[Mb-civic] Medical Breakthrough - Washington Post Editorial
William Swiggard
swiggard at comcast.net
Wed Jan 18 02:50:41 PST 2006
Medical Breakthrough
Wednesday, January 18, 2006; A16
THERE AREN'T a lot of things that could save half a million children
annually, but an effective rotavirus vaccine could. This diarrheal
disease is one of the world's top killers -- less murderous than AIDS
(which caused an estimated 3.1 million deaths last year) or malaria (a
bit over 1 million), but remarkable for the fact that its name is not
widely known. Earlier this month the New England Journal of Medicine
published the promising results of large-scale clinical trials for two
rotavirus vaccines. It seems a breakthrough has arrived.
The question is how quickly the vaccines can be deployed in the poor
countries where nearly all the deaths happen -- and, by extension,
whether other new vaccines can be put to use quickly, transforming life
expectancy in the poor world. History counsels caution: Every year,
about 27 million children don't get the basic shots that are standard in
rich countries. But two major efforts have recently improved the odds of
deploying new vaccines widely.
The first is the global polio eradication campaign. Starting in 1998,
polio immunization drives have greatly reduced the burden of this
paralyzing disease; in India, for example, the number of cases has
fallen from 75,000 annually to fewer than 100 last year. With enough
persistence, polio may be eradicated; but in the meantime, the campaign
has created an infrastructure for delivering vaccines -- everything from
detailed registries of the children living in each village to supplies
of cold boxes for transporting doses to remote clinics. The progress
against polio has created thousands of motivated health care workers
and, just as important, millions of parents who have learned to trust
the health system.
The second promising development is the creation in 2000 of the Global
Alliance for Vaccines and Immunization, which aims to tackle financial
and other obstacles to the broad deployment of vaccines. So far the
alliance has disbursed about $700 million, enabling millions of extra
children to be vaccinated and saving an estimated 1.7 million lives. But
this is just the beginning: Governments and private donors have
committed a further $5.1 billion, about $3 billion of which will come
via a new mechanism that uses financial markets to front-load aid
spending. If the rotavirus vaccines had been developed 10 years ago,
there would have been a scramble to find money to pay for them. Now,
millions of dollars are available.
Failure is still possible. Last month The Post's Justin Gillis reported
on the delays in launching clinical trials in Asia and Africa, which
will hold up deployment of rotavirus vaccines there. But enough is going
right in this field to dream of a real turning point. The more vaccines
are put to use, the stronger the delivery infrastructure becomes and the
stronger the incentive for firms to invent more vaccines -- which in
turn will further energize the delivery system, leading to still wider
deployment of vaccines and even greater financial incentives to
inventors. To enable that virtuous cycle, rich countries must continue
their support for the Global Alliance for Vaccines and Immunization, and
poor countries must make the most of the opportunities created by the
alliance's money. It is not an iron law of nature that life expectancy
has to be 32 years more in rich countries than in sub-Saharan Africa.
http://www.washingtonpost.com/wp-dyn/content/article/2006/01/17/AR2006011701510.html?nav=hcmodule
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