New and Old Vaccines Still Out of Reach for Many

UNITED NATIONS, May 26 (IPS) - While long-awaited new vaccines for malaria and dengue may finally be within reach,
many of the world's existing vaccines have remained unreachable for many of the people who need them most.
The recent outbreak of yellow fever in Angola shows how deadly infectious diseases can return when gaps in vaccination programs
grow. Earlier this week World Health Organization (WHO) Director-General Margaret Chan noted that the recent outbreak of deadly
disease has happened despite a vaccine being available for nearly 80 years.
"The world has had a safe, low-cost, and effective vaccine that confers life-long protection against yellow fever since 1937," she
said. "Yellow fever vaccines should be used more widely to protect people living in endemic countries."
Unfortunately yellow fever is one of many vaccine preventable diseases which has persisted and at times resurged. So far only one
of the world's existing vaccines, the smallpox vaccine, has reached the ultimate goal of eradicating a disease entirely. In 2015, the
world inched closer to eradicating one other disease through the use of immunisation, when Nigeria became the last country in
Africa to get rid of polio.
"We are in the endgame period of polio as we expect to see soon the interruption of polio in the remaining two countries of
Afghanistan and Pakistan," Dr Jean-Marie Okwo-Bele, Director of the WHO Department for Immunization, Vaccines and Biologicals
told IPS. Last month an ambitious plan to switch to a new polio vaccine was rolled out globally. The switch took place because the
vaccine no longer needed to fight against type 2 polio which has not been seen since 1999, said Okwo-Bele. However Okwo-Bele
told IPS that the world needs to get as good at getting rid of old vaccines as it has become at finding new ones.
"The pipeline for vaccines is so big now that we should get better at using the currently available vaccines so that we can get rid of
these vaccines," said Okwo-Bele.
"The past year only we could work and almost secure the availability of dengue vaccine, malaria vaccine and we are almost there
for the Ebola vaccine," he said. A tuberculosis vaccine may still be five to seven years away, he added, but could be an important
tool in the fight against antibiotic resistance. However although recent and promised new additions to the list of vaccinations offer
hope, some developing countries are concerned that high costs, particularly of newer vaccines, mean that their children will not be
able to benefit from these advancements. The fickle and secretive vaccines market is dominated by a handful of major
pharmaceutical companies prompting developing country governments to ask the World Health Organization last year to help them
navigate the purchasing process.
"There was real earnest frustration that they weren't getting any real assistance to benefit from those new vaccines and afford those
benefits for their children," Kate Elder, Vaccines Policy Advisor at Medecins Sans Frontieres' (MSF) Access Campaign told IPS.
One way that the WHO is addressing this problem is through establishing its own database of prices that governments pay for
vaccines. Okwo-Bele told IPS that countries without "negotiating powers" pay "far higher" prices for vaccines than other countries.
For example said Okwo-Bele, countries in Southern Africa have been known to pay higher prices for vaccines than other countries
with higher incomes.
Fortunately, not all developing countries have to fend for themselves on the vaccines market. The world's poorest countries have
access to much lower prices negotiated collectively by organisations including the vaccine alliance - GAVI, UNICEF and the Gates
Foundation. However according to the UN Children's Fund UNICEF, the children most likely to have not been vaccinated are the
ones living in countries that have been effected by conflict.
"Almost two-thirds of children who have not been immunised with basic vaccines live in countries that are either partially or entirely
affected by conflict," UNICEF said during World Immunisation Week in April.
Elder notes that governments and organisations proving vaccines in conflict affected countries are only eligible for the lower vaccine
prices negotiated via GAVI if the country affected by conflict is also considered to be a Least Developed Country. So while Yemen,
which is a Least Developed Country is eligible for these lower priced vaccines, Syrians are not.
"It's common sense that humanitarian organisations should have access to the lowest global prices, unfortunately it hasn't been the
formula so far," Elder told IPS.
"When you are in a humanitarian emergency one of the first things that you do in a camp is you vaccinate against measles," said
Elder, "because if you get measles in a refugee camp it's very, very dangerous."
While there are provisions for humanitarian organisations to access lower priced measles vaccines, the same is not true for the
relatively newer and more expensive pneumococcal vaccine, she said.
"We agree that pricing based exclusively on GNI (Gross National Income) is an artificial marker. However, we do agree with pricing
to take into account ability to pay / affordability," UNICEF told IPS in a statement. "UNICEF's work in influencing markets to achieve
a healthy state is about influencing fair prices and affordability," the statement said, noting that this approach has helped bring down
the price for some vaccines for both GAVI and non-GAVI eligible countries.
Overall, Okwo-Bele noted that vaccines should be seen as an important investment regardless of the context.
"It's linked to the basic saying, prevention is better than a cure, and prevention is cheaper than the cure, and that stands wherever
you are whether you're in the developed or developing countries," he said.
Original source: Inter Press Service
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