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CGD Policy Blogs

 

New Data, Same Story: Disease Still Concentrated in Middle-Income Countries

This is a joint post with Yuna Sakuma.

The majority of the world’s sick live in middle-income countries (MIC) – mainly Pakistan, India, Nigeria, China and Indonesia (or PINCI), according to new data from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.  Sound familiar? Andy Sumner, Denizhan Duran, and I came to the same conclusion in a 2011 paper, but we used 2004 disease burden data, which didn’t provide an up-to-date view of reality.  So I was pleased to see that our findings still hold based on IHME’s 2010 Global Burden of Disease (GBD) estimates.  

Is the Price Right? Evaluating Advanced Market Commitments for Vaccines

CGD has been following Advanced Market Commitment (AMC) for vaccines for a while now: from its groundwork in the CGD report Making Markets for Vaccines, to its launch and the delivery of its first vaccines in 2010 (GAVI also offers a nice timeline of events here).  This innovative financing mechanism aims to increase investment in vaccines for use in lower-middle income countries (LMIC)by guaranteeing a market for appropriate health products and services, reducing unpredictability or volatility that can discourage private investment, and increasing competition and innovation between companies and organizations (read more here). 

World Immunization Week: Leaders and Laggards

Immunization saves millions of lives, is among the most cost-effective health interventions ever developed, and has attracted a great deal of attention and funding from public and private donors in recent years.  Indeed, global health leaders have committed to making this the ‘Decade of Vaccines’ with the vision of delivering universal access to immunization by 2020, and the World Health Organization has put out a Global Vaccine Action Plan (GVAP) to serve as a blueprint to achieving this goal.

An Executive Order That Could Save Children Here and Abroad

Amanda and I wrote before the New Year about the tragic violence against vaccination workers in Pakistan who were doing vital work in the struggle to completely wipe out polio worldwide. Their deaths were linked to allegations that the CIA had used a vaccine campaign as part of intelligence gathering operations in the country.  I’d like to propose a specific policy action by the US government that might marginally reduce the risk of such attacks –and their knock-on effect in terms of more

Taliban’s New Weapon: Childhood Vaccination

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.

Setback for Malaria Vaccine: Time for an AMC?

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.

Love Thy Neighbor(s): The Need for Herd Immunity

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.

Why Are People Hesitating to Get Vaccinated? Distinguishing Context vs. Individuals

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:

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