Report Urges Immunization Funding

November 20, 2002

DAKAR, Senegal (AP) -- Without urgent action to close the gaps in global immunization, old scourges could make a comeback and new infections may emerge, warns a U.N.-backed report released Wednesday.

Nearly 3 million people -- 2 million of them children -- die every year from vaccine-preventable diseases, said the report, produced jointly by the World Health Organization, the U.N. Children's Fund and the World Bank.

The report highlights major strides made in global immunization over the past decade, including the near-eradication of polio worldwide and dramatic reductions in the incidence of measles in some of the poorest nations. More than 70 percent of the world's children now benefit from immunization, said the report, released at a meeting of the Global Alliance for Vaccines and Immunization.

But tuberculosis, a disease that once appeared under control, is re-emerging, fueled by the spread of HIV and by growing resistance to TB treatments, the report says.

And the children who receive immunizations are mostly in the world's wealthier nations, or among the wealthier classes in poorer nations.

"It is a call to arms, if you will, both to the donors to prepare to invest more money, but also the countries themselves, that they are failing their children," said UNICEF head Carol Bellamy, who chairs the alliance of governments, U.N. agencies, charities, drug companies and other health institutions.

"We need to invest more -- and more rationally -- in vaccine coverage and research, and ensure access in all corners of the globe."

In developed countries, children benefit not only from higher immunization rates, but have access to a wider range of vaccines -- including newer and more expensive ones -- than in the developing world, according to the State of the World's Vaccines and Immunization report.

But in sub-Saharan Africa, only about 50 percent of children are immunized in their first year against common illnesses such as measles -- which alone causes about 700,000 deaths a year.

Inequalities also exist between the poor and wealthy within countries, with the poorest 20 percent of the world accounting for over half of all childhood deaths from whooping cough, polio, diphtheria, measles and tetanus, the report said.

"In most developing countries, infectious childhood diseases -- many of which are preventable by vaccines -- continue to kill in large numbers," Senegalese President Abdoulaye Wade said at the opening of the three-day meeting in this West African country.

attended by about 40 health and finance ministers and other alliance partners.

"That is to say that humanity is not yet entirely benefiting from the many advantages realized by vaccines."

Insufficient donor support for immunization programs in developing countries -- currently about $1.56 billion a year -- is cited as one of the major reasons for the gaps in coverage. But poorer countries themselves have in some cases failed to prioritize immunizations.

Efforts to meet immunization targets are also hampered by poorly functioning health systems in many developing countries.

Imbalances between wealthy and poor countries only increased over the past two decades as new, lifesaving vaccines for hepatitis B, yellow fever and other diseases became available at prices many developing countries cannot afford.

The lack of demand for new vaccines in poorer countries has in turn affected funding for research, which has focused on the needs of children in wealthier countries rather than on diseases like malaria -- which alone kills more than a million people a year, most of them in Africa.

Meanwhile, vaccines against diseases in the developed world are often unsuitable for use against developing-world strains of the same infections.

Shortages of existing vaccines are also starting to occur following a series of industry mergers, and because manufacturers are deterred by low prices for the basic vaccines that are most needed in developing countries. UNICEF is concerned about possible shortfalls next year in yellow fever, and other vaccines.

"Five or ten years ago, we could buy vaccine stocks off the shelf and get a fairly good price," said Paul Fife, health adviser to UNICEF. "Today we are buying anything we can get our hands on."