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Why Is the World's Most Successful Child Health Intervention Going Begging?

Posted: 08/03/10 01:26 PM ET

Vaccines have saved the lives of millions of children around the world, and have the potential to save millions more in the future as newer vaccines are developed and introduced. Vaccines have resulted in global eradication of smallpox, we are on the brink of attaining global eradication of polio, and measles deaths have decreased by 78 percent since 2000. Newly developed vaccines will prevent hundreds of thousands of child deaths each year from rotavirus diarrhea and pneumococcal pneumonia when countries can gain access to these vaccines. Immunization is one of the most cost-effective investments in child health. Yet in 2009 in low-income countries, two out of five deaths in children under five-years old were due to pneumonia or diarrhea. New vaccines can prevent a large proportion of these deaths but the global community has not committed the resources necessary to bring the full range of vaccines to all children. Polio eradication is not yet assured, and we are at great risk of losing the dramatic progress made against measles as donor funding has dropped precipitously despite rapid movement toward elimination. The reduction in measles deaths alone accounts for nearly 25 percent of the overall reduction in child deaths since 1990. Achieving Millennium Development Goal 4 -- to reduce under-five child mortality by two-thirds by 2015 -- will not be possible without additional support for immunization. It would be a crime if this goal were missed simply for lack of adequate financial support.

Society has long recognized the value of vaccines. Since 1974, the World Health Organization (WHO) has coordinated a global Expanded Program on Immunization (EPI). Major support came from bilateral development agencies and UNICEF negotiated a significantly reduced price for vaccines in developing countries. However, vaccines don't give themselves. It takes organized structures and trained personnel to deliver vaccines safely to those who need them. In 2008, more than twenty-two million infants were missed by routine immunization services and remain unprotected.

Recognizing that developing countries need assistance to enjoy the full benefits of immunization, important global partnerships were developed. The Measles Initiative has provided more than $700 million in support of campaigns and disease surveillance that strengthen the components of routine immunization systems, delivering nearly 700 million doses of measles vaccine since 2000 and preventing an additional 4.3 million childhood deaths. The result is measurable success in improving routine vaccination coverage and in reducing child deaths at an incredibly low cost. However funding for measles control has dropped 75 percent since 2007, resulting in delayed campaigns, outbreaks and deaths.

For the Polio Eradication Initiative, Rotary International has played an exemplary role in raising more than $1 billion over the past 25 years, working closely with partners. The GAVI Alliance was formed to ensure that children in the poorest countries of the world have access to the life-saving potential of new vaccines. The GAVI Alliance currently provides more than $1 billion per year.

The Measles Initiative and the Polio Eradication Initiative maximize the impact of vaccines. Country-wide immunization campaigns ensure all children are vaccinated, even in hard to reach areas where many children cannot access routine immunization services. During campaigns, thousands of health care workers move out across a country to immunize millions of children under five-years old over a few days. Campaigns are complex undertakings that also deliver other preventive interventions such as deworming medicine, insecticide-treated bed nets for malaria control, and vitamin A to prevent blindness often associated with measles disease.

Yet, with all of this cooperation, innovation and collaboration, we are at risk of losing many of the gains that have been made and forgoing the additional benefits that are within reach.

Since June 2009, more than 30 African countries have experienced measles outbreaks resulting in more than 89,000 cases and 1400 deaths. The World Health Organization estimates that the combined effect of decreased financial and political commitment may result in a return to over 500,000 measles deaths a year by 2013, erasing progress achieved over the past 18 years. Why is this?

First, prevention is invisible. When immunization is successful, nothing happens. In contrast, disease or injury is highly visible and demands attention. Those who are sick with malaria, TB, or HIV are in immediate need of treatment and can be passionate advocates. In contrast, there are not the same kinds of passionate advocates for prevention as there are for treatment. Furthermore, children do not vote and cannot influence social priorities. So, immunization often receives lower priority.

Second, the global economy and many individual developing country economies are in deep distress. This lessens the likelihood they will invest in low visibility activities despite very high returns.

Third, there is both donor and recipient fatigue. Donors are tired of being asked to give more even though gains are measurable by decreases in child deaths. Recipients often get tired of having to ask for more, especially when they are having difficulty sustaining the costs of new vaccines.

What needs to be done to save more children? We need a balanced immunization investment strategy that reinforces routine immunization, achieves existing initiatives to eradicate polio and reduce measles deaths by 95 percent, and enables introduction of new vaccines. At the global level, developed countries and philanthropies need to recognize that developing country needs are increasing as new life-saving public health measures become available, and adjust their support accordingly. National governments must review budgetary priorities and increase their support of their own programs -- for example, many countries are not currently providing the 50 percent of operational costs for follow-up measles campaigns requested by the Measles Initiative. At the local level, people must demand that vaccines and immunization services be made available without barriers. Only by concerted actions at local, national, and global levels can we fully realize the massive potential benefits of vaccines.


