New report on global access to childhood vaccines

In January 2004 the Global Alliance for Vaccines and Immunizations (GAVI) published a report on progress and challenges in its campaign to increase access to childhood vaccines in developing countries. Since 2000, GAVI and its partner organization the Vaccine Fund have provided grants and technical assistance to help countries strengthen their existing childhood immunization programs and to purchase additional vaccines for these programs. Although early childhood immunization programs are found in most developing countries, each year an estimated 37 million children do not receive routine immunization against diphtheria, tetanus, and polio (a combination vaccine called DTP3). Even more children do not receive newer vaccines, and so are vulnerable to infection by hepatitis B virus, yellow fever virus, and Haemophilis influenzae type b (which causes meningitis).

GAVI-funded programs provide vaccines against these and other serious diseases, including the DTP3 vaccine.

GAVI has helped increase access to vaccines which have not been widely available in developing countries. One example is hepatitis B vaccine, which was licensed in 1981. Nearly twenty years later, it was estimated that less than half of the world’s children received the hepatitis B vaccine at birth. The new GAVI report estimates that more than 35 million children have been vaccinated against hepatitis B virus since 2001.

GAVI found that many developing countries needed financial support to build their health care infrastructure before they could begin to deliver childhood vaccines. One critical need is the “cold chain” of refrigerators, refrigerated trucks and storage facilities that are used to keep vaccines at the correct temperature at all times.

The report also notes that interest in manufacturing childhood vaccines has increased since GAVI was created. Currently there is only one manufacturer who produces a vaccine that combines vaccines against diphtheria, tetanus, pertussis and hepatitis B in one shot. But 11 manufacturers have now applied to produce and supply this vaccine combination by 2006. One reason for this is that GAVI and the Vaccine Fund have increased the funding available for purchasing these vaccines. This provides an incentive to vaccine manufacturers to invest in these vaccines.

GAVI’s work may hold useful lessons for the AIDS vaccine field. Even though it will likely be many years before an effective preventive AIDS vaccine is developed, there is still a need to plan ahead so that there is adequate manufacturing capacity and so that developing countries have the infrastructure and funds required to supply the vaccine to all who need it once it is available. AIDS vaccines will first be delivered to adults, rather than infants. This means that an effective vaccine will probably not be distributed through existing early childhood immunization programs; additional resources will be needed to design and build systems for delivering an AIDS vaccine to adults.