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.
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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?)
Here are two pictures to help you get into the holiday spirit. The World Health Organization has data on global incidence of various diseases that can be prevented by vaccination. These are numbers aggregated from country reports to the organization, which are subject to considerable error. The WHO warns that reported disease incidence data usually represent only a fraction of actual cases of the disease. Nonetheless, the data is useful to monitor trends in prevalence, and a lot of those trend
This is a joint post with Kate McQueston
November 12th is fast approaching and with it comes world pneumonia day. Unfortunately, pneumococcal diseases still pose an enormous global threat--remaining the leading cause of death for children worldwide and taking the lives of 1.4 million children under five years annually. What’s more—a staggering 98% of these children live in developing countries.
News this month that an experimental vaccine cuts in half the risk of malaria in children in Africa is a welcome success story 20+ years in the making. It’s also a rare bright spot in the clinical trials labyrinth that stands between promising new medicines, vaccines, and diagnostic techniques and the one billion people in the developing world who suffer from one or more neglected diseases. Ninety other drug and vaccine candidates for neglected diseases are waiting in the pipeline for late stage clinical development. Under current arrangements, they will face lengthy, inefficient reviews in countries where the regulatory capacity ranges from weak to non-existent.
While the developed world commits itself to austerity measures and slashes aid budgets across the board, emerging economies are increasingly using foreign aid and direct investment to increase their soft power and global clout. In two articles this week, The Economist reports that India plans to set up its own aid agency. Once the world’s biggest aid recipient, India now plans to give $11.3 billion in the next five to seven years. While most of this sum is expected to be in the form of foreign direct investment, it also covers capacity building and humanitarian assistance for the poorest countries.
They argue that vaccines which are developed for rich country markets should be available at the lowest possible price in developing countries:
This blog was co-authored with Orin Levine, Executive Director, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health and it will be cross-posted on his Huffington Post blog at www.huffingtonpost.com/dr-orin-levine
In low- and middle-income countries, children living in poverty are much less likely to be vaccinated and more likely to die or become ill from a vaccine-preventable disease than better-off children. An example comes from Nigeria, where less than 5% of children in the lowest quintile of the wealth distribution were fully vaccinated in 2003, as opposed to 40% of children in the wealthiest quintile. (For more on inequalities in health, see here)
Progressive development thinkers have welcomed the announcement of new money for the Global Alliance for Vaccination and Immunization (GAVI), and support the partnership between governments and the private sector. A minority of NGOs have criticized GAVI on the grounds that it is too cozy with pharmaceutical companies. But we should be encouraging more, not less, engagement by pharmaceutical companies in the health needs of developing countries. Perhaps pharmaceutical companies have done more for the world’s poor than the aid industry?