Rwanda launches vaccination drive against pneumococcal disease in under 5s

BMJ 2009; 338 doi: (Published 27 April 2009) Cite this as: BMJ 2009;338:b1729
  1. Peter Moszynski
  1. 1London

    This week Rwanda launched a national drive to combat pneumococcal disease, the leading vaccine preventable killer of children under 5 worldwide. The drive is thought to be one of the developing world’s first national immunisation programmes against a disease that causes life threatening illnesses, such as pneumonia, meningitis, and sepsis, and might have a substantial effect on mortality in children under 5.

    The programme is a joint effort by the Rwandan government and the Global Alliance for Vaccines and Immunization (GAVI), a partnership that includes the World Health Oorganization, Unicef, and the World Bank, funded by donor countries and the Bill & Melinda Gates Foundation, and the Pneumococcal Accelerated Development and Introduction Plan team from Johns Hopkins Bloomberg School of Public Health.

    Richard Sezibera, Rwanda’s minister of health, who led a group of doctors and nurses in giving the first doses of pneumococcal conjugate vaccine to Rwandan children, said, “This is a proud day for Rwanda and an important milestone for the developing world. We are committed to saving the lives and improving the health of our most precious national resource—our children. With the introduction of this vaccine, our goal of significantly reducing child death in Rwanda will now be within reach.”

    The campaign, due to be replicated soon in Gambia, was made possible by the free provision of the pneumococcal conjugate vaccine, Prevenar, by its manufacturer, Wyeth. Its chairman, Bernard Poussot, said, “Wyeth is committed to protecting current and future generations from pneumococcal disease . . . Wyeth is honoured to provide GAVI with more than three million doses of Prevenar to help Rwanda and the Gambia protect its children against the potentially devastating consequences of this disease.”

    The fourth millennium development goal (MDG4), related to child health, aims to reduce the disparity in child mortality, which is much higher in poor than in wealthy nations.

    According to GAVI, this is “significantly driven by lack of access to appropriate health care, including treatment and prevention of serious infections. The routine use of new vaccines against the two leading killers of children under age 5, pneumonia and diarrhoeal diseases, could save more than 800 000 lives by 2015 and put low income countries significantly closer to reaching their MDG4 targets.”

    Pneumococcal disease takes the lives of 1.6 million people a year, including around one million children under 5. More than 90% of these deaths occur in developing countries. The alliance says that pneumonia, the most common form of serious pneumococcal disease, accounts for one in every four child deaths, making it the leading cause of death among children younger than 5 years of age.

    Young children and people older than 65 are the most vulnerable to acquiring pneumococcal disease as well as people with a weakened immune system from undernutrition, AIDS, or sickle cell anaemia. People with HIV have a 20-40 times greater risk than people who are HIV negative.

    Prevenar, originally introduced in the United States in 2000, is the first new generation vaccine to be introduced to the developing world by GAVI.

    The alliance claims that the introduction of the vaccine in Rwanda signals “a new era in vaccine access and delivery in the developing world. Thanks to the partnership between developing countries, donor governments and industry, the GAVI alliance will be able to offer the same access to life saving, new generation vaccines currently utilised throughout the industrialised world.”


    Cite this as: BMJ 2009;338:b1729

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