[Mb-civic] Medical Breakthrough - Washington Post Editorial

[William Swiggard]

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
-------------- next part --------------
An HTML attachment was scrubbed...
URL: http://www.islandlists.com/pipermail/mb-civic/attachments/20060118/dda93730/attachment.htm