HEALTH: More Child Deaths as Funds for Vaccines Dip – Report

By Marwaan Macan-Markar Reprint | | Print |

Marwaan Macan-Markar

BANGKOK, Nov 20 2002 (IPS) - Donor fatigue will condemn more people in developing countries to die from vaccine-preventable diseases, warns a report released globally on Wednesday.

Children will be the worst affected, states ‘The State of the World’s Vaccines and Immunisation’, a report that takes stock of the present efforts to thwart the spread of diseases through vaccinations.

Currently, close to three million people – two million of them children – die each year from diseases where vaccines are available, adds the 96-page report brought out jointly by the World Health Organisation (WHO), the United Nations Children’s Fund (UNICEF) and the World Bank.

The diseases include whooping cough, measles, diphtheria, polio, tuberculosis (TB) and tetanus. A common childhood disease like measles, for instance, is responsible for 700,000 deaths a year.

”Vaccines and immunisation are the most cost effective health tool we have,” Bjorn Melgaard of the WHO said at a press conference here to launch the report. ”The potential of vaccines has not fully materialised.”

For Carol Bellamy, UNICEF’s executive director, no child in the world should have to die from a vaccine-preventable disease. ”We need to invest more – and more rationally – in vaccine coverage and research, and ensure access in all corners of the globe,” she states in a media release accompanying the report.

But attracting funds for routine immunisation programmes is becoming increasingly difficult, the authors of the report note. ”Routine immunisation programmes have been neglected as funding has failed to keep up with population growth and the higher cost of delivering services.”

And in some countries, according to the report, funds have evaporated ”dramatically” due to foreign donors withdrawing from vaccination programmes and ”greater pressure on public spending”.

Currently, overseas funding for vaccine programmes in the developing world comes close to 1.56 billion U.S. dollars a year, of which 1.1 billion U.S. dollars is channelled towards immunisation efforts in the poorest countries.

”With an additional investment of U.S. dollars 250 million a year, at least 10 million more children would be reached with basic vaccines,” states the report.

On top of that is the limited amount of funds the poorer countries in the developing world are setting aside to cover immunisation programmes. ”Least-developed countries spend on average only U.S. dollars 6 per capita a year on all health services, including immunisation,” the report reveals.

However, according to the Global Alliance for Vaccines and Immunisation (GAVI), the U.N. agency taking the lead to increase immunisation efforts around the world, it costs around 25 U.S. dollars to vaccinate each child against the basic six vaccine-preventable diseases.

The most deprived region is sub-Saharan Africa, where only half the children are vaccinated during their first year of life, the report notes. ”By contrast, the wealthier developed countries have not only far higher immunisation rates but children also have access to a wider range of vaccines.”

At the same time, there are discrepancies in immunisation efforts across other regions in the developing world, where, for instance, those living in urban areas have access to vaccine initiatives as opposed to those residing in remote rural areas.

By the end of last year, countries in Latin America and the Caribbean and the Middle East and North Africa had achieved impressive heights in their immunisation programmes, with vaccine coverage nearing 80 percent of the population, according to the report.

East Asia and the Pacific, on the other hand, had achieved nearly 75 percent immunisation coverage by the end of 2001, while in South Asia it 60 percent immunisation coverage, the report adds.

Such achievements were due to the sustained immunisation programmes during the 1990s, states the report.

”Through national immunisation programmes around the world, millions of deaths have been prevented since the launch of Expanded Programme on Immunisation (EPI) in 1974,” the report states.

The six traditional vaccines under EPI are for diphtheria, whooping cough, tetanus, polio, measles and TB.

So far, only one major disease has been eradicated: smallpox in 1979, and another disease, polio, is heading for a similar fate.

But achieving such success for diseases such as TB or malaria may be difficult due to another hurdle: a drop in investment for the research and development of vaccines needed in developing countries.

”Today, vaccine manufacturers have little commercial incentive to develop vaccines against diseases such as HIV/AIDS, TB and malaria, which kill millions of people in developing countries, but relatively few in developed countries,” the report states.

That stems from the high cost vaccine manufacturers in the developed world incur to produce vaccines. ”Each new vaccine can cost U.S. dollars 500 million or more to research and develop, often over a period of 12-15 years,” the report adds.

And vaccine manufacturers have not been convinced that they can recoup these costs and make a profit by marketing their products in the developing world.

That, according to the report, has been due to the ”low or uncertain demand for new vaccines in developing countries”.

The low prices negotiated over the years for the traditional six vaccines for use in developing countries have ”deterred vaccine manufacturers from developing vaccines for use almost exclusively in what are perceived to be ‘low profit’ countries”.