In the field of vaccinology, older vaccines that prevent diseases such as polio, as well as promising new vaccines for HPV and other illnesses, reflect immunization’s power to save lives and change the course of a disease’s spread. Providing access to vaccines is an ongoing challenge, as Dr. Seth Berkley, CEO of the GAVI Alliance, explained in a May 22 talk at NIH.
His presentation on the theme “Getting the Miracle of Vaccines to Those Who Most Need Them,” served as the John Ring LaMontagne Memorial Lecture. “It is fitting that our speaker today…will discuss the challenges of delivering vaccines for…deadly diseases to children in the poorest countries in the world, something that was near and dear to John’s heart,” said Dr. Anthony Fauci, director of NIAID. LaMontagne, former deputy director of NIAID, collaborated on the predecessor to the GAVI Alliance and helped develop vaccines for pertussis and childhood diarrhea.
“It’s an extraordinary history of vaccinology,” said Berkley. “We started a long time ago and over time we have seen an acceleration of different antigens that exist for infectious diseases. The challenge was that these vaccines weren’t being made available to people who need them most.”
The GAVI Alliance addresses this problem by helping increase access to immunization in poor countries. A public-private partnership founded in 2000, GAVI’s mission is to save children’s lives and protect people’s health by pulling together in one decision-making body the special skills of the main players in immunization: WHO, UNICEF, the World Bank, the Bill & Melinda Gates Foundation, donor governments, developing countries, non-governmental organizations, the pharmaceutical industry and other corporate and foundation partners. This has brought a single-minded focus to the task of delivering vaccines to developing countries and helping ensure a stable and secure vaccine market.
Berkley accepts the LaMontagne lectureship plaque from NIAID director Dr. Anthony Fauci.
Photos: Bill Branson
“The good news [in global health] has been…a huge reduction in child deaths around the world. We’ve seen a decline from greater than 12 million deaths in 1990 to 7.6 million in 2010,” said Berkley, and the decline in mortality is accelerating. “The bad news is we’re still seeing 21,000 children die each day.” Most of these deaths are in sub-Saharan Africa and Southern Asia, with pneumonia and diarrhea responsible for a large percentage of childhood mortality.
“GAVI’s immunized over 326 million children, contributing to preventing over 5.5 million future deaths, and accelerated vaccine introduction in over 70 countries,” Berkley reported.
Work remains in ensuring access to vaccinations, as more than 19 million children, largely in India, are missing out on immunization. India, which has emerged as one of the world largest manufacturers of vaccines, illustrates the role political will plays in ensuring access. Yet, as governments co-finance vaccinations on a sliding scale with the GAVI Alliance, immunization programs may increase government investment in health care.
The benefits of vaccination, Berkley said, extend beyond saving lives. In the U.S., evidence suggests that vaccinations result in less time spent caring for sick children by family members, herd immunity and trade and tourism benefits. The tangential benefits of vaccines are less documented in the developing world, but research shows that healthy children do better at school and require fewer out-of-pocket expenses, which can push families into poverty. Additionally, when parents believe their children will survive, fertility rates go down.
|“The good news [in global health] has been…a huge reduction in child deaths around the world. We’ve seen a decline from greater than 12 million deaths in 1990 to 7.6 million in 2010,” said Berkley.
The benefits of vaccination are substantial, but challenges remain to ensuring universal access to immunization. “One of the challenges in doing this [immunization work] is the infrastructure in the countries,” Berkley said. “Immunization is a wedge into the health system,” and by strengthening immunization efforts, you strengthen outreach to the population. The GAVI Alliance and other health care organizations grapple with how you build on these interventions; the organization is working with the Global Fund to help integrate the provision of immunizations with treatment for AIDS, tuberculosis and other diseases.
A new challenge for the GAVI Alliance is that some anti-vaccine information is reaching developing countries. “We’re beginning to see this misinformation spread from the West into the developing world,” said Berkley, adding, “How do we fight the Internet?”
In some countries, such as Ethiopia, data on vaccination rates vary greatly and more surveillance is necessary. Other vaccinations present new challenges, such as providing multiple-dose HPV vaccinations to adolescent girls, who may be finished school and are hard to reach by health care programs.
You can view the lecture online at http://videocast.nih.gov/summary.asp?live=11173.