Inflammation and stories on vaccines

Vaccines in Developing CountriesHow much can the world really rely on vaccines as a cure to disease? For many impoverished communities, the jury is still out; many recent studies show that vaccines in developing countries are more ineffective than those in developed, high-income nations.

However, developing countries are at greater risk for all infectious diseases than developed countries. The World Health Organization (WHO) documented that the “total number of healthy life years lost per capita was 15-times higher in developing countries than in developed countries.” In addition to this imbalance, vaccines in developing countries also threaten these nations with ineffective treatment. Due to the many factors that impact disease, it is difficult to pinpoint specific causes behind vaccine acceptance or denial. However, the health effects of poverty contribute to the reasons why vaccines in developing countries are often ineffective.

How Poverty Increases Sickness

Poverty is a health epidemic. In 2008, PBS aired an original docu-series called “Unnatural Causes” that outlined the ways diseases disproportionately affect poor and marginalized groups. The show posed one overarching, famous question: “Is inequality making us sick?” In the assessment of vaccine effectiveness in rich versus poor countries, the creators of “Unnatural Causes” say the answer is yes.

A functioning immune system is largely responsible for an individual’s ability to make antibodies, the infection-fighting proteins developed via vaccines. Impoverished people often do not have high-functioning immune systems. This means that they cannot produce antibodies as well as their developed-nation counterparts.

Multiple factors contribute to the prevalence of ineffective immune systems in developing countries. The overpopulation and crowding common in low socioeconomic areas increase the risk of disease exposure. Pre-existing health conditions, resulting from vitamin deficiency and little clean water or sanitation, increase individual susceptibility to sickness. Further, unreliable health care places systemic, structural constraints on impoverished communities. In this way, poverty and disease continually reinforce each others’ negative effects.

Comparison Studies: Developed Nations vs. Developing Nations

Water-borne diseases, malaria, tuberculosis and HIV/AIDS continually afflict developing countries. They may be responsible for damaging people’s natural immunity, thus decreasing the likelihood of vaccine acceptance. Indeed, one study found that these diseases “may damage lymph node structures that are crucial to developing immunity after a vaccine.”

This study from the University of Minnesota compared Americans to Ugandans. Researchers discovered all the Ugandans had “significantly higher levels of inflammation in their bodies and a depleted supply of protective T cells.” In addition, the Ugandan’s lymph nodes (which help filter infections and respond to vaccines) were inflamed and scarred. None of the American participants had these issues. After administering a yellow fever vaccine to the Ugandan test subjects, researchers discovered a positive correlation. The more damaged their lymph nodes, the less likely it was for antibodies to form.

Another series of studies in Dhaka, Bangladesh discovered that a poor response to vaccines in developing countries could be correlated to the small intestinal bacteria endemic to low-income countries. Petri’s team surmised that “inflammation [in the intestine] could prevent vaccines from lingering in the gut and could keep the immune system from reacting to them.” The team also identified a similar issue with rotavirus vaccine response. In contrast, 98% of children in the developed world do not have complications after vaccination.

The Future of Vaccines

According to the World Bank, “nearly half of the world lives on less than $5.50 a day.” In addition, only 59 of the 195 countries in the world possess a Human Development Index (HDI) at or above 0.8, making them developed countries. This means that ineffective vaccination responses affect the majority of the world’s nations. Thus, the world needs a systemic change in public health to fix this issue. Studies in Bangladesh and Africa “are testing whether sanitation interventions such as installing hand-washing stations in rural homes” can relieve the gut inflammation thought to be causing poor responses to vaccination.

However, even though vaccines in developing countries are sometimes ineffective, routine vaccination for infants and children may help. Young children are less likely to have the long-term health effects responsible for ineffective responses to vaccines, with the exception of illnesses inherited from a mother’s womb. WHO estimates that approximately 70% of the 9 million deaths from children under five “could be prevented or treated with access to simple, affordable interventions,” including vaccines.

Vaccinating Children in Developing Countries

Still, the complicated relationship to vaccines in the developing world is palpable. One study in India found that there is only a 55% rotavirus vaccine efficacy rate in young children. However, India’s plan to make the rotavirus vaccination routine may “save 27,000 of the 78,000 young lives that infections claim every year.”

Thus, expanding coverage of vaccines in developing countries has proven successful in many cases. Various programs work to extend this success. Since 1990, WHO’s Expanded Programme on Immunization has helped decrease mortality rates among infants and children via vaccination. The Global Vaccine Alliance has also “vaccinated more than half a billion additional children since its founding in 2000,” often in developing countries. While routine vaccination is not a panacea, it helps prevent disease before long-term health issues develop.

