[india-drug] layperson administered tetanus vaccination

[Edrug <e-drug@usa.healthnet.org>]

(copied from Edrug. Thanks????SS)


E-DRUG: layperson administered tetanus vaccination
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[From UNICEF, http://www.unicef.org/newsline/02pr46mali.htm
This may be a useful user-friendly technology, and may be safe in
laypersons. However, what about the costs? The new technology is
donated
for 3 years. Will it be available for USD 1.20 per case after that (as
the current vaccines cost)?
WB]

UNICEF Press Centre

New effort to reach women with tetanus vaccine could save thousands of
lives

Pre-Filled Injection Device Is Helping Reach Remotest Communities

Bamako / Geneva / New York, 26 July 2002 -

UNICEF today announced concentrated efforts to reach women in poor,
hard-to-reach communities with vaccine against maternal and neonatal
tetanus, an effort it said could potentially save the lives of
thousands of women and their new-born children.
UNICEF said the campaign, which starts today in Mali, is being enhanced
by the introduction of a pre-filled injection device that will make it
easier to immunize women in remote areas. The new device, BD UnijectT
with tetanus toxoid is a single dose, pre-filled syringe and needle
that can be administered by lay people.

Maternal and neonatal tetanus can be eliminated globally through
immunization and hygienic birth practices. But it has often been
difficult to reach women and children in remote communities since the
traditional vaccination can only be administed by trained health
workers. As a result, last year alone, tetanus claimed the lives of
200,000 newborns and 30,000 women in 57 developing countries.

"The introduction of a pre-filled injection device has the potential to
greatly simplify the way this vaccination is given, making it possible
to train non-medical personnel such as social workers and teachers to
vaccinate women against tetanus," said Carol Bellamy, Executive
Director of UNICEF. "Our goal is the elimination of maternal and
neonatal tetanus by 2005, and reaching women in remote areas is
essential to succeeding." She noted that women at risk must receive at
least three doses of the vaccine over a one-year period to be fully
protected.

Since lay people can use the new device, traditional birth attendants,
teachers and community workers are being trained to support health
workers in immunizing women in communities without access to clinics or
health centers.

The pre-filled device has additional advantages:

It is a single-use needle and syringe, reducing the possibility of
transmission of blood-borne diseases such as HIV/AIDS and Hepatitis.

It has a very small needle, about an inch long, making it easier to
dispel fears of needles and vaccinations.

UnijectT is manufactured by BD (Becton, Dickinson and Company) and
another company, Bio Farma, produces the vaccine and fills the syringe.
The two companies have jointly donated 9 million units to UNICEF over
the next three years for use in the collaborative effort to eliminate
maternal and neonatal tetanus.

"This is an excellent example of a partnership between the public and
private sectors," Bellamy said. "We are grateful for the donation these
companies have made and hope their commitment to this campaign will be
a
lasting one. There is no reason why women and children should die from
a
disease we can effectively prevent."

The first major use of UnijectT for tetanus immunizations will be in
two
remote districts in Mali - Bla and Bougoni - from July 25 to July 31.
The Ministry of Health is carrying out the campaign with support from
UNICEF, BASICS and Save the Children (U.S.). A total of 118,000 women
of
childbearing age (14-45) will be vaccinated during this period. The use
of UnijectT will be extended later in the year to other districts in
Mali and to other developing countries where maternal and neonatal
tetanus is still claiming the lives of thousands of children and their
mothers.

The global campaign to eliminate maternal and neonatal tetanus is being
spearheaded by Ministries of Health, UNICEF, WHO, UNFPA, PATH, BASICS,
Save the Children (US) and other partners. The Maternal and Neonatal
Tetanus Elimination Initiative has received major donations from the
Government of Japan, the US Fund for UNICEF, the UK National Committee
for UNICEF, Ronald McDonald House Charities, The Bill and Melinda Gates
Foundation, and Becton Dickinson.

About Maternal and Neonatal Tetanus

Neonatal tetanus is a deadly disease, common in poor countries, mostly
affecting populations with little or no access to basic health care
services and education. The disease, which was eliminated in the
industrialized world as far back as the 1950s, is still a major killer
of infants in the developing world, responsible for no less than
200,000
infant deaths every year and accounting for 14 per cent of all neonatal
deaths.
Up to 70 per cent of all babies that develop the disease die in their
first month of life. It occurs as a result of unhygienic birth
practices, leading to contamination of the umbilical cord with tetanus
spores when it is being cut or dressed after delivery. The disease
usually presents itself on the third day after birth, causing the baby
to stop feeding due to stiffness of the jaw muscles. The baby then goes
into painful convulsions, coma and eventually dies.

Maternal tetanus is also caused by contamination from tetanus spores
through puncture wounds, and is linked to unsafe and unclean
deliveries.
Maternal tetanus is responsible for at least five per cent of all
maternal deaths, and accounts for up to 30,000 deaths each year.

Unlike smallpox and polio, complete eradication of tetanus is not
possible as the tetanus spores can survive outside the human body, in
dirt and in the stools of infected people and animals. The disease can
be transmitted without any human contact.

In the past it has cost $1.20 per woman to provide three doses of
tetanus toxoid and promote clean delivery practices. Over the 2-year
period since the Initiative began (in 1999/2000) the partnership has
been able to prevent 15,000 additional newborn deaths.







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