BARCELONA, SPAIN 24 April 2008 - Top vaccine experts and child advocates meeting in Barcelona today hailed dramatic new evidence of the role of immunisation in reducing deaths among children in the world's poorest nations.
"Each day, more and more children are being given life-saving vaccines. With higher immunisation rates, fewer of them are now dying of preventable infectious diseases," said Graça Machel, President of the Foundation for Community Development (FDC) for Mozambique.
Sponsored by the GAVI Alliance, Barcelona Centre for International Health Research (CRESIB), and "la Caixa" Foundation, the event brought together high-level policy makers, researchers, and funders to announce progress to date in childhood immunisation and options for overcoming the financial, logistical, and technical barriers that hinder steps forward.
Participants at the conference, entitled "Advancing Immunization in Developing Countries: New horizons in children's health," called for continued support for delivering life-saving vaccines to the developing world. They noted that immunisation rates serve among the most promising trends for reducing childhood mortality and achieving Millennium Development Goal 4, which aims at reducing by two thirds the mortality rate among children under five.
Projections from the World Health Organisation show that since its inception in 2000, through to 2007, GAVI support has prevented 2.9 million future deaths, protected 36.8 million additional children with basic vaccines against diphtheria, tetanus, and pertussis, and protected 176 million additional children with new and underused vaccines.
Thanks to support from GAVI and its partners, measles' deaths have been slashed across Africa by more than 90 percent since 2000, and 158.6 million children have been immunised against hepatitis B. Recent successes reported in Uganda, The Gambia and Kenya show that introducing the Hib vaccine in those countries has - within five years - prevented thousands of child deaths and virtually eliminated this deadly and painful cause of meningitis.
The Secretary of State for International Co-operation, Ms. Leire Pajín, stressed the firm commitment of Spain with international efforts to improve health, medical services and vaccination in developing countries, noting "the fundamental right of every child, woman and man to decent, comprehensive and qualified health services, wherever they live. As the 7th bilateral donor in the world, Spain has made substantial contributions to global initiatives: among others, supporting GAVI with more than EURO 189 million for 20 years. The Spanish government is also especially satisfied in supporting innovative collaboration schemes to strengthen research capacities in developing centres such as the Manhiça Health Research Centre in Mozambique that has carried out the pivotal clinical trials of the most advanced malaria vaccine candidate."
"Three years ago in Barcelona, many of us here today signed the Barcelona Declaration, calling on increased investment in existing and future vaccines," said Julian Lob-Levyt, GAVI Executive Secretary and CEO. "I am delighted to report that, three years later, we are delivering on that promise."
"Governments, the private sector and many players in global health are heeding our call. I particularly commend the Spanish government, which responded immediately to become one of the first to help fund an innovative financing mechanism for vaccines, known as IFFIm. And the private sector is delivering on that promise too. With its announcement of a EURO 4 million contribution to GAVI earlier this year, La Caixa is leading a remarkable effort in Spain to both encourage its employees and its many clients to become involved in our life-saving efforts."
Dr. Lob-Levyt commended la Caixa for creating a "new business alliance which will provide thousands of enlightened individuals and enterprises across Spain with opportunities to join our Immunize Every Child campaign and thereby help address one of the world's most glaring injustices."
"The GAVI Alliance has made a critical contribution towards reaching the Millennium Development Goals in the field of mother-and-child health," said HRH Princess Cristina of Spain, Director of the Social Area of the "la Caixa" Foundation. "Advances in vaccination, which we are sharing today are extremely important for the future of developing countries. Health care is a key piece in the construction of solid and healthy communities."
"La Caixa" Foundation is Spain's largest corporate foundation and ranks second in Europe and fifth worldwide.
"La Caixa's support to GAVI is further example of our social commitment. It gives "la Caixa" great satisfaction to stand alongside GAVI and invite other Spanish companies to join this global effort," said Mr. Isidro Fainé, Chairman of "la Caixa" and of the "la Caixa" Foundation.
In recent years, immunisation efforts have suffered from a lack of stable, predictable and coordinated cash flows, but new financing mechanisms such as IFFIm and an upcoming Advance Market Commitment (AMC) are helping to ensure long-term, sustainable funding for immunisation programmes. An anticipated IFFIm investment of US$4 billion (October 2004 value) is expected to protect more than 500 million children against measles, tetanus, and yellow fever.
"For the first time, we see a clear path that ensures that future and urgently needed vaccines, like those against malaria, pneumococcal disease, rotavirus and others, will reach young children across the developing world," said Dr. Pedro Alonso, Director of CRESIB (Hospital Clínic de Barcelona - Universitat de Barcelona).
Supported by a committed group of donor governments and the Bill and Melinda Gates Foundation, the Advance Market Commitment (AMC) pilot for pneumococcal disease has been created to ensure that developing countries have access to an appropriate vaccine at an affordable price faster than they otherwise would. Normally, it takes between 15 and 20 years for a new vaccine to become available in the developing world.
The AMC is expected to speed that process up to three to five years. Pneumococcal disease is a major cause of meningitis and pneumonia, and is responsible for the deaths of more than 1.6 million people worldwide each year, including at least 800,000 children. The AMC vaccine is expected to save 5.8 million additional lives by 2030.