Improving World Health

Obviously, this is a hefty challenge. Changing human response to vaccines will take years of improving sanitation and living conditions. In addition, developed countries often receive vaccines first and in larger quantities due to having more money. In the meantime, scientists and doctors are experimenting with speedier methods to the vaccine problem. Take mesalazine, a drug that treats the bowel inflammation preventing antibody response to vaccines. This drug could possibly treat unreliable oral vaccines for stomach illnesses. Recognizing the issue of vaccines in developing countries is the first steps in improving global health.

Grace Ganz
Photo: Flickr

COVID-19 Vaccine
The World Health Organization (WHO) is making plans for how a life-saving COVID-19 vaccine could be distributed around the globe.

COVID-19 Vaccine Distribution

There are concerns about countries “hoarding” stores of vaccines for their own citizens. The countries that have the most money on hand will have the ability to buy a larger portion of available vaccines for citizens. While global leaders have come together to pledge $2 billion towards the creation of a vaccine, there is currently no formal worldwide plan to successfully manage the future COVID-19 vaccine and its distribution.

The public-private partnership that lead to this $2 billion pledge, Gavi, focuses on increasing childhood vaccinations in underdeveloped countries. It has support from WHO, UNICEF and the Bill and Melinda Gates Foundation. Bill Gates himself has promised $1.6 million towards Gavi, along with $100 million to help countries that will need aid to purchase COVID-19 vaccines.

U.S. Involvement and WHO

The U.S. government has decided to stay out of the recent Gavi-organized funding pledge. The country has also pulled monetary support from WHO. In the past, the U.S. has been a large supporter of the creation of the HPV and pneumococcal vaccines, which has left many experts confused by the recent moves of the U.S. to disassociate itself from the larger global race towards a COVID-19 vaccine.

Beyond hoarding concerns, there are always issues surrounding legal and sharing agreements between countries, quality control, civil uprising and unrest and natural disasters when it comes to vaccine distribution.

A recent example of how the world dealt with vaccine distribution during a pandemic is the 2009-2010 H1N1 swine flu pandemic. With the money they had, wealthier countries purchased most of the vaccine available through early orders, leaving developing countries to scramble for leftover vaccine stores. Eyjafjallajökul’s eruption in Iceland in April of 2010 also created vaccine shipping delays. Many countries, such as the U.S., Australia and Canada would not let vaccine manufacturers ship vaccines outside of their countries without fulfilling their people’s needs first.

Going Forward

To create a successful global vaccination program requires the cooperation from all countries involved, not just a few. Many may die without the equitable sharing of vaccines as this pandemic will flourish in underdeveloped nations. It may be seen by the rest of the global community as selfish to not try and help other countries in their fight against the virus.

Even after a vaccine is created, different strains of COVID-19 could easily return to Australian, Canadian or American shores, wreaking havoc all over again. While there are efforts being made to prevent distribution issues with the future vaccine, without the help of the United States,—one of the wealthiest countries on Earth—it may be long before a COVID-19 vaccine is fairly distributed.

Tara Suter
Photo: Flickr

history of Vaccines
The history of vaccines starts centuries ago, with some accounts dating back to 2000 B.C. In the 1500s, smallpox inoculations took place in India and China. In the 17th century, Buddist monks drank snake venom for immunity as an early form of vaccination. Smallpox Inoculation meant cutting up smallpox scabs and blowing them into the nostrils, the left nostril for the girls and right nostril for the boys. Even though Emperor K’ang Hsi had his children inoculated, these practices did not spread to the rest of the country and the smallpox epidemic continued for 200 years.

Most virologists cite 1796 as the history of vaccines’ beginning. Edward Jenner was a country doctor living in England when he performed the first vaccination in history. He took pus from a cowpox wound and injecting it into James Phillips, an 8-year-old boy. Six weeks later Jenner visited the two spots with smallpox on Phillips’s arm to find he was not affected. In addition, Jenner did 12 more experiments and 16 case studies before publishing “Inquiry Into the Causes and Effects of the Variolae Vaccines.” Cow-pox protects humans from the infection of smallpox created the foundation for vaccinology.

