[e-drug] Expensive vaccines not needed?

[andy@healthlink.org.za]

E-DRUG: Expensive vaccines not needed?
-------------------------------------------------
[copied from DRUGINFO with thanks; WB]

Hi all

The BMJ today has this news item on yet another critical evaluation of
GAVI - http://bmj.com/cgi/content/full/324/7330/129 - this can be read
with the Anita Hardon report published in
HAILights(http://www.haiweb.org/pubs/hailights/mar2001/HAILightsMar200
1_1.doc; also covered in the BMJ at
http://www.bmj.com/cgi/content/full/322/7289/754/c).

regards
Andy Gray
~~~~~~~~~~~~~~~~~~~
Andy Gray MSc(Pharm) FPS
Senior Lecturer
Dept of Experimental and Clinical Pharmacology
Nelson R Mandela School of Medicine
PBag 7 Congella 4013
South Africa
Tel: +27-31-2604334/4298 Fax: +27-31-2604338
email: graya1@nu.ac.za or andy@healthlink.org.za

~~~

BMJ 2002;324:129 ( 19 January )

Children's charity criticises global immunisation initiative

Fiona Fleck, Geneva

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; Euro 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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