Haemophilus influenzae type b is the third vaccine-preventable cause of death in under-fives
By 1999, 10 years after being licensed, Hib vaccine only available in one low-income country
Spread through sneezing and coughing, in the pre-vaccine era Haemophilus influenzae type b (Hib) was the leading cause of childhood meningitis - inflammation of the membranes covering the brain and spinal cord. Many survivors suffer paralysis, deafness, mental retardation and learning disabilities.
Even today, almost 20 years since safe and effective Hib conjugate vaccines were first licensed in the early 1990s, Hib remains the second most common cause of bacterial pneumonia deaths in children aged under five and the third vaccine-preventable cause of death in children aged under five.
Globally, the disease accounts for about eight million serious illnesses each year, resulting in nearly 400,000 child deaths, most of them in low-income countries. Ten countries in Asia and Africa account for 61 percent of all Hib-related deaths.
Hib can be treated with antibiotics, but lack of access to adequate medical facilities and increasing levels of antibiotic resistance lead to high mortality rates.
Vaccine fails to take-off in low-income countries
After Canada became the first country to introduce Hib vaccines in 1986, uptake was fast and, by 1998, 50% of high income countries had introduced the vaccine into their immunisation programmes leading to dramatic declines in the incidence of Hib disease.
However, high costs meant low-income countries could not afford the vaccine. The Gambia was the lone exception, becoming the only developing country to introduce Hib vaccine thanks to a manufacturer's donation in 1997.
In 2006, WHO issued a powerful recommendation for Hib vaccines, urging that it be included in all routine immunisation programmes around the world.
Map of the global burden of Hib disease