Goldmark: Delivering vaccines to the world's neediest kids
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A report out this month shows a 50 percent drop among teenage girls in the most common sexually transmitted infection, the human papillomavirus, which can lead to cervical cancer. What's driving the decrease? Vaccination against HPV -- the latest in a long line of victories in vaccination campaigns.
Vaccination against most common diseases, including many that kill us, is relatively recent. In most of the world, and for most of human history, death from diseases that we now know how to prevent was a terrifying but expected part of life. Vaccines became widely used in the developed countries toward the end of the 19th century and the beginning of the 20th. They were not introduced in widespread form to the populous countries of the underdeveloped world till after World War II.
The range and effectiveness of vaccines have been increasing for a century, and today there are even vaccines against some forms of cancer, such as liver cancer. Polio, a scourge that was dreaded in my own youth, is now endemic in only three countries. And smallpox, which killed more people than all the wars of the 20th century combined, has been eliminated.
The two largest killers of children today are diarrhea and pneumonia, and vaccines against the leading causes of those diseases are being introduced throughout the developing world.
How is all this being done? Many of the countries where vaccines are most needed cannot afford, or do not have the organizational resources to mount, large vaccination campaigns. So in the 73 poorest countries of the world, financial and technical assistance is provided by the Global Alliance for Vaccine and Immunization. GAVI was founded in 2000 and is a partnership of international bodies like the World Health Organization, UNICEF and the World Bank, as well as nongovernmental organizations and foundations such as the Bill and Melinda Gates Foundation. GAVI channels money into vaccination programs, works with pharmaceutical companies to reduce vaccine prices, and uses its technical know-how to help poor countries expand their capacity and their health infrastructure -- so that someday they'll be able to take over full responsibility for vaccinating their own populations.
Delivering vaccination programs isn't always a slam dunk. Vaccination workers in Pakistan have been killed by fundamentalists who believed they were agents of Western governments injecting children with poison. In war-torn areas like northern Nigeria, health workers risk becoming pawns in the violent politics of armed bands who couldn't care less about making sure children don't die of disease.
And even in the developed world we have seen a backlash against vaccines. Dr. Andrew Wakefield, a British surgeon and medical researcher, published a widely reported article in the prestigious English medical journal Lancet in 1998, in which he argued that vaccinations for measles, mumps and rubella led to autism in some children. Lancet retracted the article in 2010, and Wakefield was found guilty by the British General Medical Council on more than three dozen charges, including four of dishonesty and 12 involving abuse of developmentally challenged children. But the stir caused by his campaign against vaccines had a widespread effect of scaring some parents. Vaccination rates in Great Britain fell, and there has been a rise in measles.
GAVI is a cooperative effort that can be described by adjectives that are not universally popular these days: "international," "United Nations sponsored," or "charitable." It's easy to criticize if your own children are not in danger. Put yourself in the place of a young mother in South or Central Asia, or in the rural areas of Africa. What you and I take for granted, they seek desperately for their children. GAVI is something we're doing right for tens of millions of the world's children, together.
Peter Goldmark, a former budget director of New York State and former publisher of the International Herald Tribune, headed the climate program at the Environmental Defense Fund.