Mark Tran
guardian.co.uk, Tuesday 27 September 2011 14.38 BST
A child is treated for pneumonia at Kigali central university hospital in Rwanda. Gavi has stepped up its pneumococcal vaccine funding programme. Photograph: AFP
The Global Alliance for Vaccines and Immunisation (Gavi) said on Tuesday it will provide more funding for developing countries to introduce vaccines against severe diarrhoea and pneumonia, two leading causes of child deaths.
Gavi, a public-private partnership to help the world's poorest countries obtain vital vaccines and reduce child mortality, described the rollout of rotavirus and pneumococcal vaccines as its biggest commitment of funds to date.
Rotavirus is the leading cause of severe diarrhoea in children under five, killing more than half a million each year worldwide and causing illness in several million more. Nearly 50% of all rotavirus deaths occur in Africa, where access to treatment for severe rotavirus diarrhoea is limited or unavailable.
Pneumococcal disease causes pneumonia, meningitis and sepsis and also kills more than half a million children each year, the vast majority of them in Africa and Asia.
"These new vaccines will prevent millions of children from dying of pneumonia and diarrhoea, the biggest killers of children under five," said Anthony Lake, executive director of Unicef, the UN agency for children. "We need to focus especially on reaching the children at greatest risk, for it is among the most vulnerable that these vaccines can make the biggest difference."
Dr Catherine Sanga, health attache for Tanzania, predicted the announcement will mean 50% of children who suffer from diarrhoea in Africa will survive.
"We believe it will reduce child deaths and help us achieve the millennium development goals," she said. "We felt that getting these resources and Gavi support will push us further … I'm convinced that it will reduce hospital attendance, will have an economic and social impact and [that] it brings hope to many families to Africa in general."
The rollout of rotavirus vaccines across Africa has already begun in North and South Sudan and Tuesday's announcement confirms funding for 12 more African countries. The programme is expected to reach more countries in early 2012 and 2013.
Countries seeking funding for vaccines make an application for what they want. Gavi assesses whether the countries have the infrastructure in place to store and distribute the vaccines. If approval is given, procurement follows and the vaccines are delivered with the help of partners on the ground.
Last year, Gavi's independent review committee approved funding for rotavirus support for what was then Sudan, worth $69.8m between 2010 and 2014.
"We have to make sure that delivery is done well," said Seth Berkley, chief executive of Gavi. "We want people to have confidence in the system. This requires planning to make sure there are enough vaccines. In the past, people have walked hours to far-away clinics to find vaccines not available."
Families will not have to pay for the vaccines as governments and co-funders will have done so already. The vaccines for pneumonia will come from GlaxoSmithKline (GSK) and Pfizer and the target price for them will be $3.50, 90% less than when sold in the west. The vaccines for diarrhoea will be provided by GSK and Merck, again at a greatly reduced price of $5.
Berkley said he expected the prices to fall as pharmaceutical companies from India and Brazil enter the market.
"We are excited by the reductions that have already occurred and we are working to make these more affordable," he said.
Gavi said rotavirus vaccines have proven to be highly effective at reducing severe and fatal diarrhoea and have saved thousands of children's lives. It cited Mexico, where there has been a 46% reduction in the number of children under five dying from diarrhoea. Gavi and its partners also plan to support more than 40 countries to introduce pneumococcal vaccines and immunise more than 90 million children against pneumococcal disease by 2015.
On Monday, Gavi's executive committee approved applications from 37 countries. Sixteen countries received approval for rotavirus vaccines, 18 for pneumococcal vaccines, five for pentavalent vaccine and 12 for other types of vaccines. Out of the 37 countries, 24 are in Africa. The total cost for all 37 countries is more than $1bn.
Save the Children welcomed the announcement, but said Gavi must work with its partners to ensure vaccines reach every child.
"Often the poorest children are at the highest risk of vaccine preventable disease, and yet are the last to be immunised," said Patrick Watt, director of policy and research. "In Nigeria, one of the countries approved today, a child in the top income bracket is over nine times more likely to have received basic immunisation than a child in the poorest income group. The announcement today marks the moment when the hard work must start."
• This article was amended on 29 September 2011. The original named one of the companies supplying the pneumonia vaccine as Wyeth. This has been corrected to Pfizer, which acquired Wyeth in 2009.
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