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“Sign of hope” in fight against world’s number one vaccine-preventable killer

Jaziru Amiru - severe bronchial pneumonia
Copyright: 2008/GAVI/Tanzania/Rudden

In poor countries, at least one child dies of a pneumococcal disease every minute. A new approach to public health funding offers hope that many of these deaths can be averted through the development and manufacture of a simple vaccine suitable for the developing world.

Morogoro, Tanzania, 16 October 2008 – Jaziru Amiru lies wide-eyed, panting weakly on a gurney at Morogoro Hospital as the admitting nurse checks him over. The mother of the14-month-old boy desperately searches the health worker’s face for a sign of hope.

She does not find the comfort she craves. Her son is diagnosed with severe bronchial pneumonia and admitted to a bed in the paediatric ward. In hushed tones, the nurse explains that unless Jaziru’s fragile body can defy the odds, he will most likely die before the week is out.

Every year, pneumonia kills more than two million children aged under five – more than AIDS, malaria and tuberculosis combined.

His distraught mother cannot believe what is happening. Since his birth, she has made sure Jaziru never missed a single vaccination at the local health clinic.

Missing shot

Yet there is one shot missing from Jaziru’s immunisation card: the vaccine that protects under-fives from Streptococcus pneumoniae, a group of bacteria that is the world’s leading cause of child pneumonia deaths and the second leading cause of childhood meningitis deaths.

Every year, pneumonia kills more than two million children aged under five – more than AIDS, malaria and tuberculosis (TB) combined.

If Jaziru was born in Swindon or Seattle, a simple, readily available vaccine would have guaranteed protection from the types of pneumococcal infection common to Europe or the United States.

However, in Tanzania and other developing countries, different strains of pneumococcal disease are more prevalent and a suitable, affordable vaccine is not yet available. More than 90 percent of deaths attributable to pneumococcal diseases occur in the developing world.

A preventable tragedy
A report launched today by the United Kingdom All-Party Parliamentary Group (APPG) on Pneumococcal Disease Prevention in the Developing World describes these deaths as “a preventable tragedy” and demands that rich governments give pneumococcal diseases the same prominence and standing as better known killers such as HIV, malaria and TB.		APPG report

“We have a responsibility to help reduce the global health problem of pneumococcal disease, which is under-recognised and until recently, has had few dedicated efforts made to tackle it,” said Dr. Desmond Turner, MP and APPG Chair.

“Speaking at the report’s launch, Turner emphasised that if nothing is done to speed up the development and manufacture of a suitable vaccine, it will take up to 15 years for one to be made for the developing world.

“That is approximately 15 million lives lost,” he said.

Innovative solution

In an effort to save lives faster, the GAVI Alliance and a group of committed donors launched a new initiative known as Advance Market Commitments (AMCs). An innovative approach to public health funding, AMCs are designed to dramatically shorten the time span to produce an affordable vaccine for poor children.

The governments of Italy, the United Kingdom, Canada, Norway, and Russia, and the Bill & Melinda Gates Foundation launched a pilot AMC against pneumococcal with a collective US$1.5 billion commitment. In June, GAVI committed an additional US$1.3 billion towards the pilot.

Guarantee price

The donor commitments will guarantee the price of vaccines once they have been developed, thus creating the potential for a viable future market. This gives vaccine makers an incentive to invest the considerable sums required to conduct research, train staff and build manufacturing facilities for a pneumococcal vaccine.

At the same time, the AMC mechanism assures developing countries a safe, effective vaccine at an affordable price. If successful, the AMC would prompt the roll out of a suitable pneumococcal vaccine as early as 2010.

“By guaranteeing a long-term purchase and a long-term market, industry will recover its investment costs, and that’s entirely legitimate. These vaccines are costly to develop and costly to bring to market; those costs have to be recovered,” says Julian Lob-Levyt, GAVI Executive Secretary.

Saving lives

Until the pneumococcal AMC delivers a vaccine for developing countries, antibiotics will remain the only hope of a cure for Jaziru and countless other children clinging onto life at Morogoro Hospital.

However, if successful, this first AMC will not only save the lives of an estimated seven million children by 2030. It could also pathe the way for future AMCs, each designed to accelerate the development of vaccines already protecting children from lethal diseases in rich countries, but cruelly absent from paediatric wards across the developing world.