A New Decade of Vaccines

Karachi, Pakistan, June 13: In the last century, vaccines have improved the health of millions of people and substantially reduced the toll of major diseases such as measles, yellow fever and diphtheria besides completely eradicating small pox. In the last 20 years, great progress has been made in the prevention of meningitis, pneumonia and hepatitis, and efforts are being made to develop better vaccines against malaria, measles and tuberculosis.

Vaccines have helped child mortality rates to fall dramatically and if coverage worldwide could be scaled up to 90 per cent, the lives of over 7.6 million children under the age of 5 could be saved between 2010 and 2019, estimates the Bill & Melinda Foundation. If a malaria vaccine becomes available by 2014, a further 1.1 million children could be saved.

These dramatic developments have helped global leaders, in December 2010, agree to support the Decade of Vaccines, to ensuring the discovery, development, and delivery of lifesaving vaccines globally, especially to the poorest countries.

One example is polio, the second disease up for global eradication – behind small pox – because of vaccines. Professor Zulfiqar Bhutta, Chair, Division of Maternal and Child Health, Aga Khan University and member of the steering committee of the Decade of Vaccines initiative, discusses the last mile in global polio eradication for the medical journal The Lancet as its latest Series explores what needs to take place to realise the tremendous potential of vaccines during the next decade.

Around the 1950s, polio was endemic in 125 countries on five continents, paralysing 350,000 children annually. But half a century of efforts has led to a 99 per cent decrease in the global incidence of polio with only 20 countries with endemic disease in 2000 and one type of wild poliovirus (out of three) eradicated since 1999.

But pockets of the disease remain in geographically limited areas in just four countries – Nigeria, India, Pakistan and Afghanistan – and have also affected countries with low overall immunisation coverage and weak health systems in central and the Horn of Africa.

Nigeria and India have made enormous gains in controlling polio with more than 90 per cent reduction in cases in the last year. Even Afghanistan has shown a 34 per cent reduction in cases, but Pakistan remains a challenge. “But weakness in the polio programme in Pakistan, compounded by recent floods and a conflict in the north, lead to a 62 per cent increase in cases, with 144 confirmed children with polio in 2010 and over 35 cases in the first quarter of 2011,” says Dr Bhutta. “All resources and collective wisdom should be combined to ensure that the last mile in the race to eradicate polio is the very last mile that we ever run in the quest to relegate polio to the corridors of history.”

The release has been timed to coincide with the Global Alliance for Vaccines and Immunisation’s (GAVI) pledging conference, on June 13, 2011, in London meant to raise US$ 3.7 billion to scale-up immunisation programmes between 2011 and 2015. This would be in addition to the US$ 10 billion already pledged by the Bill & Melinda Gates Foundation.