More funds needed for research and immunization

If urgent and strategic action is not taken to close the gaps in funding, research and global immunization coverage, the world could see the re-introduction of old diseases and the emergence of new infections, three international institutions warned in a report released on Wednesday. The State of the World's Vaccines and Immunization report, jointly produced by the World Health Organization (WHO), United Nations Children's Fund (UNICEF) and World Bank, highlights achievements in immunization over the last decade and outlines the challenges for the future. According to the report, polio is on the verge of eradication; deaths due to measles and maternal and neonatal tetanus have been significantly reduced; and major new resources for immunization and new vaccines are being channelled to the poorest nations through the Global Alliance for Vaccines and Immunization (GAVI) and the Vaccine Fund. However, tuberculosis, once thought to have been brought under control, is now a re-emerging disease, fuelled by the rising tide of co-infection with HIV (especially in Africa) and by increasing resistance to TB medicines, the report says. Between 1997 and 2000, there was a 9% increase in cases of TB, which killed 1.7 million people in 2000. Out of the 8 million new cases of TB each year, only 130 000 occur in industrialized countries. "TB needs a more effective vaccine. The current one, BCG, creates an immunity that lasts at best up to adolescence, but not for a lifetime," said the report, launched on Wednesday in the Senegalese capital, Dakar, at the 2nd Partners' Meeting of the GAVI. "While new initiatives to fight killer diseases abound, it is the hard cash that is missing," Dr Daniel Tarantola, Director of Vaccines and Biologicals at the WHO, said. "The global campaign for access to medicines and vaccines needs to be backed with political and financial commitment if we want it to get beyond words and make a difference to people." Children in the developed nations now have access to additional, newer and more expensive vaccines to protect them against major childhood diseases including hepatitis. In sub-Saharan Africa only half of the children have access to basic immunization against common diseases such as tuberculosis, measles, tetanus and whooping cough. In poor and isolated areas of developing countries, vaccines reach fewer than one in twenty children. "In wealthy countries we tend to take the absence of certain illnesses for granted," said Dr Gro Harlem Brundtland, Director-General of WHO. She noted that in many regions of the world it was more the rule than the exception for children to die of common childhood conditions such as measles, which alone caused about 700,000 deaths a year. "We need to act fast and effectively to ensure that children and adults everywhere have access to life-saving vaccines. From a global perspective, this is the only way of avoiding major epidemics of new and old diseases," Bruntland said. "Vaccines are among the most cost-effective public health interventions," said Carol Bellamy, Executive Director of UNICEF and chair of GAVI. "Today, no child should 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 said. The report cites low donor investment as a major reason for the huge gaps in coverage. External aid to developing countries for immunization currently stands at approximately US $1.56 billion a year, it says. With an additional investment of US $250 million a year, at least 10 million more children would be reached with basic vaccines. It adds that a further US $100 million a year would cover the cost of newer vaccines including hepatitis B. It is estimated that every year hepatitis B causes 520,000 deaths a year worldwide. The report also attributes the low vaccination coverage to the low level of investment in immunization by developing countries. Low-income countries spend as little as US $6 per person per year on health, including immunization. The report underscores the urgent need for vaccines against malaria, and a new vaccine for tuberculosis. "Today, malaria kills approximately one million people a year, the majority of them African children," it said. "Most importantly, the most common and most accessible medicines for malaria are now ineffective as populations develop resistance to them," it added. Among other things, the report recommends that efforts be invested in ensuring a fair return on investment in the research, development and production of vaccines, leading to a strong and healthy global vaccine industry. It recommends the improvement of skills and infrastructure in countries to better forecast and plan long-term vaccine needs, optimize the impact of vaccines and reduce wastage and encourages that creative and sustainable financing mechanisms ensured to enhance vaccine security - the uninterrupted sustainable supply of affordable vaccines to developing countries The full report