Advancements in Vaccines

Until 1885 after the invention of a rabies vaccine, the word “ vaccine” had only referred to smallpox inoculation. The history of vaccines continued with French physicians Albert Calmette and Camille Guerin creating the tuberculosis vaccine by weakening the bacteria over 230 versions. Furthermore, the first influenza vaccine emerged in the 1940s, 10 years after the discovery of the virus. The U.S. Army sponsored the flu vaccine and used fertilized chicken eggs, something still used today.

In 1952, the U.S. reached 57,879 polio cases resulting in 3,145 deaths. Survivors ended up in wheelchairs or crutches, severely paralyzed or having to use an iron lung to breathe. Moreover, Jonas Salk created the Polio Virus vaccine in 1955. Consequently, Salk became one of the most celebrated scientists in the world. Between 1955 and 1962, more than 400 million vaccines were distributed under leading drug manufacturers and polio cases were reduced by 90%.

Vaccine Safety Worldwide

In 1901, the U.S. Congress passed The Biologics Control Act which regulated the selling of serums, toxins and analogic products. This was the first legislation in the history of vaccines for managing vaccines and drugs. Additionally, the act established the Hygienic Laboratory of the U.S. Public Health Service, now known as the National Institution of Health.

Since then, other countries have taken many steps to ensure vaccine safety. China currently has a three-level moderating system for monitoring vaccines. The country’s vaccine industry is able to produce over 1 billion doses per year for preventing 30+ diseases. Moreover, vaccine efforts have made significant progress in Bangladesh. The country has established two production facilities for vaccines. In addition, Bangladesh has increased the monitoring of Adverse Events following Immunization (AEFI).

COVID-19 Vaccine

While vaccine development has advanced since Edward Jenner’s invention of vaccinology, citizens all around the world are waiting for a new event in vaccine history: the coronavirus vaccine. With 22.4 million cases worldwide, 778,000 deaths and countries re-entering lockdown, it’s no exaggeration to say a COVID-19 vaccine is necessary to end the pandemic. The good news is that over 165 vaccines have undergone development around the world. About 35 of the vaccines are in the human trial stage and two vaccines have received approval for early or limited use.

The U.S. is running an experimental vaccine, mRNA-1273, in the phase one trial. The Washington Health Research Institute, being led by Lisa Jackson, began the initial trial in March with 45 participants from 18 to 55 years old. In April 2020, the trial expanded to add citizens over the age of 55 and 120 participants. After no serious side effects occurred, phase two began in late May 2020 and Phase 3 launched in early July 2020.

A Chinese company Cansino Biologics partnered with the Academy of Military Medical Sciences to create the Ad5 vaccine. In May, phase one was completed with promise. In July, the company concluded that phase two produced “a strong immune response.” In addition, the military approved the vaccine after just two trial runs on June 25 as a needed drug. The third trial will take place in Saudi Arabia and negotiations with other countries are taking place.

The failures and successes of the coronavirus vaccine all add to the history of vaccines. The quality of life has drastically increased thanks to Jenner’s first vaccine trials in 1796. With the help of vaccines, polio measles and smallpox cases are incredibly rare in the 21st century. Using the history of vaccines and the invention of new technology, a COVID-19 vaccine is right on the horizon.

Breanna Bonner
Photo: Flickr

Biotechnology in UgandaBiotechnology’s recent rise has led many countries with abundant resources to further their healthcare services and agriculture. Embracing this innovation movement has led Uganda to improve its economic growth and the country’s development significantly. By doing so, Uganda progresses to have an edge in growing a bio-resource economy due to the country’s rich resources. The constant advancement of biotechnology in Uganda has led to improved farming, toxic waste management and medical diagnostics and treatments. Continued improvement depends on the governmental support to the science and technology field.

About Uganda’s Biotechnology

While this form of technology covers a wide range of live organism manipulation, biotechnology in Uganda solely deals with technology associated with transgenic organisms and recombinant DNA alteration. This form of modern scientific technology became prominent in 1993. This was when the Ugandan Department of Animal Science and Faculty of Agriculture at Makerere University proposed using the transgenically derived bovine somatotropin (BST) hormone for cattle growth and lactate production. Genetic engineering of agrobacteria produces the BST hormone and boosts the agriculture economy in return. However, due to the controversy over growth hormones at the time, the import of BST halted.

Two years later, biotechnology usage was necessary for Phase 1 trials of a potential HIV-1 vaccine (ALVAC vCP 205). It was the first HIV-1 preventative vaccine study in Uganda and Africa as a whole. This vaccine was a live recombinant canarypox vector expressing HIV-1 glycoproteins. Both the BST and HIV-1 vaccine proposals provided a basis for the foundation for the national biosafety guidelines. They led to the establishment of the National Biosafety Committee in 1996.

