How to Fight Poverty: 8 Programs That Work #1
Universal vaccination is cost-effective foreign aid at its best. It is so successful, so widely considered essential, that many people today do not realize that it began only 20 years ago.
When Unicef and the World Health Organization started a global effort to vaccinate children against common childhood diseases in 1985, they were met with widespread skepticism. Vaccination rates for children in many countries were appalling – only 20 percent of the world's children in 1980 had gotten their third shot of D.P.T. (diphtheria, pertussis and tetanus) on time, the conventional measure of vaccine coverage.
But the program has had stunning success. By 1990, 75 percent of children had completed their D.P.T. shots on time. Bangladesh went from 9 percent D.P.T. completion in 1987 to 98 percent five years later. Worldwide, children were being immunized against polio and measles as well.
The logistics are heroic. Wars are routinely halted for inoculation campaigns. Entire countries get vaccinated in two days. Measles vaccines are successfully kept cold during day-long journeys by bicycle and canoe.
A full course of immunization, including everything in the supply chain, costs only $30. In the last 20 years this campaign has saved 20 million lives. It has given hundreds of millions of children a better start.
In the 1990s, however, the world's attention turned to other problems, and vaccination rates slipped backwards. Bangladesh fell back to 66 percent in 1999. Every year 27 million children — a quarter of the world's children — go unvaccinated against the basic diseases. Two to three million of these children die. Even for those who survive, these diseases can be crushing, forcing children to drop out of school, and parents to spend time and money they cannot afford on doctors and care for their sick children.
The challenge today is two-fold: to improve basic vaccine coverage, and to put new vaccines into global use. Vaccines now exist to protect children against common diarrheal and pneumococcal killers, against hepatitis B and a common influenza. But they are mainly in use in wealthy countries. Soon there may be a malaria vaccine as well. All these must become part of the universal vaccine package.
Help has come from an organization launched in 2000, the Global Alliance for Vaccines and Immunization. Financed by governments, organizations such as the World Bank and Unicef and the Bill and Melinda Gates Foundation, GAVI gives poor countries money to improve their infrastructure and logistics – and then gives them more if they actually achieve improved vaccination rates. It also helps assure a predictable market for new vaccines, which encourages drug makers to produce them in large quantities. It has helped expand both basic and new vaccine coverage – because of GAVI, for example, 90 million children have been immunized against hepatitis B(pdf).
Immunization became a victim of its success, but close attention and new partnerships are now reviving vaccines. It is a lesson that eternal vigilance is needed, even to protect a program that became venerable practically overnight.
Credit: NYtimes,
By TINA ROSENBERG