Access to New and Underused Vaccines

Jon Kim Andrus and John Fitzsimmons have an interesting article in the current edition of PLoS Medicine about the introduction of, and access to, new and underused vaccines.They highlight their concern about the restriction of GAVI funds based on average per-capita incomes:

In the context of access and equity, there is concern about global approaches to support only countries with average annual per capita income of less than $1,000, such as the approach taken by the Global Alliance for Vaccines and Immunization, thus limiting the scope of work and benefits that impoverished children and families could otherwise receive in the Americas. ...Future approaches that attempt to enhance practical markets for vaccines and that enhance the introduction of new and underutilized vaccines should consider prioritizing the following: access and equity for as much of the population as is possible, well-implemented accelerated disease-control and prevention strategies, and development of a public-health infrastructure.The general approach also requires high-level political commitment, adequate attention to management, supervision, and logistics, and sound technical strategies. The opportunity to address widespread disparities in health that exist in low- and low-middle-income countries that otherwise do not benefit from Global Alliance for Vaccines and Immunization's marketing approaches will be a huge challenge for the future.

Owen comments: Defining eligibility in terms of average per capita incomes for a country as a whole means that the funding is not available for substantial numbers of poor people in countries which have very unequal distribution of income.Andrus and Fitzsimmons have direct experience of the challenges of providing access to exising and new vaccines. The world should heed their call to emphasize access, accelerated regional disease control, and the development of a public-health infrastructure.