In this Decade of Vaccines, the Partners Forum discussions are centred on four of its founding principles-Results, Innovation, Sustainability and Equity.
Babatounde Osotimehim explained that even if ‘For every woman, for every child’ falls short in its mission goal to reach MDG4 and 5, he is confident that progress will be made in the three years that remain until 2015.
He emphasised that there has been lots of progress through GAVI and immunisation on MDG4; the true concern is world’s 600 million adolescent girls who account for 36% of maternal mortality. They should have access to education, reproductive health services, including family planning and understand that immunisation is a priority.
Babatounde also underlined the need for a package of integrated services for adolescent girls: immunisation, antenatal & postnatal care, contraception, HIV care.
In a final statement on intent, Babatounde declared that adolescent girls are a new cohort for GAVI following its support for the HPV vaccine. This will require creative approaches to reach out to adolescent girls.
Christopher Viehbacher, the head of Sanofi, shared the complexities and realities of producing and supplying vaccines in order to reach the demand for new vaccines.
He shared the industry’s commitment to make vaccines more adaptable and cited in his own company, CEO roundtables to discuss this issue, while acknowledging this area of vaccine development “had long been neglected,” primarily because it had low interest in the industry and low margins. “Our industry is committed not only to new vaccines but are aware of the practical difficulties of using our vaccines and there is now a concerted effort in industry to make vaccines more usable and affordable.”
The importance of partnership and collaboration from research and development to the actual site of vaccine delivery in country was essential to make this happen.
He referred to discussions at the Forum, citing the importance of sharing information to get a sense of what’s happening on the ground, and to know what’s happening in the supply chain, for example.
He noted a comment that “vaccines don’t deliver themselves” so there is the need to be innovative in production.
He recognized the need to make vaccines adaptable to public health needs, recognizing the complexities of long stages of research and development, regulation, and the biological nature of vaccine development.
Finally, regarding access and affordability, much can be done as evidenced by working closely with GAVI where the industry has better predictability of what is required, allowing the industry to get better at producing new vaccines
Drawing on data-visualisation software, Dr Hans Rosling held his audience spellbound, as he demonstrated that the eligibility criteria for GAVI support is unique in recognising a world no longer divided between developing and developed countries.
By plotting country by country child mortality rates against average national income over time, Dr Rosling showed how once poor countries have shifted closer to their ‘western’ counterparts. In 2011, places such as Ghana and Tanzania recorded relatively low infant mortality and higher income with the likes of Somalia and Afghanistan at the other “extreme end of the spectrum”.
Superimposing the average national income figure of US$ 1,500 that is the cut-off point for GAVI support on the graph, it was clear that the relatively few countries above the line corresponded to the high infant mortality rates traditionally associated with developing countries.
“How did GAVI become clever to have this line at US$ 1500,” he said. For Dr Rosling, the correlation between his graphics and GAVI’s eligibility line represents confirmation that it no longer makes sense to consider the world as divided between developing and developed countries.
The majority of people, he said, are living in the middle—although the distance from the very poorest to very richest is wider than ever.