According to Medecins Sans Frontieres (or Doctors Without Borders) - GAVI -- the Global Alliance for Vaccines and Immunisation -- should work to extend the prices it obtains for vaccines to humanitarian agencies.
That's because they are better placed to reach unvaccinated children.
Presenter: Geraldine Coutts
Speaker: Kate Elder, Vaccines Policy Advisor, Médecins Sans Frontières' Access Campaign
ELDER: The GAVI Alliance project is bringing around vaccine … from all over the world, I think there's almost 700 people here talking about immunisation, the achievements that have been made today and where we have still yet to go as the global vaccines community.
COUTTS: And what about that question of getting more affordable prices for vaccines on a more regular basis? What's stopping that at the moment?
ELDER: That's an excellent question, I mean when we look at the numbers of unimmunised children, MSF is really concerned about the fact that the number of unimmunised has actually been increasing, has actually risen. So in 2010 there were upwards of 19-million kids who weren't getting the basic package of vaccines, and then last year in 2011 that number actually rose about three million more, so edging near 23-million. And MSF in the field sees the effects of these low immunisation rates when we are having to respond to for example measles outbreaks and other epidemics that would be otherwise easily preventable with your basic immunisation, but these kids aren't being reached for a couple of reasons; one is the price that you bring up. These new vaccines are incredibly expensive, the GAVI Alliance while it has been able to reduce the price of vaccines, significantly the costs are actually still too high. For example the two newest vaccines; pneumococcal vaccine preventing pneumonia, and rotavirus vaccine which prevents diarrhoea, account those two, the vaccines account for about 70 per cent of the total cost of fully vaccinating a child right now. So we see that these prices are really too high which is making it unaffordable which is really limiting access.
COUTTS: And what was the second reason apart from the affordability?
ELDER: Another area that's limiting our access and our operations to extend vaccination coverage to all kids, particularly kids that are being repetitively missed, is the fact that the tools that we currently have available really have not been developed for the places where these kids are being met. So there's about 70 per cent of those, almost 23-million kids who are being missed, are in countries like, the top ten countries, a lot of them are countries where MSF work. So for example a country like DRC, Democratic Republic of the Congo or a country like Chad or Ethiopia, and our field teams tell us that the current products in presentation really don't permit them to take vaccinations to the kids that are furthest out, the most hard to reach. For example most kids need to be fully vaccinated by your first birthday, you have to at a minimum go through a health facility five times. And mothers find that incredibly difficult, caretakers to leave their current jobs, travel long distances to have these shots repetitively. So if we had vaccines that required fewer doses we would be able to more fully vaccinate children. Additionally most vaccines, actually all of the vaccines for the time being require something called cold chain, that means keeping vaccines in refrigerators between two to eight degrees Celsius. That seems easy enough, I live in New York, it's easy enough to keep vaccines cool, but when you go to places like Chad, where the temperature reaches 45 degrees typically and where electricity is really intermittent, it's incredibly difficult logistically to keep vaccines cold. So if we had vaccines that were more what we call thermal stable, which didn't require refrigeration, we would be able to take them out to these areas where there's high numbers of unimmunised children. So that's really some of the limitations that we face in the field in terms of extending vaccination coverage to children.
COUTTS: It seems a more reasonable plea on all the counts that you put, but how far off is it from reality?
ELDER: Well that's a very good question. I mean there are some good initial innovations certainly. I think what MSF is calling for is a more accelerated progress towards getting those innovations in the field. We're also looking for big vaccination organisations, such as the GAVI Alliance, which has huge influence on how we do vaccinations, particularly in these most difficult to work contexts, we're looking for them to play a much more active role in getting these better adapted vaccines developed, and then pre-qualified by the World Health Organisation and put in these route immunisation programs in these countries. So yeah we think it's certainly within reach, but we need the global community to be much more ambitious. We're in the midst of a process called the decade of vaccines, Bill and Melinda Gates launched the decade of vaccines about two years ago, and the global community for the past two years has been putting together what's really the blueprint, the framework if you will, for the decade of vaccines. It's a framework called the Global Vaccine Action Plan, and we're only shooting for in that Global Vaccine Action Plan, we're only aiming for one new innovation to deliver vaccines by 2020, one new innovation. And we think we can be much more ambitious and do much better by 2020 if you have these better adapted vaccines available, so field teams like MSF can extend the coverage and start to bring down that number of unimmunised children. So that's kind of one area we think there's room for improvement. Additionally on the pricing matter, there needs to be much more public scrutiny as to how much we're paying for vaccines. While prices may have been decreased, the fact of the matter is these are public taxpayers dollars that are going to these vaccines. These prices are too high to begin with and we need a kind of global tracking mechanism to look at how much we're decreasing prices for these most low-income countries and middle-income countries, and really around the world over the next decade. MSF has been calling for this Global Vaccine Action Plan, an indicator, a way that we're track vaccine prices over the coming decade.
COUTTS: Well in summary then according to Medecins Sans Frontieres, you need access to vaccines when you need them, where you need them and at affordable prices?
ELDER: Absolutely, that's what we're calling for, and that will enable our field teams to vaccinate more children in these areas where kids are being and where they harbour the most of these vaccine preventable diseases. So that yes we can absolutely kind of really fully optimise the value of vaccines.