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World: WHO Says Vaccines Unavailable To One-Fourth Of Children

Prague, 20 November 2002 (RFE/RL) -- The World Health Organization, or WHO, says in a comprehensive worldwide report published today that one-fourth of the world's children still go unvaccinated against easily preventable killer diseases.

One of the report's authors, WHO executive Michel Zassran, said the report shows that immense efforts in the last 20 years have resulted in progress, but that millions of children in poor countries still die needlessly. "In spite of all the efforts made over the past two decades -- and a lot of progress was indeed made -- we still have approximately 35 [million] to 37 million children that do not have access to routine immunization every year. And most of these children live in the poorest countries in the world," Zassran said.

The WHO says that the situation is at its worst in the world's poorest regions -- sub-Saharan Africa and Southeast Asia -- where it is exacerbated not only by a lack of funds but also by lack of information. Zassran said it is substantially better in the poor countries of Eastern Europe and Central Asia. He said that is because the countries of the former Soviet Union at least have a tradition of relying on preventive tactics. "The [health-care] system was substantially disrupted after the fall of the Soviet Union. However, I would say that these countries have, in their tradition, immunization as a core health intervention. So, although the situation is not perfect, I think it takes less effort there to actually improve the situation," Zassran said.

The WHO, the World Bank, and the UN children's fund, or UNICEF, all collaborated on the report. They made it public today in Dakar, Senegal, at a meeting of the Global Alliance for Vaccines and Immunization. The WHO also published the report on its website.

The report says that the children of the poorest 20 percent of the world's population are the victims of more than half of child deaths in the world from whooping cough (pertussis), polio, diphtheria, measles, and tetanus. They make up nearly 45 percent of all infant deaths at or near the time of birth.

The WHO report's authors say thousands upon thousands of these deaths could be prevented if wealthy donor countries and nongovernmental organizations would supply another $350 million a year for vaccinations that already are routinely provided for nearly all children in wealthy countries. The report says that immunization is the most cost-effective of all public-health measures.

In a telephone interview with RFE/RL, Zassran said that the lack of well-known and established immunization procedures is one immense gap separating poor states from wealthier ones. But he said there is another gap as well. "The second major gap that we have is a gap that is between the rich and the poor world in terms of use of new vaccines or more recently available vaccines," Zassran said.

The report says that one available tactic for decreasing a 10- to 20-year delay in introducing new vaccines into developing countries is what the WHO and UNICEF call "tiered pricing." UNICEF buys vaccines in bulk for use in the lowest-income countries and negotiates lower prices than those paid for the same product in industrialized countries. UNICEF used this method in 2000 to buy more than 2.4 billion doses of vaccine, most of it oral polio vaccine.

The WHO says that a principal purpose of the report is to point out that vaccines have saved billions of lives in the past century and are still the least expensive way to control the spread of infectious disease. However, they are not reaching the populations that need them most.

Zassran said the document is intended as a wake-up call to the world. "So this is a sort of a big call to do something about better using the technologies that we have today in order to insure a secure access to routine immunization services for all children, irrespective of whether they live in poor or rich countries," Zassran said.

The report says that another problem is a lack of market incentive for pharmaceutical companies to invest in research into prevention of diseases most common in poor countries. Such diseases include Shigella dysentery, dengue (hemorrhagic) fever, Japanese encephalitis, leishmaniasis, schistosomiasis, and cholera. The need is there, but the money to buy vaccines, once developed, is not.