at it the results are fantastic. Best investment I ever made.
-Bill Gates, Co-founder, the Bill & Melinda Gates Foundations
In many poor countries the terror remains. An estimated 30 million children each year still miss out on vaccination. As a result, two to three million will die annually from easily preventable disease and many more will fall sick, missing school and feeding the vicious circle that links poor health to continued poverty in adulthood.
The Global Alliance for Vaccines and Immunization, GAVI, was launched by its partners in 2000 to revitalize the field of immunization. A new type of public-private partnership, GAVI brings together governments in developing and industrialized countries, established and emerging vaccines manufacturers, nongovernmental organizations (NGOs), research institutes, UNICEF, the World Health Organization, the Bill & Melinda Gates Foundation and the World Bank.
Making this alliance much more powerful is The Vaccine Fund, established by GAVI partners to raise new resources and provide multi-year grants to the world's poorest countries to strengthen their health systems by improving immunization services and introducing new and under-used vaccines.
Four years later there is much to report. It is estimated that more than 500,000 lives will be saved because of GAVI support provided so far. In one of the most rapid international health scale-ups ever, more than 35 million children have been immunized against hepatitis B, making it the largest cancer prevention effort ever undertaken. The hepatitis B virus strikes most often curing childhood, but its ill-effects strike young adults in their most productive years, causing liver cancer and cirrhosis -- disease which kill quickly in developing countries where treatment is prohibitively expensive.
In the countries which have introduced the vaccine against Haemophilus influenzae type b (Hib), there has been a dramatic reduction in Hib-related meningitis - a nasty disease that kills 400,000 children annually and disables thousands more. Finally, many countries have increased immunization coverage - more than eight million additional children have received basic vaccination.
GAVI is also changing the vaccine manufacturing field. Today there is only one manufacturer who produces a vaccine that combines vaccines against diphtheria, tetanus, pertussis and hepatitis B into one shot - a highly desirable product in many developing countries. Eleven suppliers have submitted bids to UNICEF to supply this vaccine by 2006.
Meanwhile, the GAVI-supported Accelerated Development and Introduction Plans are working to ensure that the public health community participates early in the development of vaccines against rotavirus and pneumococcal disease. The goal is to ensure that if the vaccines developed are appropriate, children in the poorest countries will receive these vaccines as soon as possible.
One of the greatest challenges is finding ways to help countries strengthen their health systems over the long-term, so more children can be reached year in and year out. System-wide barriers must be tackled to ensure long-lasting improvements.
And many countries have shown dramatic advances. Uganda has seen a rapid expansion of coverage through political commitment and innovative community mobilization efforts. Madagascar has emerged from deep political crisis and is turning its health situation around, and Afghanistan is overcoming acute political problems and war to immunize its children. These countries are showing us that positive change is possible, even under the most trying circumstances.