Press Release WHO/83GLOBAL FINANCIAL CRISIS INCREASES RISK OF DEADLY CHILD INFECTIONS, CHILDREN'S VACCINE INITIATIVE SAYS
10 November 1998
Countries reeling under the global financial crisis are having to cut back on children's vaccinations or delay plans for protecting children with newer vaccines, a world gathering of 400 vaccine experts learned here today. They were meeting as the "Consultative Group" of the Children's Vaccine Initiative (CVI), a worldwide coalition of organizations from the public and private sectors, including the vaccine industry, set up eight years ago to ensure that all children everywhere are getting all the vaccines they need to protect themselves against all life-threatening infections. The Consultative Group meets every two years review progress and thrash out roadblocks in achieving the CVI's.
The global financial crisis is clearly a worrying roadblock. Representatives of some countries reported to the meeting difficulties or delays in getting enough vaccines for their children because of government cuts in vaccination budgets. In some countries local currencies have collapsed and budgets set for vaccines priced in foreign currency can no longer be met. Others are so far managing to cope but vaccination officials fear shortages in vaccine suppliesand their potential crippling effect on the capacity of national vaccination services to protect childrenif the financial crisis persists.
"We are very worried about the situation in countries that rely on foreign aid or on foreign exchange to buy vaccines and run their vaccination programmes," says CVI Executive Secretary Bjorn Melgaard. "Clearly, Asian and African countries have been hit badly by the crisis. But some big Latin American countries are also threatened. It would be tragic if our long-term efforts over the past 20 years to set up an efficient system that is bringing vaccines to the vast majority of the world's children were to suffer as a result of a hopefully short-term financial crisis."
Even without the financial crisis many children in fact are not getting the vaccines they need. As WHO Director-General, Dr Gro Harlem Brundtland, told the meeting, "At least 20 percent of the world's children are still not being vaccinated with the basic vaccines and the poorest countries still cannot afford to buy these vaccines."
These two facts could partly explain why, according to CVI estimates, four million children are still dying every year from infections that can be prevented by existing vaccines. Most of these children are in the poorest countries, where vaccine delivery is just not efficient enough to reach all children, particularly those living in hard-to-reach places. Of those four million children, two million are dying because they are not getting vaccines that were developed and licensed many years ago against measles, tetanus, rubella and yellow fever. A further one million deaths occur from infections with hepatitis B virus and Haemophilus influenzae type b (a common cause of pneumonia and meningitis) that can be prevented by vaccines licensed in the last few years.
Many participants at the CVI meeting blamed the gap between rich and poor for these needless deaths. The gap is clearly getting bigger and the global financial crisis isn't helping matters. Even without the crisis that gap had become a yawning gulf. A child born in a developing country runs a 1,000-fold greater risk of contracting and dying from measles than a child born in an industrialized country. The reason is clearly related to wealth: to take one example, Switzerland's gross national product per capita (US$41,000) is 500 times greater than Mozambique's (US$80). And the inequity is growing despite the fact that all countries in the world, with the exception of the United States and Somalia, have ratified the Convention on the Rights of the Child, thereby pledging to put basic health care, including universal child vaccination, high on their priorities, however limited their resources.
Vaccination, however, is vulnerable to disruption from many factorsnot only financial but also social unrest. The recent outbreak of polio in Albaniathe first in 18 yearsor of diphtheria in the countries of the former Soviet Union are recent examples.
The lives of the four million children dying every year for lack of existing vaccines could be saved, the meeting concluded if at least two conditions were met.
First and foremost, all governments must put and keep vaccines and vaccination among their top priorities and stop spending, as some of them are doing, on less cost-effective things, like high-tech hospitals. Second, the world must double the US$10 billion it is spending annually (US$1.80 per person vs. US$139 per person on military equipment) on all aspects of vaccination, from research and development to delivery.
The picture painted by meeting participants, however, was not all gloomy. A number of participants pointed to some good news:
- Today the traditional paediatric vaccinesagainst tuberculosis, polio, diphtheria, measles, tetanus and whooping cough (pertussis)are reaching 80% of the world's children vs. barely 5% 20 years ago.
- Routine vaccination services throughout the world are now saving every year the lives of three million children and preventing blindness, paralysis and mental disability in a further 750,000 at a cost of less than US$15 per child in the poorest countries.
- Newer vaccinesagainst pneumonia, meningitis and rotavirus diseaseare coming off the development pipeline (a rotavirus vaccine has just been licensed) and could save a further two million children.
- Research on vaccines has never been so active or so promising, with a record 250 new vaccines in different stages of research and development and the research community is also busy exploring ways of simplifying vaccination programmes so that they reach even more children.
- Thanks to what Dr Brundtland called "the largest public health initiative ever taken," poliomyelitis is now confined to South Asia and sub-Saharan Africa.
- About one hundred countries now use the hepatitis B vaccine routinely in children vs. only 20 countries in 1990. In many of these countries routine use of the vaccine has brought the proportion of the population carrying the virus down from 10-15% to less than 2%. In some places, liver cancer rates in children have halved since introduction of the vaccine.
The CVI was set up in 1990, just after the World Summit for Children. It is co-sponsored by the United Nations Children's Fund (UNICEF), the United Nations Development Programme (UNDP), the World Health Organization (WHO), the World Bank and the Rockefeller Foundation. Its Secretariat is in Geneva.
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