April 23, 2013 | The Editors

The promise of immunization

Guest contributor Erin Fry Sosne is PATH’s government affairs officer for child health, advocacy, and public policy.

It’s World Immunization Week, which gives us the chance to celebrate one of the most successful and cost-effective health interventions of all time. Vaccines prevent 2 to 3 million deaths every year, and by reducing illness and long-term disability, they generate economic savings for health systems and families alike.

A nurse in white uniform administers a shot to a young boy.
Happy World Immunization Week: Vaccines save between 2 and 3 million children every year. Photo: PATH/Gabe Bienczycki.

But one child in five doesn’t receive even the most basic vaccines, and as a result, 1.5 million children die each year from vaccine-preventable diseases like diarrhea and pneumonia. Tens of thousands of others suffer from severe or permanently disabling illnesses.

To realize the full benefits of immunization, we need financial, political, and technical investment from all stakeholders: governments, elected officials, health professionals, academia, manufacturers, global agencies, the private sector, communities, and families.

More affordable vaccines

Over the last decade, we’ve gotten better at making vaccines affordable in poor countries. Innovative financing partnerships, like the GAVI Alliance, provide manufacturers with incentives to keep prices low, negotiate more affordable bulk purchases, and scale subsidies to countries over time. For the past 30 years, the Revolving Fund of the Pan American Health Organization has provided joint procurement of vaccines, syringes, and related items for its member states—often negotiating the lowest prices.

Closer to home for me, the Meningitis Vaccine Project, a collaboration between PATH and the World Health Organization (WHO), worked with the Serum Institute of India, Ltd. to develop a vaccine against meningitis A. Together, we made the vaccine available at a price countries that needed it said they could afford: less than $.50 a dose.

We need more mechanisms and partnerships that make vaccines affordable, especially in low-income countries that graduate from GAVI support and in lower-middle-income countries that don’t qualify for help from other programs. And we also need to factor in the cost of getting the vaccine in the vial to the arm of a child.

Product to the people

Some of the people who most need vaccines are children living in remote rural locations where the circumstances of their daily lives make them especially vulnerable to disease. Immunization here requires far more than a safe and effective vaccine. Once a vaccine is available, it must be delivered to the right place, at the right time, in the right condition.

Vaccines must be transported and stored within a very narrow temperature range. High temperatures, unreliable electricity, long distances between health care facilities, and outdated supply and logistic systems all impede delivery to the most rugged settings.

We could go a long way toward solving delivery problems by preparing delivery systems for future vaccines that may have different proprieties than today’s products. We could further help by matching vaccines to the countries that will use them.

The future of vaccines

Some vaccines already used in industrialized countries aren’t appropriate for the developing world. They’re too expensive. They may not protect against specific strains of viruses or bacteria in the region. Research into making products more appropriate for the developing world—such as vaccines that don’t require refrigeration, or needle-free injectors—can amplify the efficiency and efficacy of immunization programs.

The good news is we are taking some actions to make these recommendations reality. Last year, for example, nearly 200 countries endorsed a shared vision known as the Decade of Vaccines. Their goal is to extend the benefits of vaccines to every person by 2020, thereby saving more than 20 million lives.

That’s an admirably aggressive goal. And it’s just the kind of target we need to reach for—this week and every week—to fulfill the promise of immunization.

More information

•    Our work in vaccines and immunization
•    The power of vaccines
•    GAVI Alliance website
•    Decade of Vaccines Collaboration website
•    Foundations for health photo set on Flickr

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