When the media writes about vaccines in the U.S. and Europe, usually we’re reporting on the endless controversy over whether some vaccines cause autism. (Short answer: they don’t.) That’s the luxury of wealth and health — thanks in no small part to the 20th-century legacy of mass vaccinations, virtually no parent in the developed world needs to worry that their child will be carried off by measles or rubella or polio or any of the other childhood diseases that once terrorized families. Vaccination is almost certainly the greatest triumph in the history of public health, even if it’s one that many otherwise intelligent people feel free to turn their backs on.
In much of the developing world, however, access to vaccination can still mean the difference between life and death — and too often, it’s the latter. That’s why Monday’s news from London that the Global Alliance for Vaccines and Immunisations (GAVI) had far surpassed its funding goals — raising $4.3 billion — is so welcome for global health.
The international charity, which promotes improved access to vaccines around the world, managed to pull in $600 million more in pledges than it had sought, thanks largely to a $1 billion gift from the Gates Foundation and a $1.34 billion donation from the British government. Money also came from the U.S., Norway, the Netherlands, Australia, France, Germany and Italy. GAVI says that the money will help immunize more than 250 million children in the developing world by 2015, and prevent more than 4 million premature deaths.
Addressing the London conference, British Prime Minister David Cameron noted that his country’s gift alone would make a vast difference for public health:
This will help vaccinate over 80 million children and save 1.4 million lives. … That is one child vaccinated every two seconds for five years. It is one child’s life saved every two minutes. That is what the money that the British taxpayer is putting in will give.
For Gates, who has long made vaccine development and distribution a keystone of his charity’s work, the economics of vaccines are simply too good to pass off. Vaccines are “magic,” as Gates said in a British interview on Sunday:
They are very inexpensive, they can protect you for your entire life, so diseases like smallpox that used to kill millions are completely gone because of the vaccine. It’s the greatest thing that ever happened in human health. We need to get them out to people and invent some more.
That includes diseases that have yet to be tamed by vaccines, including malaria, which kills nearly a million people a year, mostly African children. Gates and others have worked hard to reduce that death toll through bed nets, the development of new anti-malarial drugs and other on-the-ground interventions. But a vaccine that would protect against malaria for life — as the smallpox vaccine did, which led to the eradication of that horror — would be a home run for health.
GAVI has been criticized by some relief groups, including Oxfam and Doctors Without Borders, for being too close to the pharmaceutical industry and not doing enough to push for cheaper vaccines. (Two representatives from drug companies sit on GAVI’s 27-member board.) From the Wall Street Journal:
Mr. Gates praised Glaxo’s recent decision to cut the price of its rotavirus vaccine for GAVI by 67%, to $5 for a full course of shots. But others have criticized the prices Glaxo and Pfizer are charging GAVI for pneumococcal vaccine, which protects against pneumonia and meningitis. The companies are getting $7 a shot for the first 20% of the shots they deliver, and $3.50 a shot for the remainder. A child needs three shots to be fully immunized. The companies defend their prices, saying they represent a big discount on the prices charged in Western countries.
GAVI’s critics have a legitimate gripe. If vaccines are really going to be distributed to every part of the world that needs them, they’ll need to get cheaper — and as one of the biggest purchasers of vaccines in the world, GAVI could push for lower prices. But that doesn’t change the essential fact that the developed world should do all it can to ensure that vaccination really does become universal, rather than just the province of those who have the luxury of not needing them.