http://bmj.com/cgi/content/full/324/7330/129
BMJ 2002;324:129 ( 19 January )
News
Children's charity criticises global immunisation initiative
Fiona Fleck
A global initiative that seeks to save millions of children's lives by
immunisation is in danger of saddling the world's poorest countries
with expensive vaccine regimes they cannot afford and perhaps do not
need, a new study has found.
The study, conducted by the UK charity Save the Children and the London
School of Hygiene and Tropical Medicine, criticised the Global
Alliance for Vaccines and Immunisations (GAVI) for including
managers from pharmaceutical companies on its governing board,
saying that this created a potential conflict of interest.
"GAVI needs to ensure that it can focus on the most appropriate assistance
to an immunisation system without the risk of commercial, product-oriented
pressure," the UK charity said in a statement.
The alliance, based on partnership between the public and private sectors,
was launched in 1999 to combat falling immunisation levels by
providing vaccines to 74 of the world's poorest countries. Dubbed
the "billion dollar fund" after a contribution of $750m (£517m;
839m)
from Microsoft's founder and chief executive, Bill Gates, it seeks
to achieve this by incorporating new vaccines into national health
systems while promoting existing immunisation programmes.
The study, reported on Tuesday in Geneva, was based on research conducted in
Mozambique, Ghana, Lesotho, and Tanzania. It concluded that although
the initiative had succeeded in raising the profile of immunisation
programmes in developing countries, it had failed to ensure that
additional resources were provided to countries with weak health
systems before they take on expensive new vaccines.
It warned that raising poor countries' awareness of immunisation programmes
without detailed advice and financial support in implementing such
schemes could end up creating markets for costly new vaccines while
doing little to tackle the biggest killer diseases.
The report said, for example, that refrigerators for storing vaccines were
poorly maintained and often broke down. It also said that Ghana was
given only 10 days to decide whether to accept a new high tech
vaccine for hepatitis B without any evidence that this was actually
needed
a
decision that more than doubled the cost of the country's
immunisation programme.
It concluded that although the funding gap would initially be covered by the
alliance, the long term sustainability of the programme was in question.
"Due to lack of funding and the added burden of the HIV crisis, many
countries' health systems are on the verge of complete and utter
collapse," said Regina Keith, a senior health adviser at Save
the Children in the United Kingdom.
"Money must be spent on the upkeep of equipment, as well as on training
and paying the salaries of health workers. If the billion dollar
fund goes bust, developing countries will be left footing the bill
for costly new vaccines that are of no use to the children whose
lives they are meant to save," she said.
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Rapid Response responses to
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responses
GAVI from the country perspective
Gill Walt, et al.
bmj.com, 18 Jan 2002 [Response]
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