Research into biotechnology continues to pose an advantage for Uganda. Moving these transgenic products to the commercial market requires a full governmental understanding within the biotechnology innovation market.

Effects on Ugandan Healthcare and Agriculture

Over the years, Ugandan biotechnology has widely helped both the healthcare and agriculture industry. Laboratory projects regarding genetic resistance to pathogens, droughts and other disasters aid the crop growth throughout the nation. Ongoing research on animal vaccines such as East Coast Fever and Foot and Mouth Disease has facilitated the animal life expectancy. The study has also improved food production in Uganda.

Characterization of crop pathogens such as sweet potato feathery mottle virus through molecular markers has led to better disease prevention techniques. For example, east African Highland bananas are being genetically modified to resist banana bacterial wilt, weevils and overall improve the nutritional value of the plant. Established in 2007, these modified bananas have been able to confer resistance against the black Sigatoka disease.

Additionally, the crops’ genetic diversity multiplies more now than ever, prompting a path towards a more complicated and safe GMO industry. Bananas and pineapples are artificially bred using tissue culture techniques, providing more products annually. Agro-Genetic Technologies Ltd’s (AGT) coffee bean proliferation is also underway.

Regarding the health sector, pharmacokinetics and drug resistance techniques receive heavy study. Multi-drug and drug-resistant diseases widespread in Uganda, such as tuberculosis, HIV/AIDS and malaria, are especially heavily studied. Clinical trials for DNA-based vaccines utilizing the recombinant adenovirus five vectors are also in progress.

Population Participation Increases

In the past few years, an average biotechnology worker in Uganda earned around 3,520,000 UGX per month. Biotechnology in Uganda has led to sufficient wages. However, this form of science has also increased the participation of different demographic groups, namely women. Women in the field have strongly encouraged the use of agricultural biotechnology.

Dr. Priya Namanya Bwesigye is the lead Ugandan banana researcher at the National Agricultural Research Laboratories (NARL) in Kawanda. She claims that African women are looking for new solutions. They are also looking into how they can use technology to give their people and themselves better and improved crop varieties to fight hunger and improve living quality. Bwesigye and her team use genetic engineering to make disease-resistant bananas and provide more nutrition. One of these modified bananas provides vitamin A as well. Her program provides farmers with these improved bananas and a foundation for the multiplication of said fruit with proper restraints.

For biotechnology in Uganda to take off, the population must be adequately educated about the effects of this form of science and its changes. Bwesigye, for one, explains agricultural biotechnology to farmers and why it is necessary. The Uganda Biosciences Information Center (UBIC) began training teachers in this modern form of science. This was done to popularize the technology in local communities. UBIC trained 27 teachers and 12 textbook authors after the education department mandated that the national curriculum in secondary schools integrated this new form of science. The National Crops Resources Research Institute (NaCRRI) held a one-week training course. Participants visit field trials of genetically modified crops and other research laboratories. These trials and laboratories involved different aspects of agriculture and health.

The Biosafety Bill of Uganda

With the use of biotechnology rising, ethical problems have started to arise. To ease integrating this new form of technology into the mainstream market, the Ugandan government established the Biosafety Bill of Uganda. This bill’s mission is to provide a proper framework that enforces safe development and biotechnology in Uganda. Its mission is also to regulate research and the release of these GMOs into the public. The population was torn between the ethical controversy surrounding biotechnology. However, the bill was able to go into effect in 2018 after much deliberation.

Overall, Ugandan biotechnology has dramatically impacted the country, especially in its agriculture and the healthcare industry. As time progresses, biotechnology in Uganda has improved and heavily aids as an asset to the country.

Aditi Prasad
Photo: Flickr

Vaccines in Developing Countries
It is estimated that immunization practices save two to three million lives each year. The development of vaccines and mass immunization practices have helped eradicate deadly diseases such as smallpox, while drastically reducing the number of people infected by influenza, hepatitis A and B, rubella, measles, chickenpox, polio, tetanus, mumps and other preventable illnesses. Vaccines also help prevent outbreaks and epidemics by increasing the number of people immune to various diseases within populations. Despite these benefits, global vaccine coverage is inadequate. Developing countries, in particular, often lack access to life-saving vaccines. Here are six facts about vaccines in developing countries.

