Poor nations are being lured into a debt trap

doi:10.1136/bmj.39563.529757.BE

BMJ 2008;336:974-975 (3 May), doi:10.1136/bmj.39563.529757.BE

Letters

Global access to vaccines

Poor nations are being lured into a debt trap

The first 150 words of the full text of this article appear below.

With regard to access to papillomavirus vaccine (Gardasil),¹let us assume that the vaccine covers all strains causing cervicalcancer. In India 21m girls would have to be vaccinated eachyear to avoid 260 000 deaths at a cost for the vaccine aloneof $8400m. The programme would have to be sustained for over20 years. Even if it prevented all cervical cancers, it wouldreduce by only 2% the 10.9m deaths caused by infectious diseases.²If the cost of the vaccine fell to $1 per dose, it would stillcost $63m for the vaccine alone.

So rotavirus causes 440 000 deaths each year.¹ If we have avaccine that covers all the human strains (an overgenerous assumptionfor India³), 126m children around 2 months of age will needto be vaccinated three times (378m doses).² At the present publicsector cost of $7/dose⁴ the cost of the vaccine . . . [Full text of this article]

Jacob M Puliyel, consultant paediatrician and head of department, Ashutosh Shrivastava, resident in paediatrics

¹ St Stephen’s Hospital, Tis Hazari, Delhi 110054, India

puliyel@gmail.com