Filed under Immunisation

The world’s first ever malaria vaccine has been developed. This is incredible news: scientists once believed a vaccine for such parascitic diseases would be impossilbe to find, yet here is the first of its kind. The vaccine cuts malaria cases by half, promising a halfing of the global burden of malaria from 200m to 100m if it’s put into use. Furthermore, GlaxoSmithKline, who developed the vaccine, will sell the drug at just a fraction over cost-price, and invest any profits into further tropical disease research.

See here for the Guardian’s full article.

Hundreds of thousands of Somalians live in crowded, often unsanitary, camps in Mogadishu; they have moved there to escape famine, drought and insecurity. Now in these camps, they face instances of cholera two to three times greater than last year. Health officials fear cholera could now rapidly spread to the camps’ hundreds of thousands of inhabitants.

IRIN reports:

In Mogadishu’s largest health facility, Banadir Hospital, 4,272 cases of acute watery diarrhoea, a symptom of cholera, have been recorded so far this year, causing 181 deaths. (Random laboratory tests showed that 60 percent of the cases also tested positive for malaria, according to WHO.)

Children under five, weakened by malnutrition, make up three-fourths of the cases…
WHO spokesman Tarek Jasarevic said: “This sudden increase had various reasons. First, the numerous informal settlements of internally displaced persons with makeshift shelters, poor sanitation and limited access to safe water. Second, the limited capacity of existing health partners to access those informal settlements and provide essential health services. And third, the high number of malnourished children due to the ongoing famine increased the susceptibility to waterborne diseases such as acute watery diarrhoea.”

Cholera is an acute intestinal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. It has a short incubation period, from less than one day to five days, and produces an enterotoxin that causes a copious, painless, watery diarrhoea that can quickly lead to severe dehydration and death if treatment is not prompt.

See here for IRIN’s full article.

David Cameron today announced that the UK will increase its funding of two ‘highly cost-effective’ health interventions: the provision of pneumococcal and rotavirus vaccinations. 814 million pounds will be donated, which the Prime Minister states will treat 80 million children and save 1.4 million lives in the developing world.

Health researchers have estimated that the best use of the pneumococcal vaccine provides one DALY (disability adjusted life year- the equivalent of giving someone a year of life at full health) for every $100 spent. Thus, if all of the investment were spent on pneumococcal vaccines, it would save around 13,200,000 years of healthy life! This puts the intervention in the category of highly cost-effective measures.

However, one can still do more than 30 times better… And that is very important. It’s like getting a “96% off” sale, or 3000% extra free, in the cost of curing life-wrecking diseases in the third world. For example, if Cameron had instead decided to boost the treatment of soil-transmitted helminthic infections, he could have saved 30 DALYs (rather than 1) for every $100 spent. Or, by directing aid to the Schistosomiasis Control Initiative, roughly one DALY would by provided with every 2 pounds and 9 pence ($3.41) spent.

Likewise, here you can see how the DALYs/$100 provided by Rotavirus immunisations (the other vaccinations pursued by DfID’s aid boost) are dwarfed by certain measles and other vaccinations.

Cameron/ DfID’s conception of cost-effectiveness may be confused by their tendency to think about cost-effectiveness as “getting vaccines from GSK at the lowest possible price”. Vaccines, however, are only important for the health outcomes (and other good side effects) they produce. Thus, rather than principally focusing on getting the best price for vaccines, we should focus on getting the best price for health outcomes. For this, DALYs are the best available measure.

In keeping the UK’s pledge to raise aid to 0.7% of GDP by 2015, and in consciously boosting aid to more effective causes, this is certainly a welcome move in the right direction. We just hope that with their increased focus on cost-effectiveness, DfID and David Cameron will spot the even greater opportunities to help some of the world’s most vulnerable people offered the most cost-effective interventions.

Sources:

http://www.independent.co.uk/news/uk/politics/pm-announces-extra-814m-for-vaccines-2296883.html

http://www.sciencedirect.com/science/article/pii/S0140673607601950

http://www.sciencedirect.com/science/article/pii/S0140673607601950

A vaccine for Dengue Fever is in the process of being developed, and might be ready for use by 2015. However

 While dengue vaccine development has been widespread among research institutions and pharmaceutical companies, Sanofi Pasteur, the largest vaccine developer in the world, is years ahead of the rest. If all goes well in the ongoing clinical trials, experts say immunizing the public may begin as soon as 2015. But the estimated 300 to 400 million people who will want the vaccine is too much for just one manufacturer.