6 Facts About Vaccines in Developing Countries

  1. An estimated one-quarter of all deaths in low-income countries are attributable to communicable diseases. More than 1.5 million people die annually from diseases that are preventable through vaccination. In 1990, 2.5 million children in developing countries under five died from vaccine-preventable diseases such as rotavirus, measles and pneumococcal disease. No deaths were attributable to these diseases in industrialized nations. Efforts to expand access to vaccines in developing countries reduced the child mortality rate to 750,000 in 2013. Despite this improvement, 19.7 million children under the age of one still lacked access to basic life-saving vaccines as of 2019.
  2. High manufacturing costs for vaccines hinder accessibility in many developing countries. Poverty-stricken nations often rely on vaccines to be imported from developed nations. Inefficient public health infrastructure and a lack of resources for transporting vaccines pose an obstacle to widespread immunization access.
  3. Developing countries continue to lack access to vaccines. Vaccine coverage has remained unchanged throughout the past few years in many developing countries, despite global advances in immunization knowledge and technology. Humanitarian crises caused by conflict and natural disasters threaten to perpetuate this stagnation in vaccine access.
  4. Several preventable diseases are making comebacks. In recent years, an increase in vaccine hesitancy among populations in developing countries has resulted in reductions in already poor immunization rates. The result has been outbreaks and resurgences of vaccine-preventable illnesses such as measles, diphtheria and even polio.
  5. Vaccinations also have significant economic benefits. Expanding access to vaccines in developing countries is a strategic economic investment because the financial and human costs of death and disease outweigh the burden of implementing immunization programs. Between 2001 and 2020, the economic benefit of vaccinations in developing countries was nearly $2.3 trillion.
  6. The World Health Organization has proposed the Immunization Agenda 2030 to address vaccine access. This program plans to address the shortcomings and challenges of immunization globally, including the recent outbreaks of infectious diseases such as Ebola and COVID-19. The Immunization Agenda 2030 envisions “a world where everyone, everywhere, at every age, fully benefits from vaccines to improve health and well-being.” Amidst the current COVID-19 global pandemic, its mission to improve access to life-saving vaccines in developing countries is more important than ever.

These six facts about vaccines in developing countries highlight the work that still needs to be done. Moving forward, it is essential that the World Health Organization and other humanitarian organizations make increasing access to vaccines a priority.

– Alana Castle
Photo: Flickr

Immunization Rates Worldwide
As COVID-19 continues to spread across the globe, there is growing concern that immunization rates worldwide will be drastically impacted. Impoverished nations are particularly susceptible to declining vaccination rates due to COVID-19. Therefore, it is critical that routine vaccinations continue to be delivered globally to avoid the resurgence of preventable diseases in the years to come.

DTP3 Vaccination Rate

The concern that routine vaccination rates will drop in 2020 stems primarily from data collected in the first four months of this year. The most widely-used indicator of vaccination coverage in a country is the number of children completing the full course of DTP3; this course consists of injections of the vaccines against diphtheria, tetanus and pertussis. In 2019, the vaccination rate for completing this indicator vaccine reached 85 percent globally. However, in 2020 there has been a large drop in the number of children receiving all three doses of DTP3. If this trend continues for the rest of the year and fails to rise quickly in the coming months, this year could be the first since 1992 to have a decrease in the DTP3 vaccination rate.

Preventable Disease Vaccination

The fall of the DTP3 vaccination rate suggests that the administration of other critical vaccines is following the same pattern. The World Health Organization reports that a minimum of 30 global vaccination initiatives for measles were canceled or are currently at risk. A survey of 82 countries conducted by multiple vaccine providers and affiliates found that 75% of those surveyed reported disruptions to vaccination campaigns due to COVID-19. In addition to challenges in providing vaccines, people refusing to leave their homes and government restrictions are factors in this sharp decrease.

Prior to the COVID-19 pandemic, there was already concern about stalling vaccination rates. The DTP3 immunization rate has hovered around 85%, but a minimum of 95% is recommended to avoid outbreaks. It is critical that routine vaccination rates do not fall in order to prevent the resurgence of diseases. It is estimated that over two million children die every year from vaccine-preventable diseases. Furthermore, these preventable diseases disproportionately affect those living in impoverished countries, which already have lower vaccination rates.

The GAVI Alliance

There are some organizations working hard to face the new challenges to vaccination campaigns brought about by COVID-19. The GAVI Alliance, a vaccine organization, operates in 73 countries, 70 of which have reported COVID-19 cases. The organization has reaffirmed its commitment to providing routine vaccinations, as well as additional funding for health institutions to combat the pandemic. It is also working to establish equitable access to a vaccine for COVID-19 once one becomes available.

