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HEALTH: One in Five Infants Still Lacks Essential Vaccines

Eli Clifton

WASHINGTON, Oct 21 2009 (IPS) - A record 106 million infants were vaccinated in 2008 – the highest rate of immunisation ever – according to a report released Wednesday in Washington, but NGOs are calling for an increase in funding to fill the gap affecting the world’s poorest nations and communities.

“The State of the World’s Vaccines and Immunisation” report, released by the World Health Organisation (WHO), the U.N. children’s agency UNICEF and the World Bank, calls attention to the huge improvements made in childhood immunisation rates and in prevention of communicable diseases in the world’s most vulnerable communities.

For the first time in documented history, the number of children dying each year has dropped below 10 million.

“Immunisation is a major component of the right of the child to health, we should not forget that,” said UNICEF deputy executive director Saad Houry at the release of the report.

“It is not right for children to be in hospitals due to preventable causes or put stresses on health systems due to preventable diseases,” he emphasised.

The report found that tuberculosis, diphtheria, tetanus, pertussis, polio, measles, hepatitis B, and Hib vaccines are preventing 2.5 million deaths per year. Since 2000, the measles vaccine alone has cut the number of measles-related deaths from 750,000 to 197,000.

By the 2020s, polio and measles can be eradicated, according to the WHO, UNICEF and the World Bank.

Distribution of existing vaccines, such as for polio and measles, to the developing world has played a role in reducing the number of preventable deaths. The large number of vaccines that are new on the market or in development could also lead to significant reductions in deaths from meningococcal meningitis, rotavirus diarrheal disease, avian influenza caused by the H5N1 virus, pneumococcal disease, and cervical cancer caused by human papillomavirus (HPV).

Of those vaccines in development, about 30 aim to protect against diseases for which no vaccines currently exist.

The WHO estimates that “if all the vaccines against childhood diseases were widely adopted, and if countries could raise vaccine coverage to a global average of 90 percent, by 2015, an additional two million deaths a year could be prevented among children under five years old”.

The report highlighted a surge in vaccine manufacturing capacity in the developing world. Eighty-six percent of vaccines are produced in emerging market economies, which are capable of providing large volume and low-cost vaccines for use domestically or in other emerging markets.

Emerging market economies account for 84 percent of the world’s population.

The report partially attributes the rapid expansion in vaccine availability and manufacturing to the introduction of new financial resources to support vaccine distribution in poor countries.

“This new report shows the impressive progress in immunisation that has been achieved over the last decade, in great part thanks to the GAVI [Global Alliance for Vaccines and Immunisation] Alliance, which includes among its members WHO, UNICEF, the World Bank, and the Gates Foundation, as well as donor and developing country governments, private industry and civil society,” said GAVI alliance deputy chief executive officer Helen Evans.

“More than 200 million children have been immunised with vaccines funded by GAVI and over 3.4 million premature deaths have been averted,” Evans said.

The WHO, UNICEF and the World Bank also sought to bring attention to the ongoing challenges facing sustained progress in making vaccines and immunisation available worldwide.

“Despite extraordinary progress in immunising more children over the past decade, in 2007, 24 million children – almost 20 percent of the children born each year – did not get the complete routine immunisations scheduled for their first year of life,” said the report’s authors.

“Most of these 24 million unimmunised or incompletely-immunised children live in the poorest countries, where many factors combine to thwart attempts to raise vaccine coverage rates – fragile or non-existent health service infrastructure, difficult geographical terrain and armed conflict, to mention just three.”

A 10-billion-dollar gap exists between the costs of immunisation in 72 of the world’s poorest countries – 35 billion dollars – and the estimated funding flow to support immunisation -25 billion dollars.

Efforts to expand immunisation will also meet challenges in bringing vaccines to 35 lower-middle incomes countries – containing a population of nearly two billion people – which are not eligible for GAVI funding but where immunisation costs could cost tens of billions of dollars.

The report cited three factors that have kept vaccine prices low for developing countries but recently “have evaporated”.

Manufacturers used to sell their drugs at a lower price to developing countries because they could get a higher price from industrialised countries but industrialised and developing countries no longer use the same vaccines; manufacturers no longer maintain excess production capacity; and competition among suppliers has decreased.

The report warned that while immunisation rates, particularly among children, are improving in the developing world, a loss of public confidence in vaccines has led to a disturbing resurgence of preventable diseases – particularly measles – in industrialised countries, including Austria, Israel, Italy, Switzerland, Britain and the U.S.

The trend has been linked to parents who refused to allow immunisation of their children as a result of purported links between the measles-mumps-rubella (MMR) vaccine and autism, despite a scientific consensus that no credible link exists.

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