Last week Bill & Melinda Gates announced that their foundation would commit $10 billion over the next decade to help research, develop and deliver vaccines for the world’s poorest countries.
By significantly scaling up the delivery of life-saving vaccines in developing countries to 90 percent coverage—including new vaccines to prevent severe diarrhea and pneumonia—the model suggests that we could prevent the deaths of 7.6 million children under 5 before 2019. The foundation also estimates that an additional 1.1 million children could be saved with the rapid introduction of a malaria vaccine beginning in 2014, bringing the total number of potential lives saved to 8.7 million.
Dr. Jean-Marie Okwo-Bele is the director of the World Health Organization Department of Immunization, Vaccines and Biologicals and is responsible for strategic direction, coordination and management of immunization activities. He called me yesterday from Geneva to answer a few questions about the Gates’ pledge.
What is the significance of the announcement by Bill and Melinda Gates?
This is a really great investment. As our [Director-General] said, an unprecedented one that will certainly help us advance our cause. The Gates have been investing in vaccinations over the last decade or so, and committing this support for the next 10 years means they strongly believe –as we do—in the value of these interventions and the impact of vaccinations. [The funding announced last week is in addition to the $4.5 billion that the Gates Foundation has already committed to vaccine research, development and delivery.]
Ten billion is a lot of money.
Yes, $10 billion is a lot of money. But you may want to know the estimates we did a few years back on achieving some of the globally established goals for immunization. From the 72 poorest countries between 2006 and 2015, we would need close to $34 billion. So getting closer to 2015, $4 billion per year is needed for all expenses including staff salaries, infrastructure, research. It’s a great contribution, but the work ahead is truly, truly huge, not only in terms of vaccines but insuring that they are actually delivered to the right people in some of those countries with weak delivery systems.
What vaccines are you focused on?
We’ve had tremendous progress with measles—an 80 percent reduction over the last 10 years. But to sustain this, newborns and infants require vaccination. In addition to measles mortality reduction efforts, you have polio eradication (as we have done with the smallpox in the ‘70s), meningitis outbreaks in West Africa, some of the new vaccines for childhood diarrhea and pneumonia… you bring all this together, it’s a big effort.
What will the money cover, besides vaccines?
It will contribute to [everything from] vaccine research to vaccine delivery. We would hope that some of the money would help facilitate the development of vaccines that are stable and can be readily used in developing countries. Vaccines must be refrigerated, and we could improve on the technology of some of the equipment to store the vaccines. There are many areas of research. As we are talking now, we have product available and country demand and means to deliver.
How will this affect child mortality?
It will have an amazing effect. One of the recent key successes in child mortality reduction is with measles. It was killing nearly 800,000 kids, and now we’re talking about a couple hundred thousand. That level of reduction is because of vaccination. But that’s just specific measles mortality. When one delivers measles vaccine, one brings along other intervention—like mosquito bed nets, deworming tablets that can reduce the infection due to malaria and reduce malnutrition. So the indirect effect of measles vaccination also shows success. As we go forward in the next 10 years, we’ve developed a strategy with UNICEF: When [one delivers] a new vaccine against pneumonia or diarrhea, one must bring along other child health intervention or programs so we can maximize any intervention with children. We see this as a trigger to accelerate mortality reduction in children in general.
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