If immunization rates worldwide continue to drop this year, it could set back years of progress. This could lead to larger outbreaks of preventable diseases in the near future. Some organizations, such as GAVI, are working to overcome this challenge. However, the World Health Organization’s warning is serious; there are substantial challenges facing routine immunization campaigns during this pandemic that must be mitigated.

Kayleigh Crabb
Photo: Flickr

Vaccines in Africa during COVID-19Medical progress in developing countries could unravel during COVID-19 because the global shutdown is preventing important vaccines from reaching Africa. In fact, global health organizations struggle to dispatch health care workers, make shipments, and store medical supplies and vaccines. Health care systems have halted vaccinations for cholera, measles, polio and other diseases in order to focus on stopping COVID-19. Also, parents are afraid of bringing newborns to get vaccines during the pandemic as many health care workers have been repeatedly exposed to COVID-19. Although the WHO says that children are not a high-risk category for COVID-19, the fear of exposure could perpetuate the vaccination gap and exacerbate the problem even as governments ease restrictions.

Effects of Halting Vaccine Distribution

The postponement of vaccines in Africa during COVID-19 could lead to a dramatic resurgence of measles, cholera and other diseases that have been decreasing worldwide. Children in countries with low-quality health care might not receive these vaccines. This inequality is a problem that many organizations are trying to combat. Experts are also recommending that leaders should track and trace unvaccinated children to administer the vaccines on a later date. These proactive measures could help prevent future outbreaks.

Measles Vaccinations

Measles cases have risen globally in recent years due to growing misinformation, low-quality health care and other cultural or societal issues. Coronavirus has stalled everyday life, international travel and vaccination campaigns. Because of the impact COVID-19 has had, it is now estimated that over 117 million children in 37 countries, in which the majority are located in Africa, will likely not receive their measles vaccine. The World Health Organization and other global health foundations have expressed concerns over this new problem. Data is now showing that deaths from other diseases will likely compare to COVID-19 deaths in Africa by a ratio of 100 to one because these preventable diseases will have been overlooked. 

What is Being Done to Help

Global health organizations such as UNICEF, the Gates Foundation and other private groups provide most vaccines. Most African health care systems are already not well equipped to handle basic care and disease management. The pandemic, as well as the threat of diseases becoming more prevalent, puts a strain on these health care systems. Organizations like the Gates Foundation have noticed this excess burden on the African health care system, so they are working to help improve Emergency Operations Centers and local disease surveillance and testing. The Gates Foundation is also focusing on providing routine care as that often goes overlooked during a pandemic. The foundation is working to build up their health care systems as a whole to fight other diseases.

Most world leaders are prioritizing the containment of COVID-19; however, global health organizations are encouraging governments to do more to prevent diseases that can be treated with vaccines. 

– Jacquelyn Burrer
Photo: Flickr

COVID-19 Response Plans
Gavi, the Vaccine Alliance is an international organization that Bill and Melinda Gates conceived and cofounded in the late 1990s. Its mission is to supply low-income countries with vaccinations they might otherwise have gone without. The organization has helped vaccinate more than 760 children. Additionally, it has saved more than 13 million lives in developing countries across the world. Gavi has recently aimed rigorous funding and supply distribution towards fighting COVID-19. The Vaccine Alliance has set aside $200 million for protective equipment, health care workers and increased testing with funding going towards low-income countries such as Myanmar, the Democratic Republic of the Congo, Ethiopia, Malawi, Sudan, Afghanistan, Liberia and Zimbabwe. Gavi’s 2020 initiatives and COVID-19 response plans are all efforts to prepare and provide for global health in the coming years.

The Alliance’s Fifth Phase

Gavi operates using a five-year strategic model and what it calls “phases”. With Phase I beginning in 2000, the alliance has followed this plan to the present day. In December 2019, the organization approved Phase V, a model that it will implement in 2021 and complete in 2025. Gavi tracks its success throughout these phases by creating specific goals in areas such as vaccines, equity and sustainability.

