This week, eight polio vaccination workers in Sindh and Peshawar have been killed in Pakistan during a three day anti-polio drive (see here). Last week in Afghanistan, two polio vaccinators were also killed. Suspicions of CIA involvement in the campaign have been identified as causes of the attacks. “Our teams are getting attacked, and we are having a hard time hiring health workers because they are worried about being called a spy,” said the Head of Medicine in Khyber Pakhtunkhwa province earlier this summer.
CGD Policy Blogs
There was bad news in research published yesterday in the New England Journal of Medicine about the effectiveness of what had seemed to be the best prospect for a malaria vaccine, known by the unsexy name of 'RTS,S'.
The study of the phase III trials finds that in babies (aged 6-12 weeks) the vaccine only reduces malaria by less than a third. This is disappointing because this is less than half the effectiveness that had been suggested by the phase II clinical trials.
As we posted recently, India had its first polio-free year, despite significantly lagging behind in other vaccinations. The economic losses of vaccine-preventable diseases (VPD) to developing countries are tremendous: investing in vaccines in low- and middle-income countries would save 6.4 million children until 2020 – an investment valued at $231 billion.
Vaccine uptake in several countries is stagnating or even declining (see here and here for example). What explains this poor uptake and coverage? Public health researchers have recently begun to apply the concept of ‘vaccine hesitancy’ and ‘vaccine refusal’, largely focusing on individual knowledge, attitudes, and practices (KAP). But in a new blog post Robert Steinglass of JSI has argued that, while communications and advocacy interventions to change individual KAP are important, this person-centric view will fail to consider the context and the role of quality on the supply-side in determining uptake. He writes:
Global health funders have historically focused their aid on countries with the lowest per capita incomes, on the assumption that that’s where most of world’s poor people live. In recent years, however, many large developing countries achieved rapid growth, lifting them into the ranks of the so-called middle-income countries, or MICs, even though they are still home to hundreds of millions of very poor people. Andy Sumner has called the poor people in the MICs a “new bottom billion,” as distinct from the bottom billion in poor and fragile states that Paul Collier wrote about in his popular 2007 book.
Yesterday the global health community celebrated a much anticipated anniversary: one year has passed since India’s last reported case of polio. While still tenuous, this achievement is an important milestone for the international effort to attain polio eradication. If India can maintain this progress, then only three countries – Afghanistan, Nigeria, and Pakistan – will remain polio-endemic, down from 125+ countries worldwide in 1988. (As an aside, the WHO describes India as “one of the largest donors to polio eradication being largely self financed.” Are donations to oneself – or “unilateral” donors, if you will – the way of the future?)