In today's online edition of The Lancet, a group of leading global health experts have come together to call for vaccine manufacturers and international donors to negotiate affordable pricing of pneumococcal conjugate vaccines and for governments of developing world countries and their partners to establish disease surveillance networks and begin preparations for pneumococcal vaccine introduction.
The experts believe that urgent action to introduce routine childhood pneumococcal vaccination is needed because of the enormous burden of the disease - the World Health Organisation (WHO) estimates that about 1.6 million people including up to one million children under five years old, die every year of pneumococcal pneumonia, meningitis, and sepsis.(1) In populations with high child mortality rates, pneumonia is the leading infectious cause of mortality and accounts for about 20-25% of all child deaths.(2) This call to action comes on the eve of a meeting of G8 ministers to discuss funding vaccines.This seems to be the latest step in major changes over the last five years in financing of immunisation, including the creation of the GAVI Alliance (Global Alliance for Vaccines and Immunization) Fund. Dr Orin Levine, the lead author of the article and Executive Director of PneumoADIP - a non-governmental organisation that aims to shorten the time between use of a vaccine in industrialised nations and their introduction in the developing world - commented: ‘We hope that with such mechanisms in place, all developing countries will begin to consider that millions of children can now be saved by the simple addition of this vaccine to existing immunisation programmes.’
Dr Thomas Cherian, Co-ordinator, Ad Interim, EPI, WHO, and co-author of the article added: ‘Pneumococcal disease is a major global health issue; what is promising is that a seven-valent vaccine that is effective against seven common strains of the disease is already licensed and in use in over 60 countries and that formulations containing additional serotypes of the organism that are also relevant for developing countries are under development. The WHO considers pneumococcal vaccines to be a priority and recognises the urgency to make these vaccines available for children in developing countries.’
There are other pneumococcal vaccines in development, which contain additional serotypes targeting strains of the disease that commonly cause death and disability in the developing world; however, these will not be available for several years. Introducing the seven-valent vaccine now means that lives can start to be saved straight away. This vaccine, manufactured by Wyeth, is effective, well-tolerated and can be delivered through existing immunisation systems. Surveillance data from the USA indicate that the herd immunity(i) effect from routine childhood pneumococcal vaccination prevents twice as many cases as the direct effects of vaccination alone - protecting vulnerable adults as well as children.
Responding to The Lancet paper, Julian Lob-Levyt, Executive Secretary, GAVI Alliance, said, ‘There is convincing evidence of the benefits of vaccines for major child killers especially when such a simple health intervention could help in meeting UN Millennium Development Goal no. 4: to reduce child mortality by two thirds by 2015. GAVI will be looking closely at how best to assist countries where pneumococcal disease represents a significant burden on public health.’
Jean Stephenne, President of GlaxoSmithKline Biologicals, the vaccines division of GlaxoSmithKline PLC, also welcomed the call to action in The Lancet and said, ‘GSK Bio has invested many years in the development of a vaccine that protects against the 10 most important strains of pneumococcus serotypes worldwide, and our candidate is now being studied in a global clinical program. We have a long history of supplying vaccines in developing countries and are committed to working to make our pneumococcal vaccine available worldwide at sustainable prices. We hope that our partners in governments, donor agencies, charities, and international organisations will step up with a firm purchase commitment that will allow us to save as many lives as possible.’
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Meanwhile, Wyeth researchers are continuing to work on new versions of Prevnar, including a version that will address 13 of the most prevalent serotypes of invasive pneumococcal disease, which will expand its usefulness globally for both children and adults.’
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