6,000 Kids Saved This Year in Rwanda

New York Times - On the Ground
June 2, 2009, 11:49 am
By Josh Ruxin

[Josh Ruxin is the director of Rwanda Works and a Columbia University expert
on public health who has spent the last few years living in Rwanda. He¹s an
unusual mix of academic expert and mud-between-the-toes aid worker. He has
made great contributions to this blog for nearly two years. This will be his
last entry.]

As the media turned world attention to efforts to contain a swine flu outbreak, the headlines reminded us of the unprecedented rate at which infections can travel the globe today. Yet, over this same period, in the small corner of the world I occupy, I was reminded of the extraordinary promise that globalization holds to more rapidly disseminate solutions ­- not just problems ­- in public health.

On April 25, Rwanda became the first developing country in the world to launch a national immunization program against pneumococcal disease. The program will administer Wyeth Pharmaceuticals¹ Prevenar®, a pneumococcal conjugate vaccine (PCV), to nearly all Rwandan children less than a year old by the end of 2009 and all Rwandan infants on a routine basis thereafter, free of charge.

This move will start saving approximately 6,000 kids¹ lives per year in Rwanda. This is not just good news; it must count as a major development in global public health.

As Nick discussed in his op-ed of May 10, pneumococcal disease attracts negligible investment, making it the orphan of global health. But it is vitally important that this change, as, in his words, in the five minutes it took to read his column, at least 19 children died of pneumonia, more than died in the same period of AIDS, malaria and measles combined.

Pneumococcus is the main cause of pneumonia, which kills more children than any other single disease ­- nearly one in five deaths of children under five worldwide. The bacterium can cause other life-threatening illnesses such as meningitis and sepsis; close to one million children under five years old in the developing world die every year due to these diseases. The expansion of Prevenar® use could help save up to 8 million children¹s lives by 2030.

Prevenar® was first introduced in the United States in 2000. Historically, 12-15 years pass between the introduction of new vaccines in industrialized countries and their appearance in the developing world. The use of a new-generation vaccine just nine years after its debut in the U.S. and soon after its introduction in Europe was spearheaded by the Global Alliance for Vaccines and Immunization (GAVI), a global partnership that includes the World Health Organization, UNICEF and the World Bank, and which is funded by donor countries and the Bill and Melinda Gates Foundation.

Since its founding in 2000, GAVI has worked to channel funding, optimize product availability and pricing and coordinate planning and implementation of vaccination programs in the world¹s poorest countries. GAVI has also developed unique financing mechanisms, such as a financing facility for immunization, which has raised funds for vaccination campaigns through bond issuances in capital markets.

In order to ensure a sustainable future supply of pneumococcal vaccines to developing countries, GAVI recently launched the Advance Market Commitment. This aims to spur development of new vaccines by obtaining donor countries¹ pledges to purchase the new vaccines, creating a viable future market. These commitments provide vaccine makers with the incentive to invest the considerable sums required to conduct research and build and allocate manufacturing capacity. Thanks to the work of GAVI, industry, governments and NGOs, Rwandans will now have the same access to the life-saving, new-generation pneumococcal vaccine currently used throughout the industrialized world.

Nine years is longer than it should take for health innovations to travel from the developed to the developing world ­- as we¹ve all seen, that¹s certainly far longer than it takes flu viruses and other potential epidemics to traverse the globe ­- but it is shorter than the amount of time required in the past. It¹s also a testament to the fact that innovative approaches, undertaken in partnership by governments, industry and non-governmental organizations, can accelerate the spread of life-saving products, processes and intellectual capital to significantly improve health in the developing world.


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