"This innovative funding mechanism that ensures the long-term supply of a new vaccine at an affordable price will have a huge impact on child health and help bridge the divide between those who have access to vaccines and those who currently do not," said Dr. Ciro de Quadros, Executive Vice-President of the Albert B. Sabin Vaccine Institute.
Remaining challenges to childhood immunisation
Symposium participants said that despite the progress to date, crucial obstacles continue to prevent vaccine uptake across the globe. Even where new vaccine technologies exist, gaps in delivery systems raise significant barriers.
"Even the most exciting scientific breakthroughs will struggle to achieve results if financing is not increased and sustained and the health infrastructure in poor countries is not improved," said Dr. Lob-Levyt.
Continued funding for scientific research in the diseases of the developing world should also be a priority, panellists stressed.
"While the so-called developing countries constitute more than 90 percent of the world's burden of disease and death, only 10 percent of the global research and development budget goes to the study of the diseases that affect the poor," said Dr. Alonso.
Researchers also discussed the ongoing need to reduce the burden of cervical cancer with a vaccine against human papilloma virus (HPV). One recent estimate concluded that cervical cancer is the biggest single cause of years of life lost (YLL) from cancer in the developing world. As a result, the global health community will need to address how to integrate a vaccine into existing screening efforts for poor women - against the backdrop of societal pressures and stigma against the disease.
Panellists also said that new pressure is on to find a successful vaccine against malaria. With a phase III trial - unprecedented in size - of the promising RTS,S malaria vaccine developed by GlaxoSmith Kline underway in Africa, it was noted that major challenges will fall on African research infrastructure, including the need to build capacity, harmonize sites across geographic boundaries, and train staff.
"We cannot become complacent. We must dedicate ourselves to immunising every child, regardless of how hard they are to reach. We must overcome the obstacles that remain, one by one," said Mrs. Machel.
About the symposium sponsors:
La Caixa Foundation (Fundacion Caja de Ahorros y Pensiones de Barcelona)
La Caixa is the biggest savings bank in Spain, while la Caixa Foundation, a €500 million-a-year foundation, is the number one corporate foundation in Spain, and ranks as the second biggest European foundation and fifth at a global level. Since 1997, the International Social Works Cooperation Program of La Caixa has collaborated on 345 projects in 56 countries, with a contribution of more than €31.5 million. The principal axes of action are: socio-economic development, the formation of social capital in Africa and humanitarian action.
"la Caixa": a commitment to social need
"la Caixa" is an entity committed to people's needs. Through its Social and Cultural Outreach Projects, it invests 25% of its profits in the development of social, educational, environmental and cultural programmes that seek to meet citizens' principal concerns. In 2008, "la Caixa" dedicated a budget of 500 million euros to its Social and Cultural Outreach Projects, figure that makes it Spain's leading private foundation, the second biggest in the world and the fifth in terms of budget volume.
The International Solidarity Programme of "la Caixa" Social and Cultural Outreach Projects was a 1997 addition to its solidarity commitment to help eradicate extreme poverty in low-income countries, by fostering actions that assist sustainable social and economic development in the most vulnerable populations. Health is an essential part of the struggle against poverty. In the poor areas of the planet, disease and lack of resources are so entwined that it is impossible to fight them separately.
Since 2000, the International Solidarity Programme has had as its working framework the Millennium Development Goals of the United Nations; and since 2005, it has been working with the GAVI Alliance. Recently, the two institutions signed a collaboration agreement, by virtue of which "la Caixa" Social and Cultural Outreach Projects will invest during 2008 four million Euros in the vaccination of children under 5 who live in low-income countries. Thanks to this contribution, 300,000 boys and girls will be vaccinated in the next twelve months.
The GAVI Alliance
The GAVI Alliance (formerly the Global Alliance for Vaccines and Immunisation) is a public-private partnership of major stakeholders in immunisation. It includes developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry in both industrialised and developing countries, research and technical agencies, NGOs, and the Bill & Melinda Gates Foundation. WHO estimates that GAVI support will have prevented more than 2.9 million deaths by the end of 2007.
Graça Machel is the Chair of the GAVI Fund Board. The GAVI Fund sets the policies and strategies for the investment, fundraising and financial management of the GAVI Alliance.
Barcelona Centre for International Health Research (CRESIB)
CRESIB is a research centre focused on global health and developed by a number of leading academic and biomedical research institutions based in Barcelona: Universitat de Barcelona, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS). Working together with the Autonomous Government of Catalonia, CRESIB seeks to meet the new international health challenges of the 21st century.
CRESIB's research activity covers a number of areas related to international health, mainly Poverty-related diseases (Malaria, Pneumonia, AIDS, Diarrhoeal Diseases and Tuberculosis).
One of CRESIB's aims is to transfer the results of basic research to clinical practice and to health policies of the most disadvantaged countries, thereby helping to improve their economic and health development. To pursue this aim the centre promotes multidisciplinary research and collaboration with health institutions in developing countries. CRESIB is also engaged in long-term collaborations with other international centres, participating in several consortiums to carry out research projects.