News Extra

Funds for vaccination over next decade may fall short by $10bn

BMJ 2005; 331 doi: (Published 15 December 2005) Cite this as: BMJ 2005;331:1426
  1. Ganapati Mudur
  1. New Delhi

    The cost of vaccinating children in the world's 72 poorest countries over the next decade would be $35bn (£20bn; €29bn), a new study by the World Health Organization and Unicef says.

    The study, which was released last week in New Delhi at the third partners' meeting of the Global Alliance for Vaccines and Immunisation, has estimated that, taking into account funds already pledged by donors, there will be a shortfall of $10bn to $15bn. “This tells us for the first time how much it's going to cost,” said Julian Lob-Levyt, executive secretary of the alliance.

    The funds will be used to deliver basic and new vaccines to more children and to improve healthcare services. Dr Lob-Levyt said that although the alliance is optimistic about finding extra funds, concerns persist about poor healthcare services and staff constraints that hamper delivery of vaccines.

    The alliance, which has been in existence for five years, has so far raised $2.8bn and has supported the vaccination of 13 million additional children with the diphtheria, tetanus and pertussis vaccine and of 118 million additional children against hepatitis B, yellow fever, and Haemophilus influenzae type b. It expects to receive $4bn through the International Finance Facility for Immunisation, a mechanism backed by six European countries to raise funds through the sale of bonds in capital markets (BMJ 2005;331:593).

    Alliance officials said that health systems and human resources in some countries are a source of worry. “Large numbers of doctors and nurses are leaving their own countries,” Dr Lob-Levyt said. “Nurses from Kenya go to Botswana and nurses from Botswana move to London.”

    Delegates at the meeting said that although concerns about the sustained delivery of vaccines once support from donors runs out seem to be justified today, the cost of vaccines is expected to drop in the coming years. “The alliance has had a ‘pull’ effect on vaccine makers,” said John Wecker, director of immunisation with the Program for Appropriate Technology in Health, which is based in Seattle, Washington. “As more manufacturers enter the market, the prices will drop, and countries will be able to continue immunisation.”

    Dr Lob-Levyt said an analysis has shown that 72% of innovative projects in the field of vaccinology are focused on vaccines that are relevant to the alliance's work.

    The alliance announced a new initiative to help developing countries estimate the burden of meningitis and pneumonia associated with Haemophilus influenzae type b bacteria, that causes an estimated three million cases of serious illness and 400,000 child deaths each year.

    “There are many barriers to the introduction of the vaccine against Haemophilus influenzae type b in developing countries,” said Rana Hajjeh, project director of the initiative at the Bloomberg School of Public Health at the Johns Hopkins University, Baltimore.

    “There is a relative lack of awareness, the vaccine is relatively expensive, and information about the burden [of the disease] is patchy because of a lack of diagnostic facilities,” Dr Hajjeh said. In India the four year, $37m initiative will support a project to estimate the burden of Haemophilus influenzae type b in three cities. In its second phase of activities, from 2006 onwards, the alliance will also support new vaccines against rotavirus and pneumococcus infections.

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