Kofi Annan served as 7th Secretary-General of the United Nations from 1997 to 2006. Jimmy Carter served as 39th President of the United States from 1977 to 1981.

 
 
 
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HUFFPOST SUPER USER
dsws
No owning ideas. Limit only commercial use.
10:52 PM on 08/08/2010
I think I would give the label "most successful child health intervention" to clean water (including sewage treatment).
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HUFFPOST SUPER USER
scottarino
01:40 AM on 08/09/2010
You would be wrong, Gus.
10:25 PM on 08/08/2010
People that cut on Jimmy Carter crack me up. Even if habitat for humanity only built 1 house - it is more than most people who call him names have ever done for the poor.
Why no vaccines for the poor??????
UMMMMMMMMMMMMMMM - - because they are poor and used as tools. There is no profit in it!!
Easier for most to destroy and lie and distort than create and be honest.
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NielsH
my micro-bio is less empty than my cranium
05:06 PM on 08/08/2010
If you can somehow make sure that vaccine makers can make a larger profit out of this, you will see an increase in money going to vaccination programs. Of course part of that extra money will land in the pockets of those that profit from the situation. It's all a question of aligning public and private interest.
08:50 PM on 08/08/2010
If only we could outsource vaccine manufacturing to child laborers in Congo.

You're right, but eventually no profit margin will be satisfactory enough for Big Pharma.
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04:37 PM on 08/08/2010
So answer this simple question. Who will feed the millions of additional children? I know that sounds cold but it is the other half of the equation that is not addressed and without that the first part of vaccinations is pointless..
07:50 PM on 08/07/2010
James Earl Carter became a member of the tri lateral comish in 1973 and in 76 was backed and funded by it's members in his bid for the pres. J E Carter was tutored by tri lateral big dog Bignews Brezinsky as well he tutored obama. J E's campaign slogan was " I will never lie to you" and lie is what he did.
12:01 PM on 08/08/2010
Tri-lateral commission....Really?!? Now that's some old school crazy your laying down there Joe.
12:08 PM on 08/08/2010
You like it ? Can you recall ? Jan 17, 1961 and Nov 22,1963, more ol'school crazy.
02:06 PM on 08/08/2010
Did Jimmy say we needed to go to war against an impotent country because it had weapons of mass destruction? Now that was a whopper Bush told. American has been destroyed by Bush's lies. His autobiography has been held back from release so the GOP won't be irrevecobly damaged by it in the upcoming elections. Maybe he tells the truth in it. Truth about his relationship with the Saudis and his oil companies and his selling all his shares in one before it went broke. And why he didn't have to deal with the SEC becaus4e of that. Jimmy Carter actually served in the military and didn't hide from service and lie about why he didn't fulfill his years of service in the National Guard. Jimmy Carter was never a drunk, never used illegal drugs and doesn't have a brother who also managed to escape punishment for a scam which made Madoff seem like a petty criminal.

But on to the topic of the blog - vaccines. God's gift to man and yet they are not distributed as they should be so all will be spared the horrors of diseases which they prevent. Apparently, some people consider other people not worth the time or money however, they don't understand germs and viruses - they don't care and unless all have a vaccine all are at risk unless they submit to the injection of a vaccine to save them. Ethics and morals seem to have eluded the quai Christian country of
02:29 PM on 08/08/2010
I did not and never will back any of the Bush Empire. That being said JE has the blood of East Timor on his boots.
09:21 AM on 08/06/2010
I think Jimmy Carter can go much further. I am a researcher and have just returned from Haiti where UNICEF has done NOTHING about the huge problem of child trafficking. They have a huge budget to work on this problem and to this moment there is not head of child protection--there hasn't been for six weeks and there is no new director in sight.

UNICEF is worse than the mafia--they pretend to do good and they abscond with money meanwhile a P5 in Haiti is making $19,500 per month.
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Libertarian09
Anti War Socialist with a taste for freedom
12:45 AM on 08/08/2010
At least when you pay "protection" to the mafia you can be damn sure no punks are going to rob your store or violate your womenfolk
02:58 AM on 08/08/2010
No you can't be sure you won't be robbed or that your "womenfolk" won't be violated. For one thing, they've ALREADY robbed you. And they certainly couldn't give a crap if somebody rapes your wife. Don't glamorize or justify extortionist punks. What is wrong with you?
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HUFFPOST SUPER USER
amantedelibros
06:25 AM on 08/08/2010
Thank you for the heads-up on UNICEF. I've donated to them in the past and they keep sending me requests for more donations. I've long worried about child trafficking in Haiti and it upsets me to know nothing is being done to prevent it.
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08:52 PM on 08/05/2010
FOOD. We will be short again this year for world food. The UN has not taken steps to prepare nor help. How many will die from starvation, a basic.
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HUFFPOST SUPER USER
novo organon
03:34 PM on 08/05/2010
This is why Socrates is one of my favorite philosophers:

