PHM-Exch> MSF intervention at WHO EB: Global immunization vision and strategy

[Claudio Schuftan]

From: David Legge <D.Legge at latrobe.edu.au>
From: amit sen [mailto:amit37064 at yahoo.com]
From: Thiru Balasubramaniam <thiru at keionline.org>

Global immunization vision and strategy
WHO 128th Executive Board Agenda item 4.6

Intervention by Michelle Childs, Médecins Sans Frontières, delivered on

18th January 2011

Médecins Sans Frontières welcomes the proposed Global Immunization Vision
and
Strategy (EB128/9) which rightfully encourages a rebalancing of the global
vaccine strategy, so that support for the introduction of the newer vaccines
does not mean momentum is lost as regards the need to ensure basic
immunization.

New vaccines such as pneumococcal vaccines have the potential to avert
millions
of deaths worldwide. At the same time, the need for MSF medical teams to
intervene in several measles outbreak responses illustrates the weak
coverage of
traditional vaccines, and is a clear indication of the failure of routine
basic
immunization, despite the global decrease in measles morbidity and
mortality.

Every day immunisation opportunities are missed, when young children
accessing
healthcare are not offered catch-up vaccinations. National immunisation
programmes should be supported to leverage every interaction with young
children
to provide ‘catch-up’ vaccinations.  Currently,
financial incentives reward countries for vaccinating children under one but
not
for vaccinating children above one year. The target of vaccinating children
by
the age of one should be an aspiration, and not a cut-off point.

Funding for routine measles vaccinations and catch-up campaigns has
gradually
diminished in recent years because of decreased political will and priority
setting. The Measles Initiative faces a critical funding gap and some
countries
are not in a position to raise the 50% of operational
costs asked of them to support supplementary vaccination activities.
Simultaneously, implementing countries must continually be encouraged to
increase their contribution to vaccination purchase and programmes.

To maximize the potential of vaccination, technologies better adapted to the
realities of resource-limited settings need to be developed. The arrival of
a
low-cost meningitis A vaccine last year shows the promise of tailoring
vaccine
development to the needs to developing countries. The development of a more
practical one-dose cholera vaccine, for use in
outbreaks such as in Haiti, is one of the key research and development
challenges ahead.

The report from the Secretariat rightly underlines the fact that vaccine
“prices
continue to be a major obstacle”. The current funding crisis at the GAVI
Alliance is partly due to prices that are too high. Too much emphasis has
been
put on incentivising multinational pharmaceutical companies, at the expense
of
investing in support to emerging producers that can produce
quality vaccines at dramatically reduced prices.

The report lacks strategies and concrete actions to bring vaccine prices
down.
It must include measures that stimulate competition as powerful way to
reduce
prices and should support increased price transparency. Competition can be
achieved by supporting technology transfer, development support to emerging
country vaccine makers and overcoming intellectual
property barriers where they exist. The meningitis A vaccine, developed with
the
critical participation of Southern producers and scientists, shows the
efficiency of a model that delinks the cost of research from the price of a
product, and provides a telling example of how different groups can work
together from the outset to ensure a new product is affordable.

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