  1. The Vaccine Goal: The vaccine goal focuses on effective medical outreach and accessibility. It calls for the positive integration of vaccines into countries with the highest need. Gavi will then work with each country to identify its most prominent infection to decide which vaccination would be most helpful, also considering population when determining quantity. Further criteria of the vaccine goal include the continued introduction of immunizations that in turn will pave the way for proper health care and preparedness against preventable diseases.
  2. The Equity Goal: By bolstering health care systems, the equity goal promotes the importance of accessibility. With Gavi’s financial support, governments can prioritize “reaching the unreached.” This goal primarily deals with immunization delivery services and supply chains that will ensure the sustainability of accessible health care in that country. By ensuring that each individual receives what they need, the organization will cultivate further trust in immunization.
  3. The Sustainability Goal: The sustainability goal works to strengthen administrative support for immunizations. This support will hopefully call for a nationwide commitment towards eradicating death from preventable infections. By promoting public resources, instituting a system within the country to continue to fund immunizations and adding a system to ensure post-transition support, Gavi can safeguard accessible vaccines in developing countries.

The Gavi COMAX AMC

Inspired by its 2019 pneumococcal AMC commitment, Gavi announced The Gavi Advanced Market Commitment for COVID-19 vaccines (COMAX AMC) as one of its COVID-19 response plans at the Geneva June 2020 summit. Similar to previous market commitments for infections such as pneumococcal pneumonia and Ebola, this financial plan works to encourage vaccine makers to produce large quantities of immunizations without the worry of over-investing. Stock-piling now can guarantee that vaccines are available and have the ability to be distributed quickly in the future.

Gavi’s COMAX AMC has set a fundraising goal of $2 billion for a vaccine plan-ahead preparation. The first vaccine manufacturing company to contribute to this 2020 plan is AstraZeneca in partnership with the University of Oxford. Once a vaccine emerges, AstraZeneca promises to make 300 million dosages available to the world’s poor for distribution. AstraZeneca and Oxford have pledged to work without compensation through the entirety of the pandemic. Additionally, the Coalition for Epidemic Preparedness Innovations (CEPRI) will collaborate with COVAX AMC. Furthermore, CEPRI has offered to provide manufacturing funds.

The COVAX Facility

This global access facility works as an extension of the advanced market commitment. The Vaccine Alliance is calling for worldwide participation in a new fair-trade financial plan. Under the COVAX Facility umbrella, upper-middle and high-income countries will pool resources and share risk to create a structurally sound vaccine economy. These joint investments will embolden vaccine companies to intensify manufacturing. As a result, the price of a single vaccine will decrease, making distribution to lower-middle and low-income countries easier. The plan looks to take the uncertainty out of vaccine creation and vaccine investment. In this economic proposition, Gavi argues that COVID-19 is a global catastrophe that will require a global engagement to contain.

Gavi’s 2020 initiatives and COVID-19 response plans reference the importance of a unified approach when it comes to the creation and distribution of critical vaccines. Right now, there has been no successful formulation of a COVID-19 immunization, but Gavi, The Vaccine Alliance is doing what it can to provide monetary aid now as well as for the future.

– Alexa Tironi 
Photo: Wikimedia

Vaccinations in Yemen
Situated in the Middle East, the Republic of Yemen is the second-largest sovereign state in the Arabian peninsula. Being in the clutches of a civil war since 2015, Yemen stands in the second-lowest position for life expectancy in the Middle East with an average life expectancy of 65.31 years. Research has shown that the civil war also had a significant impact on the immunization or vaccination efforts to protect the children of the nation from curable diseases like cholera and measles. Here are five facts about vaccination in Yemen.

5 Facts About Vaccination in Yemen

  1. Cholera Outbreak: Experts consider Yemen’s cholera outbreak, which started in 2016, to be the largest epidemic to ever occur in recorded epidemic history. As of 2018, Yemen reported 1.2 million cases of cholera, and 58 percent of the resulting deaths were of children. The ongoing civil war and the fact that only half the country’s population has access to clean water and sanitation has made it increasingly challenging to tackle the spread of the disease effectively. Organizations like WHO and UNICEF have made severe efforts in distributing Oral Cholera Vaccines (OCV), funding to supply clean water to the citizens and establishing health centers to combat the outbreak. Several randomized trials showed the efficacy of the distributed OCVs to be nearly 76 percent.
  2. Vaccination Rate: Even though vaccines have a proven rate of efficacy, the immense pressure that health care in Yemen experienced suddenly due to large outbreaks decreased the effectiveness with which it could mobilize its immunization efforts. According to the official country estimates of 2018, 80 percent of Yemen’s population received DTP3 vaccination coverage. However, Yemen did not distribute Oral Cholera Vaccines widely until 16 months after the cholera outbreak. This led to a rapid spread of cholera in the nation.
  3. Vaccine Storage Facilities: Many often overlook a country’s vaccine storage capacity. Yemen’s lack of proper facilities and shortage of electricity made it difficult to safely store the vaccines. UNICEF and the Kingdom of Saudi Arabia worked together to provide solar refrigerators to several health care centers to facilitate safer and more reliable vaccinations in Yemen. Health care workers say that solar refrigerators enable them to store the vaccines for one month. This reduces material waste and optimizes vaccine distribution.
  4. Impact of War: The ongoing civil war has put Yemen in a vulnerable position when it comes to the re-emergence of preventable disease outbreaks. Research has shown that countries with conflicts are more susceptible to disease outbreaks. However, these are easily preventable with vaccines. In Yemen, airstrikes destroyed many hospital centers, which made health care more inaccessible to its citizens. The civil war disrupted the stable vaccination rate in Yemen, which was at 70 to 80 percent, falling to 54 percent in 2015 at the time that the war broke out.
  5. Humanitarian Efforts of International Organizations:  In war-torn countries with feeble financial stability, humanitarian efforts play a significant role in disease control. The World Health Organization (WHO) contributed 414 health facilities and 406 mobile health teams to combat the cholera outbreak and facilitate vaccination in Yemen. Meanwhile, UNICEF made substantial efforts to provide safe drinking water to 1 million residents of Yemen. It also contributed medical equipment to remote parts of the country with the help of local leaders.

