Saving Lives from Mainstream America… to Malawi

Children receiving their routine vaccinations in Narena, 84kms south west of Bamako, Mali. The country has applied to GAVI to help fund a pneumococcal vaccine.

By:  Seth Berkley MD, CEO of the GAVI Alliance and Orin Levine, Professor and Executive Director of the International Vaccine Access Center (IVAC) at the Johns Hopkins University   



As the sun rises over the tiny African nation of Malawi on Saturday, excited families will begin lining up at stadiums and soccer fields all across the country to protect their children. In a country where the average life expectancy is less than 38 years and most people live on less than a dollar a day, mothers and fathers will celebrate an incredible accomplishment: the opportunity to immunize their babies and children against the world’s leading child killer, pneumonia.

It is nothing short of devastating that childhood pneumonia claims the life of a baby or child every 20 seconds. The greater tragedy though is this horrible disease could be easily prevented and treated. Simply ensuring that existing vaccines reach the children who need them would go a long way to preventing the more than 1.5 million young lives lost each year, the overwhelming majority of which occur in the developing world.  By integrating these vaccines with improved nutrition and access to simple antibiotics, we can further diminish their risk.

Those of us concerned with this child killer will remember these lives lost on World Pneumonia Day, which takes place this Saturday, November 12. This year’s commemoration will also mark a particularly important turning point for many parents who live in Malawi and other poor countries who for the first time will be able to vaccinate their children against the pneumococcal bacterium, which is the leading cause of deadly pneumonia in small children.

This remarkable change was unthinkable just a few short years ago and signals dramatic progress toward vaccine access and equity that has been over a decade in the making.  Children in the United States and other wealthy nations have benefited from the lifesaving protection of pneumococcal vaccines since 2000, but limitations in supply, high prices and characteristics of the first generation vaccine that limited their effectiveness in developing world settings obstructed access to these vaccines for the kids that need them most.

The GAVI Alliance is a public-private partnership dedicated to increasing access to immunization in poor countries whose members include UNICEF, WHO, the World Bank and the Bill & Melinda Gates Foundation.

Thanks to the joint commitment of governments like ours, GAVI Alliance partners, manufacturers and developing country leaders, that is now beginning to change – not only in Malawi, but throughout the developing world.  In fact, the number of low-income countries offering pneumococcal vaccines has increased eight-fold in the last year alone – from two to 16 – and 18 more have recently been approved to follow suit, meaning that children in countries from Azerbaijan to Zimbabwe are receiving the newest-generation pneumonia vaccines within two years of their introduction in the United States, instead of 15 years later, as has been the case historically.

This progress is due in large part to an financing breakthrough spearheaded by GAVI, called the Advance Market Commitment (AMC), that leveraged $1.5 billion in donations to provide the incentive necessary for vaccine manufacturers to develop and produce pneumococcal vaccines tailored to developing world markets and the confidence in developing countries that the vaccines would be affordable, effective, and available in adequate supply.

Nicaragua became the first country to benefit from AMC funded vaccines and began introducing them nation-wide in December 2010.  Since that time, 15 of the world’s poorest countries have introduced the vaccines, making this life-saving technology available to more than 11 million children.  GAVI’s recent approval of 18 more low-income countries for the program means that tens of millions more children will be protected from pneumococcal disease and other potentially fatal illnesses.

Introducing a new life-saving vaccine might seem routine in the United States, but it is met with jubilation and tremendous relief among families and health providers in developing countries. The fact that parents in Malawi will stand for hours in line this World Pneumonia Day for a vaccine we take for granted in places like Milwaukee is a testament to their fear of pneumonia, their commitment to their children’s safety, and the power of vaccines to protect.

We cannot take these gains for granted.  These advances are at risk if America and other generous nations don’t make good on their global health funding commitments.  In the USA, the entire foreign aid budget is less than 1% of our national budget, and global health funding is a small fraction of that.  As members of Congress take on the unenviable challenge of reducing our national deficit, we hope they will consider the life-saving benefits of effective vaccination programs and the impact on the world’s poorest children.

This World Pneumonia Day we hope our nation’s leaders can reflect on how foreign aid for vaccines and treatments that combat pneumonia saves lives – and in doing so, makes countries more stable, creates markets for US products, and makes the world a better, more just place for all of us.

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