Intended for healthcare professionals


Refugees in South Sudan to receive pneumococcal vaccine after delays over price

BMJ 2013; 347 doi: (Published 09 August 2013) Cite this as: BMJ 2013;347:f5042
  1. Peter Moszynski
  1. 1London

Residents of crowded refugee camps are particularly susceptible to vaccine preventable diseases but they have largely been neglected in the roll out of new vaccines, Médecins Sans Frontières (MSF) has said.

As it begins a pneumococcal vaccination campaign for children living in Yida, the largest refugee camp in South Sudan, the international medical charity is calling for the discounted prices negotiated by the Global Alliance for Vaccinations and Immunisations (GAVI) to be available to all humanitarian organisations working in crisis situations.

Kate Elder, vaccines policy adviser at Médecins Sans Frontières, said, “Refugee children are incredibly vulnerable to developing vaccine preventable diseases, so why do we keep hearing the players in the global vaccination community tell us these kids aren’t their problem? We should be making every effort for refugee children to benefit from the newest vaccines, instead of letting them languish in the global community’s blind spot.”

The charity complains of 11 months of “lengthy legal and bureaucratic delays in buying the newest drugs at the lowest prices to treat pneumonia in children” and says these delays “led to high numbers of children dying, when vaccinations could have protected them.”

Camp conditions make children particularly vulnerable to pneumococcus, the most common bacteria causing pneumonia, as crowding and exposure to multiple different strains of the bacteria lead to increased risk.

Heather Pagano, the MSF’s regional spokeswoman, told the BMJ, “This time last year, when the rains set in, the situation in Yida was appalling, with children dying of diseases that vaccines could have protected them against. We determined that the pneumococcal conjugate vaccine (PCV) could result in a substantial mortality reduction and have been struggling to distribute it before the start of the rains.”

This is one of the first times this vaccine has been used in a refugee camp, and also the first time it has been used in South Sudan, which is due to begin GAVI supported vaccinations next year. A similar vaccination campaign also started across neighbouring Sudan this week—although not in the refugees’ conflict ridden homeland in the Nuba Mountains of South Kordofan1 because of the continuing lack of humanitarian access to rebel held areas.

GAVI spokesman Dan Thomas congratulated MSF for bringing the vaccines to Yida. He told the BMJ, “We were pleased to have been able to play a facilitating role in helping MSF procure these vaccines. Like MSF, which is an active member of the Global Alliance, we are working to ensure that all children have access to the latest and best vaccines available.”

He explained that although pneumonia was “the world’s biggest killer of children under 5,” until recently the vaccine’s “prohibitive cost” meant it was only used in developed countries. However, in 2010 a mechanism called the advance market commitment (AMC) was established with a $1.5bn (£964m; €1.1bn) donor grant, which allows GAVI eligible countries to purchase the vaccine at under $3.50 per dose, far less than the $90 it costs in developed countries.

Médecins Sans Frontières has now managed to procure the vaccines for $7 per dose.


Cite this as: BMJ 2013;347:f5042