Putting Children First

Rotavirus vaccines can save millions of lives, but we must commit to action Every year, millions of African children do not live to see their fifth birthday because of illnesses such as pneumonia and diarrhoea, which are among the top causes of childhood deaths. We know that we cannot make any strides in child health without addressing these two illnesses. Two germs, pneumococcus (pneumonia) and rotavirus (diarrhoea) account for most of the illnesses and deaths from these diseases and both are now preventable by vaccination. Since the pneumococcal vaccine is already scheduled to reach our national programme shortly (It is already in use in Rwanda), I would like to offer some thoughts on rotavirus and vaccines for the disease, which have already enjoyed success in wealthier parts of the world. Today, we have reached a historic moment: rotavirus vaccines are now ready for use in Africa. Because of the imminent arrival of rotavirus vaccines into Africa, paediatricians and public health officials recently converged in Nairobi for the first “African Rotavirus Conference.” In this meeting, the group pledged, among other items, that rotavirus vaccines should be delivered to the children of Africa without further delay. African children who get this infection are many more times likely to die from it than anywhere else in the world. I joined my colleagues for this meeting and noted that, while our commitment is real, it is only a first step to ensuring the widespread use of these important vaccines. This group of eminent academics and health care managers from all over Africa further reiterated that there is need for co-operation between national policy makers and local communities throughout the continent to win the fight against rotavirus. Vaccination has generally been proven to be a high-impact and cost-effective public health intervention. It is without question the most effective tool to help save children’s lives from rotavirus diarrhoea, which can frequently lead to lethal dehydration. This virus is minimally prevented by standard hygienic behaviour. Of course, if the illness is identified in time in a well-equipped health facility, relatively simple treatment techniques, such as rehydration with salt and sugar solutions, can be effective in averting death. However, many children throughout Africa still die of the disease because their families cannot reach health facilities in time or because they do not have access to local clinics. It has taken many years for rotavirus vaccines to reach Africa. In 2000, the World Health Organisation (WHO) called on the public health community to focus urgent attention on the issue and make rotavirus vaccine research a higher priority. After some of the largest clinical trials ever, conducted all over the world, two effective rotavirus vaccines are now available in certain regions. Having established that the existing vaccines can work in Africa as well as they do elsewhere, the WHO recently recommended the use of one of them in Kenya and throughout Africa and Asia. This critical WHO decision will allow African countries to purchase the vaccine in partnership with UN agencies and international donors at heavily subsidized prices. Research studies conducted in Africa confirmed that rotavirus vaccination has the potential to bring about a tremendous public health impact across the continent. For years, health advocates in Africa have sought more technologies to improve public health. With the recent WHO decision on rotavirus vaccines, we are on the verge of making significant and lasting change in our children’s lives. We should take advantage of this opportunity to incorporate rotavirus vaccines into our national immunisation programmes. Where these vaccines have been introduced nationally, significant decreases have been reported in the number of hospital visits for serious diarrhoeal diseases. Nearly 1,400 children die from rotavirus every day in the developing world – approximately one child every minute. An immediate, widespread global immunisation campaign against rotavirus could save the lives of 2.5 million of these children by 2025. Of course, like most policies that cost money, the inclusion of rotavirus vaccines into our children’s menu of immunisations will require political goodwill. I pray that our leaders in Africa have the courage to do whatever it takes to introduce effective strategies, such as vaccines, to our children. I pray that our leaders consider the importance of improving child health ahead of the cost of achieving it. As an advocate of the millions of children under the age of five who call Africa their home, I honestly believe that vaccination should be considered a human right. Dr. Fred Were is the National Chairman of The Kenya Paediatric Association. He is also a lecturer at the University of Nairobi and the Aga Khan University Nairobi. Ends

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Putting Children First