With 2.5 billion at risk of dengue fever, health officials expect many of the urban poor (dengue is an urban, mosquito-born disease) to miss out on this important vaccine.

See here for an IRIN article, which explains more about the vaccine and dengue fever itself.

Burkina Faso has become the first country to run a nationwide campaign to vaccinate citizens against the most common causes of meningitis. The vaccine costs just 50 cents. It has been under development for 10 years, at a cost of $50million. But The World Health Organisation reports that this development cost and speed is actually relatively impressive:

the development of MenAfriVac cost only US$ 50 million - a fraction of the amount usually required to develop and bring a new vaccine to market… The rapid development of the vaccine is in large part due to the commitment of the Serum Institute of India, Ltd., the vaccine manufacturer. Africans have in the past waited as long as 20 years for a vaccine to travel from the industrialized north to the nations of the south. In this case, MenAfriVac will be introduced in Africa before it is distributed anywhere else.

WHO also reports that:

If MenAfriVac is introduced throughout sub-Saharan Africa, the resulting reduction in cases of meningitis is expected to free up more than US$ 120 million in the period up to 2015, money from national budgets which would otherwise be spent on medical costs for diagnosis and treatment. These funds can then be brought to bear on other problems of disease and poverty that weigh so heavily on the region. 

See here for the full story.

An unnamed drugs company has lowered the price of a vaccine that combats five diseases still prevalent in the developing world- diphtheria, whooping cough, tetanus, Hib and hepatitis B. Over the past six years, the price of this vaccine has fallen by $0.68 to $2.97. This change brings the price down to $2.56, making it even easier for individuals, political bodies and aid organisations to prevent people suffering from debilitating, lifethreatening diseases.

The Guardian comments:

It’s a long time since we [in the developed world]’ve had babies dying from diphtheria, which used to be a lurking evil here. In an ideal world, cost would not be an issue. These sorts of vaccinations should be automatic everywhere. But GAVI has limited funds from the donor nations, which have become less generous in the recession, and pressure on those funds is getting heavier all the time… [Nevertheless], When money is tight and the need is great, it’s an approach that makes sense.

See here for the Guardian’s report.

GlaxoSmithKleine have pledged to donate £12m per year of the drug albendazole, which will treat some of the world’s poorest people for intestinal worms. The one billion tablets to be donated are sufficient to treat every child in Africa. Other drugs companies have followed up with similar commitments.

See here for the full story, from the Guardian’s Global Health Blog.

Four years of negotiations with drugs companies and extensive fundraising to provide a guaranteed market for vaccines have enabled nonprofit organisation the GAVI Alliance to secure a reduced price for vaccines against pneumococcal diseases.

Pneumococcal diseases include pneumonia and meningitis and are responsible for 1.6 million deaths every year.

Pfizer and GlaxoSmithKline will provide up to 300 million doses each of their vaccines over a 10-year period. The price for the first 20 percent of the supply will be $7 a dose. Then the price will drop to $3.50 a dose for the remainder.

The vaccine remains relatively expensive; at least three doses are needed, resulting in expected costs of around $21/ person. The estimated cost of producing the vaccine is $1.50-$2.50, so the drugs companies are still safely profiting from the deal.

GAVI have raised $1.5bn of the $3bn needed to pay for the immunisation program, which they expect to save up to 900,000 lives by 2015.

See here for the full article.

A mass drive to eradicate polio begins today. See here for the full article.

“More than 85 million children under five years old will be immunized against polio in 19 countries across West and Central Africa in a massive example of cross-border cooperation aimed at stopping a year-long polio epidemic.”

400,000 volunteers will administer two drops of oral polio vaccine (OPV) to every child at the door of every household in 19 African countries. The drive hopes to finally eradicate polio in Africa:

A previous round of campaigns in 2009 did not stop the outbreak completely, as not enough children were vaccinated to stop polio transmission. After years with no polio cases, some countries lacked the necessary skills and experience to respond adequately to the outbreak. New approaches being introduced this year include standardized, independent monitoring of whether children have been reached, better training for vaccinators to carry out the plans fully and appropriate deployment of experienced staff.

UNICEF’s Regional Director for West and Central Africa, Dr Gianfranco Rotigliano noted: “With better coverage that leaves no child unvaccinated, these campaigns can succeed in making West and Central Africa polio-free.”