The case for vaccines

Mary Moran is the Director of Policy Cures’.

Policy Cures’ mission is to provide innovative ideas and accurate analysis to accelerate development and uptake of new drugs, vaccines, diagnostics and other products for diseases of the developing world.

The widespread introduction of vaccines against common childhood diseases was one of the defining health interventions of the last century.

A decade-long immunisation campaign by the World Health Organisation resulted in the eradication of smallpox. When the programme began, the disease still threatened 60 per cent of the world's population and killed one in four people it infected. Similarly, polio at its peak paralysed or killed half a million people per year. Since the widespread introduction of a safe and effective polio vaccine, the number of reported cases has dropped by over 99 per cent. 

It’s not for nothing that WHO Director-General Margaret Chan declared vaccines to be ‘one of the best life-saving buys on offer’ – currently available vaccines are estimated to prevent over 2.5 million child deaths every year.

A new generation of vaccines for developing countries – such as those against pneumonia, meningitis and diarrhoea – is now showing the potential to extend this impact. A vaccine against meningitis A (costing less than 50 cents a dose) was introduced in three African countries in 2010. Historically, meningitis epidemics have killed as a many as 25,000 people and sickened 250,000 in a single year. Of the nearly 20 million people who received the vaccine in the 2010-11 epidemic season, not a single one came down with meningitis A. Vaccines against diarrhoea.

Australia has been a leader in developing many of these vaccines: it was an Australian who first discovered rotavirus – which alone kills nearly half a million children every year – and an Australian who developed the world’s first ever highly-protective vaccine against a parasite.

Recently, the Australian government has also stepped up: in 2011 it more than tripled its funding to the Global Alliance for Vaccines and Immunisation (GAVI Alliance), bringing its total investment to $200 million over 3 years.

This funding is a recognition of not only the importance of the problem, but also Australia’s capacity to make a difference; as Joel Negin from the University of Sydney points out, this contribution to GAVI amounts to less than a cup of coffee per Australian per year. It also highlights the way multilateral organisations like GAVI can effectively translate our aid dollars into lives and money saved.

But, as welcome as these advances are, more remains to be done. It is not enough to buy existing vaccines – we also need to make the ‘missing’ vaccines that patients in the developing world need.  Malaria still kills more than 600,000 people per year, the lack of a HIV vaccine means HIV treatment costs are soaring while overstrained health systems struggle to cope with the demands of scaling-up treatment, and our vaccine against tuberculosis is nearly a hundred years old and ineffective in the tropical regions where it is most needed.

We know that investing in R&D of new vaccines saves millions of lives, as the polio and smallpox vaccines have shown. We also know that failing to invest in R&D is a grave mistake that can cost millions of lives. In the 1990s, the global community didn’t invest in R&D to create pneumonia and rotavirus vaccines for the developing world even though the technology and expertise were available: as a result millions of lives have been needlessly lost from these two diseases while we waited for catch-up funding to create these vaccines in the 2010s. We cannot allow this to happen again.

Ongoing financial woes in Europe and slow recovery in the United States are putting pressure on the traditional funders of R&D for neglected diseases. Despite this, David Cameron’s government in the UK has ring-fenced the aid budget from huge public spending cuts – saying that it is a mark of a country that ‘we never turn our backs on the world’s poorest’. 

The US, meanwhile, continues to provide twice as much public funding for neglected R&D than the rest of the world’s governments combined. In comparison, Australia provides only around 1% of global public funding for neglected disease R&D, despite having the enviable status of being one of the only advanced economies to avoid a recession in the global financial crisis.

It would be almost negligent – not to mention short-sighted – for Australia not to strengthen its investment in vaccines and immunisation when it has the chance. Deferring the aid budget increase because of an arbitrary timeline for returning the budget to surplus would be placing political expediency before human lives.

Over two million children die every year from vaccine-preventable illnesses. Many more die from diseases against which there either no vaccine, or only a Western vaccine that is unsuited to developing country use.

Australia needs to continue to invest in delivering vaccines to those who need them, but also to increase its investment in R&D for the next generation of vaccines: we need both.