"If we may Judge from the bust come down to us as part of the ruins of ancient sculpture. Socrates was far from handsome as even a philosopher could be. A bald head, a great round face, deep set staring eyes, a broad and flowery nose that gave vivid testimony to many a symposium. It was rather the head of a porter than that of the most famous of the philosophers. But if we look again, we see through the crudity of the stone something of that human kindliness and unassuming simplicity which made this homely thinker and teacher beloved of the finest youths in Athens. We know so little about him and yet we know so much more intimately than the aristocratic Plato or the reserved and scholarly Aristotle. Across 2,300 years, we can yet see his ungainly figure. Clad always in the same rumpled tunic. Walking leisurely through the Agora undisturbed by the bedlam of politics, button holing his prey, gathering the young and the learned about him, luring them into some shaded nook of the temple porticos and asking them to define their terms."
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HUFFPOST SUPER USER
DougDeWitt
progressive social-capitalist
02:59 PM on 08/05/2010
Because in Corporate America, only programs that generate profits for corporate contributors to congressional re-election committees are funded?
02:49 PM on 08/05/2010
I see a lot of politicians campaigning for more Big Pharma drugs but very few campaigning for drug injured children?

So I ask, why should drug company execs and the politicians who support them live a life of luxury while vaccine injured children and their broke families go on begging?
02:44 PM on 08/05/2010
Hulk says: Vaccines BAAAAD. Vaccines Not Prevent. Vaccines Make Sick. Vaccines Line Coffers of Drug Industry.

Hulk also say: Medicine for Profit in Democratic Society is BAAAAD.
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parlimentMike
It's not un-American to investigate 4 crimes.
08:27 PM on 08/05/2010
Who is this Hulk, and how has he avoided smallpox?
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Libertarian09
Anti War Socialist with a taste for freedom
12:47 AM on 08/08/2010
The radiation shields him from smallpox
08:24 PM on 08/08/2010
LMAO - fanned
02:10 PM on 08/08/2010
elsell - Hulk is just plain wrong. Vaccines good. Myths about vaccines are myths. Hulk says read the real science studies not myths.
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HUFFPOST SUPER USER
MrBadger
12:48 PM on 08/05/2010
I applaud both of your efforts at advancing the cause of child health in the world. Even more should be done. But the "elephant in the room", the thing which no one speaks of, is that unless these efforts are coupled with population control we are only saving the children to make for an even bigger problem in a generation. The fact that ill considered and heavy handed approaches to the population problem have lead to abuse should not prevent us from examining the problem and seeking for the right solution - possibly through education. Otherwise we end up treating a myriad of symptoms while leaving the root problem untouched. Until we have a world in which every individual understands their interconnectedness with everyone else we will continue to simply shuffle the problems from place to place - rearranging the deck chairs on the Titanic.
08:04 PM on 08/04/2010
Vaccination are the most important step in stopping a pandemic. Any pandemic. Every person who has resistance is a broken link in the chain of spreadin the infections.
02:55 PM on 08/04/2010
I highly honour Mr. Carter -- and anyone who writes an article with him deserves honour as well. The reason vaccines are today held in low esteem is simple. Unlike vaccines of yesteryear, today's vaccines contain far more than simply dead viruses. They have preservatives, and a whole litany of other unpronouncable and unconscionable ingredients, Most parents are afraid that today's vaccines can do more harm than good. I only recently discovered that the aural polio vaccine would have come into conflict with a medication I took as a child -- and still take! I'm glad, (now), that only the injected type of polio vaccine was available to baby boomers of my age when we were in grade school. The ingredients in today's vaccines have to be looked at carefully, and vaccines should go back to the simpler kind, compounded in earlier days of vaccination!
05:51 PM on 08/05/2010
I highly honor him too. Perhaps the most honorable man we've had for President in a long long time.
08:26 PM on 08/08/2010
So very true.
12:36 PM on 08/04/2010
Sure, sure...whatever you say, "President" Carter...

...I want to know what Nobel Prize winners JIM CARREY and JENNY MCCARTHY have to say about this!

(sarcasm off-the-charts, for you humorless people out there)
08:05 PM on 08/04/2010
Unlike fellow cowboy Duhbya President Carter was actually elected.
Where is Dubhya's Nobel Prize in Chimpsterism?
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Libertarian09
Anti War Socialist with a taste for freedom
12:49 AM on 08/08/2010
I don't think he was referring to W but perhaps to some unnamed unworthy Nobel laureate