A Simple Solution to Save Lives

Every day children die needlessly from a little-known disease with a devastating impact. It is called rotavirus, and it is the leading cause of severe diarrhoea—and one of the most easily preventable public health challenges we face today. Rotavirus kills more than 500,000 children under five around the world each year—almost 1400 deaths each day—the vast majority of them in sub-Saharan Africa and South Asia. It leads to millions more hospitalizations. As a pediatrician, I’ve seen first-hand the devastation caused by rotavirus. In Rwanda alone, rotavirus is responsible for nearly 4,000 deaths each year. Rotavirus attacks our families and threatens our nation’s future by targeting our most precious resource—our children. But the true tragedy is that much of this death and suffering could be prevented right now if children in Rwanda had the same access to life-saving vaccines as children in industrialized countries, where the disease barely has an impact. In the United States, rotavirus vaccines have been widely available for five years, even though the disease only killed a handful of children a year when they were introduced. Here, where the need is much greater, they are not an option for the vast majority of children. Vaccines are one of the best long-term investments to prevent disease and give children a healthy start to life —a few shots or drops can protect a child for a lifetime. They are one of the most cost effective interventions to prevent illness in a country like ours with many competing health priorities. With rotavirus, existing oral vaccines have been shown to provide significant protection against the disease. The challenge has been that until today rotavirus vaccines have been much too expensive for poor countries, where health resources are scarce. Donors have been hesitant to support the vaccine until costs come down. But in this past week, there is new cause for optimism. Children in developing countries will finally get access to the same life-saving rotavirus vaccines that children living in rich countries do. On June 6, the GAVI Alliance, an international organization that supports the rollout of vaccines to low-income countries, announced it had been offered a significant price reduction for rotavirus vaccines from a pharmaceutical company that will lower the cost to US$2.50 a dose, a third of the previous low price. GAVI already supports introduction of life-saving vaccines in Rwanda, and now has plans to rapidly accelerate its financial support for rotavirus vaccines. At the same time, there are new, more affordable rotavirus vaccines on the horizon that will sustain our efforts to save children’s lives for the long-term. Manufacturers in developing countries, such as India, are developing vaccines for rotavirus and other diseases that should be just as safe and effective – and even more affordable – than those that exist today. In fact, when GAVI announced the price cut for the existing rotavirus vaccine, it disclosed that an Indian rotavirus vaccine candidate – which should be available around 2015 – will cost just US$1 per dose. This is great news for Rwanda and anyone in East Africa, where rotavirus is an all-too-commonly accepted part of life. It is estimated that broad access to rotavirus vaccines in low-income countries could save up to 225,000 children annually. In fact, the World Health Organization strongly recommends including the rotavirus vaccine in all immunization programs because of its potential life-saving impact. But even the most effective vaccines will only have an impact if they are made available to people who need them. Rwanda has already started introducing vaccines that could protect children from pneumonia, another major childhood killer. It is time to do the same with rotavirus vaccines. We call on our government leaders to work with GAVI and immediately prioritize rapid access to rotavirus vaccines for every child across the country. The longer we wait, the more lives are lost—lives of our future leaders. We also call upon the vaccine industry to continue making vaccines more accessible. Reducing prices of available vaccines and creating opportunities for better, cheaper vaccines will ensure that funds given to GAVI can save even more lives. Governments, donors, and manufacturers all have a critical role to play in this effort. Finally, I hope the international community will continue to recognize the value of vaccines and that their contributions are essential to support the rollout of these proven life-saving tools. Because today it is rotavirus, but tomorrow it may be new vaccines for malaria, typhoid or dengue fever. Vaccines alone will not rid the world of rotavirus or solve all of our persistent health problems. We still need to focus on long-term challenges such as improving sanitation and strengthening health systems. Yet ensuring access to rotavirus vaccines is a simple commitment that can save thousands of lives starting today. The author is a pediatrician and the National Chairman of both the East African Pediatric Association and Kenya Pediatric Association. Ends