Last week, I attended the launch of a new report - the State of the World’s Vaccines and Immunizations – at the National Press Club in Washington, DC. This report – prepared by the World Health Organization, UNICEF, and the World Bank – highlighted progress and challenges from across the spectrum from vaccine development to immunization financing to the challenges of equitable delivery. Its messages balance the successful reversal of a downward trend in immunizations – immunizations rates worldwide had begun to decline in the late 1990s - with the need to assure equity in vaccine access for all children.
It included some bright spots and some approaching storm clouds in the area of immunization financing. According to the report, low-income countries are funding an average of 33% of the costs of their vaccines. This is evidence of a major commitment to the health of their children by many poorer countries. On the other hand, the report declares that the days of pennies-per-dose vaccines are over and at least $1 billion per year are needed in the immediate future to support introductions of vaccines like rotavirus and pneumococcal in low income countries and to make sure that they reach even the hard to reach children. “The real challenge,” says the report, “will hinge on how national governments, and the international community at large manage their roles and responsibilities in reaching and financing the goals.” In short, delivery of life-saving vaccines depends on whether everyone steps up and does their part.
A panel of speakers from the lead agencies was moderated by Dr. Jon Andrus, recently appointed deputy director for the Pan American Health Organization (PAHO) and one of the most experienced leaders in vaccines today. He was joined by the Assistant Director-General of the World Health Organization, Daisy Mafubelu, UNICEF’s Deputy Executive Director, Saad Houry, and others. In short, the room was a Who’s Who of the vaccine world.
Some highlights: Rakesh Nangia, Acting Vice President of the World Bank, reminded the audience that the three F crises – food, fuel, and financing – were adversely impacting countries and their populations. Steve Blount from the US Centers for Disease Control reminded people that the novel H1N1 influenza strain is increasingly associated with a risk of bacterial pneumonia, especially due to pneumococcus, and that we need vaccines for both flu and pneumonia.
If there was anything missing from the room it was the voice of civil society and the sense of urgency that they often bring. To save the lives of a dozen whales, Greenpeace volunteers put themselves between a whaling ship and the whales. And yet, for the lives of over 2 million children each year, we don’t have anywhere near that kind of passionate civil society movement.
Professor Fred Were from the Kenya Pediatric Association reminded the room last week that for pediatricians like him in Africa these vaccine preventable diseases are an everyday reality and these vaccines are needed urgently. The voices of thousands of mothers and families who have lost children to vaccine-preventable diseases would have made a huge impact.
The WHO/UNICEF/World Bank report shows that the state of the world's vaccines and immunization is strong but the launch shows that it could get stronger still. Recently, at an event sponsored by Johns Hopkins School for Advanced International Studies I heard Lynn Freedman from Columbia University say that “we need movements that make demands, not just bring expertise”. She was talking about averting maternal deaths in developing countries, but as I sat at the National Press Club last week with my professional colleagues in vaccines and immunization, I couldn’t help but think that she might have a point worth thinking about for our vaccine community as well.
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