Yemen has clearly faced challenges in vaccinating its citizens in recent years due to civil war and conflict. Hopefully, with continued aid from UNICEF, the WHO and other countries like Saudi Arabia, vaccination in Yemen will improve.

– Reshma Beesetty
Photo: Flickr

Measles in Bulgaria
Though the increased distribution of vaccines has nearly eradicated measles around the world, countries have recently seen returning outbreaks. Bulgaria’s outbreak is one of the worst. However, the nation is working to control the measles outbreak with the help of vaccinations and strict government procedures. Here are the top 7 facts about measles in Bulgaria.

7 Facts About Measles in Bulgaria

  1. Between 2009 and 2011, Bulgaria faced a sizable measles outbreak after not reporting any cases since 2001. This outbreak was the largest in Bulgaria since 1992. All regions in Bulgaria were affected and a total of 24,364 cases were reported during this time.
  2. The Ministry of Health (MoH) and the Bulgarian National Programme for the Elimination of Measles and Congenital Rubella Infection managed the outbreak well. Both teams contacted physicians who reached out to families and educated them on the importance of timely vaccinations. These teams also advised the hospitalization of patients with measles to avoid spreading the disease to the community.
  3. Following the outbreak, the MoH distributed information about measles prevention to the national media. MoH also distributed educational materials on measles to all Bulgarians. These efforts made families in remote areas aware of the vaccinations their children should receive.
  4. Bulgaria’s measles vaccine was introduced in 1969, and the second dose was introduced in 1983. Between 2003 and 2008, more than 94 percent of the Bulgarian population had received the first dose, and more than 89 percent had received the second. Following the 2009 outbreak, health officials distributed the vaccine to those aged 13 months to 20 years who had not yet received the two doses. It also became available to those over the age of 30 who were in need of it.
  5. Children that have parents with low education levels have less access to vaccinations. This was found by a study performed by the European Journal of Public Health. Although Bulgaria has consistent access to measles vaccinations, the education level of parents appears to have an impact on vaccination access. In a survey of 206 Bulgarians from the region of Burgas, the mean number of years of education mothers completed was 5.20, while fathers on average completed 7.02. 40.8 percent of children surveyed had no measles vaccination, 45.1 percent received a single dose and only 12.1 percent received a second dose.
  6. Along with other standard, up-to-date vaccinations, measles vaccines are required by the CDC for all travelers visiting Bulgaria. This measure is to protect not only the traveler but also vulnerable Bulgarians. It also helps ensure that measles does not make its way to other countries.
  7. Bulgarians are required to notify health officials if they have measles. The Regional Inspection for Prevention and Control of Public Health (RIPCPH) and the National Center for Infectious and Parasitic Diseases (NCIPD) are then notified. The sooner individuals report cases, the sooner national health organizations can prevent outbreaks. Health officials also proactively study the demographics of measles patients to figure out where the disease came from and other risk factors.

Though Bulgaria’s recent measles outbreaks are distressing, the country has worked hard to protect as many people as possible. Additional efforts are aimed towards preparedness for the possibility of future outbreaks of measles in Bulgaria. With an increase in vaccines and a focus on the disease by medical professionals, Bulgaria will be able to keep measles under control.

– Alyson Kaufman
Photo: Pexels