New Delhi, 8 December 2005 - Disease experts from around the world are gathering this week in New Delhi to consider the projected impact of innovations in vaccine science that are expected to fuel aggressive efforts aimed at preventing millions of needless deaths among children in the world's poorest nations.
In India for the 3rd Global Alliance for Vaccines and Immunization (GAVI) Partners' Meeting, experts are reporting on advances involving several new generation vaccines that target diseases such as rotavirus, Haemophilus influenzae type B (Hib) disease, pneumococcal disease, and Japanese encephalitis-killers of approximately two million children every year.
According to experts at the GAVI meeting, the lack of demand for new and under-utilized vaccines is influenced by low awareness of disease burden among policymakers and the relatively high cost of new vaccines when compared to other routine immunizations. To increase local support, health initiatives among GAVI Alliance partners are collaborating with national governments to conduct disease surveillance and report on the burden of disease in order to accelerate the introduction of new generation vaccines in developing countries.
"Even when a vaccine is available, problems related to costs, availability, and awareness of the burden of the disease can delay adoption for years or decades," said Dr. Julian Lob-Levyt, Executive Secretary of the GAVI Alliance. "GAVI and its partners can help address these questions by developing strategies for manufacturing, distributing, and administering vaccines, and by gathering surveillance data that shows decision makers more precisely the extent to which a particular disease affects the population."
Several initiatives are making great strides in helping to introduce new and under-utilized vaccines in an effort to shorten the time it takes for vaccines to make it from the laboratory to the people they are most likely to benefit. The initiatives described below, all of which are represented at the GAVI Partners' Meeting in New Delhi, are working to build national and international support for the vaccines.
Haemophilus influenzae type B (Hib) Disease
The Hib Initiative, which is being launched in New Delhi this week, is the newest of a group of GAVI-funded health initiatives designed to provide focus for informed decision-making regarding use of Hib vaccine. Hib vaccination has been used in industrialized nations for 15 years but is still under-utilized in the developing world. This is despite evidence of its great success in developing countries, such as The Gambia, in West Africa, where Hib meningitis and severe pneumonia in young children have virtually been eliminated following implementation of routine infant vaccination against Hib. Spread by droplets through coughs and sneezing, often in overcrowded living conditions, Hib is estimated to cause 3 million cases of serious illness (mainly pneumonia and meningitis) in children under 5 years of age each year and about 400,000 deaths, the vast majority of them in developing countries.
Pneumococcal Pneumonia and Meningitis
Based at Johns Hopkins Bloomberg School of Public Health, PneumoADIP's mission is to improve child survival and health by accelerating the evaluation of, and access to, new life-saving pneumococcal vaccines for the world's poorest children. Pneumococcal disease is the leading vaccine-preventable killer of children under 5 - more than 800,000 children die every year from pneumococcal meningitis and pneumonia, according to WHO estimates, and the majority of theses deaths are in the developing world. A vaccine that targets the bacterium responsible for pneumococcal disease - Streptococcus pneumoniae, or pneumococcus - is already in routine use in the United States and elsewhere. Clinical trials conducted in South Africa and The Gambia have shown that a 9-valent vaccine (containing additional serotypes commonly responsible for invasive disease in Africa) is extremely effective in preventing pneumococcal disease in these vulnerable populations. If used routinely, a pneumococcal conjugate vaccine could prevent hundreds of thousands of child deaths each year and contribute to achieving the United Nations' Millennium Development Goal to decrease childhood deaths by two-thirds by 2015.
Seattle-based nongovernmental organization PATH is working to accelerate the introduction of new vaccines to fight rotavirus, a severe diarrheal disease that each year kills 500,000 children, almost all living in poor countries. A vaccine against rotavirus is the most promising method for preventing the disease and is especially needed in developing countries, where prompt medical care is often out of reach. PATH's Rotavirus Vaccine Program aims to decrease the typical 10 to 15 years it takes to introduce a vaccine in developing countries to less than 5 years. By demonstrating to governments the impact of rotavirus and the promise of a vaccine, PATH helps to ensure demand and works with manufacturers to establish a consistent supply of rotavirus vaccine to meet that demand.
Efforts also are underway at PATH, with funding from the Bill & Melinda Gates Foundation, to improve control of Japanese encephalitis (JE) through immunization. Over the last 60 years, JE has killed 3 million children and caused long-term disability in millions more. PATH's JE Project is accelerating wider availability of one promising JE vaccine candidate and analyzing prospects for others. The project is supporting efforts to add JE vaccine to the roster of other vaccines given to infants in endemic areas of Asia and the Pacific, with the ultimate aim of eliminating clinical JE.
In addition to advances in new vaccines, experts in New Delhi also will consider other important issues that are critical to the success of the global immunization effort, such as sustainable financing, support for health systems and the role of civil society.
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The Global Alliance for Vaccines and Immunization (now the GAVI Alliance) was launched in 2000 to increase immunization rates and reverse widening global disparities in access to vaccines. Governments in industrialized and developing countries, UNICEF, WHO, the World Bank, non-governmental organizations, foundations, vaccine manufacturers, and public health and research institutions work together as partners in the Alliance, to achieve common immunization goals, in the recognition that only through a strong and united effort can much higher levels of support for global immunization be generated. Funds channeled through GAVI's financing arm, The GAVI Fund (formerly The Vaccine Fund), are used to help strengthen health and immunization services, accelerate access to selected vaccines and new vaccine technologies - especially vaccines that are new or under-used - and improve injection safety. In addition to substantial funding from the Bill & Melinda Gates Foundation, The Vaccine Fund has been financed by ten governments to date-Canada, Denmark, France, Ireland, Luxembourg, the Netherlands, Norway, Sweden, the United Kingdom, and the United States- as well as the European Union and private contributors.
PATH (www.path.org) is an international, nonprofit organization that creates sustainable, culturally relevant solutions that enable communities worldwide to break longstanding cycles of poor health.
The Hib Initiative provides coordination and strategic focus in the fight to reduce childhood death and life-long disability from Hib meningitis and pneumonia.
The Pneumococcal Vaccines Accelerated Development and Introduction Plan, or PneumoADIP ( www.preventpneumo.org), works to shorten the time between the use of a new vaccine in industrialized countries and its introduction in developing countries.