[Ip-health] Global immunization vision and strategy: MSF WHA intervention

Joanna Keenan joanna.l.keenan at gmail.com
Fri May 20 01:03:11 PDT 2011

*Global immunization vision and strategy*

64th WHA Agenda item 13.5

Intervention by Daniel Berman, Médecins Sans Frontières, 20 May 2011

Thank you Mr Chairman.

Médecins Sans Frontières welcomes the progress report on the Global
Immunization Vision and Strategy (A64/14) which acknowledges the challenges
in reaching goals for routine immunisation while introducing new vaccines.

Vaccines such as pneumococcal have the potential to avert millions of deaths
worldwide. But as we introduce new vaccines in low-income countries we need
to simultaneously focus on strengthening coverage levels of basic vaccines.

In 2010 MSF supported 11 of 28 African countries reporting measles
outbreaks, treating over 202,000 cases.  Since September 2010, MSF has
vaccinated over 2.5 million children against measles in the Democratic
Republic of Congo --  alone.

Outbreaks can point to low vaccination coverage rates, and highlight the
need for governments to continue to strengthen their immunisation delivery
systems and supplemental immunisation activities.

For the foreseeable future, outbreaks will continue, therefore countries and
global partners need to simultaneously invest in outbreak response as well
as prevention efforts.

* *

Disparities in immunisation coverage rates between and within
countriesreflect variation in service delivery and health systems.
Addressing disparities will require more accurate, timely and comprehensive
data.  These activities will especially need more effort in hard-to-reach

There are also opportunities to improve the performance of the Global
Alliance for Vaccines and Immunisation (GAVI). GAVI has helped many
countries increase coverage rates while introducing *Haemophilus
influenzae*type b and hepatitis B vaccinations. However, GAVI’s model
has shown least
success in countries with limited healthcare infrastructure. New innovative
strategies are needed for countries with weak systems.

As GAVI refines its new procurement and supply strategy, it needs to become
much better in reducing vaccine prices by stimulating competition. The
challenge of high prices was repeatedly underlined by member-states during
yesterday’s discussion, as was growing capacity in emerging countries.
GAVI’s market power to incentivize the development of more adapted products
must also be harnessed.

The recent development of the preventive Meningococcal A conjugate vaccine
that is being sold under the initial target price of US$0.50 a dose is an
illustration of the potential for innovative development strategies.

Vaccination delivery strategies need to be tailored to national conditions.
In some countries with low coverage, guidelines focus almost exclusively on
vaccinating the youngest children.  This can be counter-productive. To
increase general awareness of the benefits of vaccines, and raise population
coverage to adequate levels, a more integrated health activities package
including vaccination should be encouraged.

New technologies that eliminate the need for needles and cold chain should
be prioritized to increase the reach of national immunisation programmes.

In sum, the support for the use of vaccines* *remains a complex
challenge* *that
requires balancing timely and effective outbreak responses, significant
improvement in basic vaccine coverage and introduction of affordable and
adapted new vaccines.

Joanna Keenan

Press Officer

Campaign for Access to Essential Medicines

Medecins Sans Frontieres

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