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The Gambia Introduces Vaccine Against World’s Leading Vaccine-Preventable Child Killer

Written on:August 20, 2009
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By Molly O’Brien, Banjul, The Gambia

Minister of Health Dr. Mariatou Jallow administered the first dose of the pneumococcal vaccine to Gambian children at a rural clinic outside Banjul today. Joined by the Gambia’s Vice President, Isatou Njie-Saidy, Dr. Jallow and hundreds of Gambian citizens celebrated this historic event which marks the first step in the rollout of the Gambia’s national pneumococcal immunisation programme.

“This is a proud day for the Gambia and a seminal moment for West Africa and all low-income countries around the world,” said Dr. Jallow. “We are committed to saving the lives and improving the health of our children and families, and we are proud to set an example for our West African neighbours to follow. With the introduction of this vaccine, the goal of significantly reducing childhood death in our country will now be within reach.”

Pneumococcal disease is the leading vaccine-preventable killer of children younger than five worldwide and can cause potentially life-threatening illnesses such as pneumonia, meningitis and sepsis.

Pneumonia, the most common form of severe pneumococcal disease, is responsible for 1 in 6 deaths in Gambian children less than five years of age, according to the World Health Organization. Safe and effective vaccines exist to combat pneumococcal disease but until recently have not been broadly available to low-income countries, despite the fact that more than 95 percent of pneumococcal cases occur in those nations.

The Gambia’s introduction of the pneumococcal vaccine follows an earlier introduction of the same vaccine in Rwanda four months ago. To help make both introductions possible, Wyeth contributed more than 3 million doses of Prevenar(tm), the company’s seven-valent pneumococcal conjugate vaccine, through the GAVI Alliance.

Thanks to the partnership between developing countries, donor governments, the World Health Organization, UNICEF, the World Bank and industry, the GAVI Alliance provides financial support to accelerate the introduction of basic and new vaccines and strengthen health systems in developing countries, including the Gambia. An important next milestone will be the availability of newer generation vaccines to the rest of the world’s low-income countries, which is expected to begin as early as 2010.

“The Gambia represents one of the 60 countries in which we hope to roll out the pneumococcal vaccine by 2015. If all GAVI countries act to introduce pneumococcal vaccine, we could save 7 million children by 2030,” said Dr. Julian Lob-Levyt, CEO of the GAVI Alliance. “Donor support will be critical to achieving this goal and to continuing progress toward Millennium Development Goal 4 – a two-thirds reduction in child mortality by 2015.”

“Wyeth is committed to protecting current and future generations from pneumococcal disease around the world,” said Jim Connolly, Executive Vice President and General Manager, Wyeth Vaccines. “Wyeth takes great pride in providing the GAVI Alliance with more than 3 million doses of Prevenar(tm) to help the Gambia and Rwanda protect their children against this serious health threat.”

Innovative Financing Accelerates Prevention

To accelerate the introduction of next generation pneumococcal vaccine in poor countries, in June 2009, the governments of Italy, the United Kingdom, Canada, the Russian Federation, Norway and the Bill & Melinda Gates Foundation, together with the GAVI Alliance, launched the pilot pneumococcal Advance Market Commitment (AMC).

Donors pledged US $1.5 billion to fund the pilot AMC for pneumococcal vaccine, and the GAVI Alliance committed to raising $1.3 billion for the period 2010-2015 to help fund the vaccine’s long-term price. The AMC is expected to help expand access to pneumococcal vaccines to all GAVI-eligible countries and potentially save millions of lives.

“Wyeth welcomes the AMC concept as an innovative financing mechanism to help accelerate the introduction of needed vaccines in the least developed countries. We look forward to working together with GAVI and the international community on the next steps of the AMC process,” said Mr. Connolly.

Clinical Trials and the Promise of Saving Lives

The nationwide rollout of pneumococcal vaccine in the Gambia follows a large-scale pneumococcal vaccine efficacy trial in the country using a different formulation. The four-year study followed more than 17,000 young Gambian children to see whether a vaccine that had been shown to prevent pneumococcal disease in urban South Africa would also work in the challenging environment of rural Africa. The results, published in The Lancet in March 2006, showed that the vaccine reduced childhood mortality by 16 percent in Gambian children – a huge impact for a single intervention and the first statistically significant reduction in overall child
mortality to be demonstrated by a major randomized, controlled vaccine clinical trial in nearly 20 years.

“It is particularly rewarding to see Gambian children now benefiting from these scientific advances and from the opportunities for access provided by the GAVI Alliance,” said Dr. Orin Levine, Executive Director of PneumoADIP at Johns Hopkins Bloomberg School of Public Health. “No other country has contributed as much to our understanding of the burden of pneumococcal disease and the value of pneumococcal vaccines as the Gambia.”

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