By Julian Lob-Levyt
Poor nations can’t develop if their children and mothers aren’t healthy enough to make it to adulthood. And that’s a big sustainability issue for Australia’s closest neighbours, one that requires new approaches. Australia has an important role to play.
Some of the thorniest problems in global health have been successfully tackled by Australian scientists. Two Melbourne researchers, Ruth Bishop and Ian Holmes, discovered rotavirus, the cause of a diarrheal disease that kills 600,000 children every year. A Queenslander, Ian Frazer, played a pivotal role in the development of the first two vaccines against the human papilloma virus (HPV), primary cause of the cervical cancer responsible for the deaths of more than 200,000 women a year in the developing world.
Getting immunisation science and technology right is just part of the solution. Without access to vaccines, two million children in developing countries, including Australia’s closest neighbours, are killed by preventable diseases are barely recognisable to parents in wealthy nations. Children in Papua New Guinea, for instance, are ten times more likely than Australian children to die before their fifth birthday.
It is this gross inequity that Australia is now helping remedy, as part of a global alliance to deliver the benefits of science to the world’s most vulnerable children.
In 2006, AusAID committed $A 21.7 million over four years to support the Global Alliance for Vaccines and Immunisation (GAVI) joining political and scientific leaders worldwide in supporting the work of this public-private partnership, which includes the World Health Organization, UNICEF, the World Bank, the Bill & Melinda Gates Foundation and donor governments and developing countries. GAVI’s primary mission is to provide basic and new vaccines to the world’s 27 million poorest children.
This month, in Papua New Guinea, with Australian technical assistance and funds from GAVI, public health authorities will begin a nationwide immunisation effort that will protect local children for the first time against Haemophilus influenzae type b (Hib), a deadly and important cause of meningitis and pneumonia. Hib kills 400,000 children in developing countries every year. The vaccine PNG has chosen to introduce also covers Hepatitis B and three other diseases.
Governments elsewhere in the Pacific have been offered GAVI support for Hib vaccination. Top of the list are The Solomon Islands and Kiribati; Indonesia has said it will introduce the vaccine in 2009. Governments must be convinced of the impact and cost-effectiveness of a vaccine before agreeing to introduce it, because the process is not an easy one. Challenges include poor or nonexistent roads, shortages of health workers, and a dearth of health facilities. Vaccines alone are not enough, but once they are able to do their work, the impact can be dramatic. For that, effective basic health services are an essential prerequisite for their delivery.
WHO researchers reported recently that Uganda, one of the first African countries to implement a widespread Hib vaccination programme, saw a nearly 100 percent drop in Hib Meningitis five years later, saving the lives of 5,000 children every year. Similar success has been achieved in Bangladesh, Kenya, Chile and the Gambia. Studies show that Hib vaccine cuts the incidence of disease by 88% or more within 3 to 5 years.
Vaccines have a central, cost effective, and transforming role to play in helping to save lives in poor nations. Bill & Melinda Gates have said that “childhood immunisation is undoubtedly the best investment we have ever made”.
Australia and other donor nations are doing their part. More can be done. Additional lives can be saved; illness and disability prevented, and huge potential realised for educated and productive future populations. But only if wealthy nations continue to ensure that cutting-edge technologies reach children in poor nations. A whole new pipeline of vaccines is coming on stream. They need to be financed. In an interconnected world and globalising economy, it is no longer acceptable that vaccines be denied for 15 years for reasons of cost. In the words of renowned Australian immunologist Gus Nossal, “Vaccines buy you a lot of health for a small amount of money.”
Dr. Julian Lob-Levyt is executive secretary of the GAVI Alliance.