Lois Privor-Dumm

By Lois Privor-Dumm. A decade can make a difference.  Eleven years ago this month, I had the privilege of launching pneumococcal conjugate vaccine (PCV) here in the US.  It was a vaccine that I knew would have a profound impact on children and families all over the country, Protection against severe meningitis and other infections allowed American children to move along the path of their lives –with a low risk of this potentially life-changing catastrophic disease.

Children in developing countries though faced a different picture over the past decade. Pneumococcus in the developing world not only causes severe meningitis, but is a leading cause of pneumonia.  Without access to PCV, 3 month-old Dominic Mwangi, found himself in the district hospital undergoing antibiotic treatment for life-threatening pneumonia.  His mother was away from home and family for 3 days.  Dominic was lucky and recovered; An astonishing 1.5 million children, mainly in Africa and Asia, are not so lucky.  Almost half of all severe pneumonias and meningitis deaths are thought to be caused by bacteria that can be prevented by the use of vaccine. Much more disease could be prevented with better nutrition and access to care.   Dominic, because he was born in Kenya, was 112 times more likely to die of pneumonia than an American child.  In Afghanistan, that number is 400. 

2011 paints a more promising picture.   A new generation of vaccines from Pfizer and GSK providing the broader protection needed to fight pneumonia and meningitis in developing countries has been made available in Nicaragua, Yemen and now Kenya within a year of launching in the industrialized world.  By 2015 more than 40 countries will do the same. 

What changed?  It was a convergence of factors – pharmaceutical companies, seeing a greater likelihood of demand with secured financing, were willing to offer low prices to those most in need, supplying at prices of less than 90% of those in industrialized countries.  Low-income countries wanted the vaccine because they saw the potential impact and a plan again for financing.  Financing was needed – and eventually made possible by Italy, UK, Canada, Russia, Norway and the Bill and Melinda Gates Foundation who donated $1.5B to the Pneumococcal AMC, an innovative financing mechanism and the GAVI Alliance who is making up the price differentials that low-income countries cannot manage as yet.   

It took a lot of effort to see these pieces fall into place, but one that can’t stop with just this example.   In a time where all of us are paying attention to how to do more with less, efforts like this one provide an important lesson of what is possible. Investing in health, individual countries have made dramatic economic progress and this will help all of us.  Take a look at this Rosling video and you’ll see why investments in health are, well, a good investment.   Children of all nations deserve a solid foundation to become healthy adults. We have more to do, we need to keep going.

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