Ebola is scary, and it has our attention. But Ebola could be even more dangerous if it is allowed to divert attention from other public health concerns.
Statistics, from the World Health Organization and UNICEF, offer some perspective:
Ebola cases now number more than 10,000, with more than 4,900 confirmed deaths in this year’s outbreak, most in the West African nations of Liberia, Sierra Leone and Guinea.
Worldwide, measles killed 122,000 children in 2012.
Rotaviruses, which cause severe diarrhea in young children, kill an estimated 350,000 children annually across the globe.
Diphtheria and pertussis, also known as whooping cough, kill another 300,000 children worldwide each year.
Haemophilus influenza type b (Hib), prevalent mostly in developing countries, causes an estimated 3 million cases, resulting in the deaths of about 450,000 children each year, most from pneumonia. Of those who survive, as much as 35 percent are left with life-long disabilities.
The statistics for tetanus are somewhat more encouraging. An estimated 787,000 newborns died of tetanus worldwide in 1989, according to WHO figures. In 2010, that number had dropped to 58,000.
Except for Ebola, vaccines are available for all the diseases above, available to prevent as many as 1.28 million deaths, most of them children, each year.
So, the problem is not the lack of a vaccine but the delivery of preventive medicine.
A doctor’s challenge
Dr. Namala Patrick Mkopi has first-hand experience in the difficulties of vaccine delivery. Head of pediatric hematology and oncology at Muhimbili National Hospital in Dar es Salaam, Tanzania, in East Africa, Dr. Mkopi also is a father, whose first child was born in 2011.
“But I couldn’t get the rotavirus vaccine for my child. I could afford it, but it wasn’t available in Tanzania, so I asked a friend to bring me some from Nairobi, (Kenya),” Mkopi said.
The doctor inoculated his child with the first dose, but a second dose, which has to be given four weeks after the first, had to wait in his fridge at home, a challenge because of frequent power outages in Tanzania. He bought a generator to ensure he had power.
“I am a doctor who knows what his child needs, but there are all these roadblocks,” Mkopi said. “It’s even more difficult for someone without the means to obtain and give the appropriate dose at the right time.”
Mkopi talked about his experience and his hope to make vaccines more easily delivered to children during a visit earlier this fall to The Herald and other news media and lawmakers in Western Washington, the West Coast and Washington, D.C., in conjunction with RESULTS, a nonprofit advocacy group addressing poverty in the U.S. and around the world. Mkopi and RESULTS are advocating for Gavi, the Vaccine Alliance, which is a public-private partnership seeking to improve access to vaccines in the world’s poorest countries.
The goal, said Crickett Nicovich, senior policy associate for RESULTS, is to immunize 300 million children by 2020, with the hope of saving 5 million lives.
Diverse funding sources
To reach that goal, Gavi is looking for a $7.5 billion investment over the next five years, said Theresa Rugg, Snohomish County spokeswoman for RESULTS. The U.S. House and Senate included $200 million in last year’s budget for Gavi’s programs. An increase is being sought to boost that to $1 billion in U.S. support over the next four years, Rugg said.
In support of that, House Resolution 688, co-sponsored by seven Washington state representatives, including Reps. Rick Larsen and Suzan DelBene, encourages the federal government’s continued funding for Gavi.
Government support from donor nations represents only part of Gavi’s funding. Much of its funding comes from direct contributions and from public-private partnerships. The program was started in 1999 with a $750 million, five-year pledge from the Bill and Melinda Gates Foundation. Gavi’s other partners include WHO, UNICEF and the World Bank.
The developing countries receiving Gavi’s assistance also make investments in the program, Mkopi said, and manage their own immunization program so that they can in time become self-sustaining. And the investment by developing countries is increasing.
“The countries, on average are pledging to allocate three times what they previously gave,” he said.
Ghana, in West Africa, is already one of Gavi’s success stories, consistently reaching immunization coverage rates above 90 percent for diptheria, tetanus and pertussis since 2007. As a graduate of Gavi’s program, Mkopi said, Ghana is committed to increasing its assistance to other countries as it supports its own programs. The same is expected of other countries as they reach immunization targets and graduate.
In Tanzania, which is also seeing recent immunization rates reach 95 percent for measles and 80 percent for all vaccines, Mkopi is seeing the results.
“The mortality rate is changing. We used to see deaths from diarrhea, tetanus, diphtheria, measles, hepatitis B, pneumonia, polio. By 2007 and 2008, we started seeing an impact from the vaccines. And starting in 2012, the rates for rotavirus were coming down,” he said.
“Fewer younger children are dying as the vaccines have taken effect. Older kids are coming in with pneumonia, but those are the kids who weren’t vaccinated.”
Mkopi remembers when the children’s diarrhea ward of his hospital in Dar es Salaam was filled with two and three children in a bed, and more on pads on the floor.
“Now, not a single patient,” he said.
The benefits of vaccination go beyond an empty hospital ward, Mkopi said.
When children aren’t sick, they can remain in school and continue their education, he said. When children aren’t sick, their parents aren’t called away from work and can support their families and help build their communities’ economy.
“It prevents the illnesses that rob children of health, vitality and mental capacity later in life. It’s an investment in our future,” Mkopi said. “And it’s the right of every child.”
Jon Bauer: 425-339-3466; email@example.com.
To learn more about RESULTS and its anti-poverty campaigns, go to www.results.org/.