The global health strategy to expand childhood immunizations, largely backed by the Bill & Melinda Gates Foundation, is too focused on new vaccines and neglects the fundamental need to improve basic public health and immunization programs in poor countries.
So says Medicins Sans Frontieres (MSF), aka Doctors Without Borders, in a new report issued today by the organization entitled The Right Shot: Extending the Reach of Affordable and Adapted Vaccines.
The medical relief and aid advocacy organization is critical of a new, 10-year, multi-billion dollar “Global Vaccines Action Plan” expected to be adopted by global health leaders at the World Health Assembly meeting next week. The plan is largely funded by the Gates Foundation.
MSF says it favors expanding access to new vaccines — just not at the expense of basic immunizations.
“Twenty percent of the world’s children aren’t even getting the basic vaccines,” said Kate Elder, MSF vaccine policy adviser. The Gates Foundation is driving much of the global health policy decisions around vaccinations, Elder noted, and “Bill Gates’ priority is new vaccines.” The philanthropy’s influence is distorting the agenda to favor new vaccines over basic improvements, she said.
Daniel Berman, MSF’s deputy director for access, cited a recent initiative to distribute a new $7-per-dose pneumococcal vaccine in DR Congo in the middle of a measles outbreak. Why, Berman asked, are donors and health agencies pushing this new, expensive vaccine in Congo if Congolese children still aren’t getting a 30-cent measles vaccine?
The approach appears aimed more at supporting drug industry desires to promote new products than at finding the most efficient and sustainable means for fighting the diseases of poverty, he said.
The Right Shot may be a new report from MSF, but it is hardly a new criticism of the Gates Foundation’s approach to vaccines. Others have criticized the philanthropy before for a tendency to place industry interests above the concerns of poverty advocates.
The Seattle philanthropy, though contacted in advance of the report’s release, declined to comment or respond today to the MSF criticism – or to the group’s call for a new global strategy with more emphasis on beefing up basic, routine immunizations. The organization sponsored by the foundation to promote the new global strategy, the Decade of Vaccines collaboration, also did not respond.
Jeffrey Rowland, spokesman for the Global Alliance for Vaccines and Immunization, GAVI, did respond to the criticism.
GAVI is one of the Gates Foundation’s longest running projects in global health, and it is the philanthropy’s single largest recipient of funding over the past 10 years. It is estimated to have saved many millions of children’s lives in poor countries in the past decade.
“MSF and GAVI are trying to do the same thing, which is to prevent as many vaccine-preventable deaths as we can, especially among children under the age of five,” said Rowland.
While it’s true that GAVI has emphasized the introduction of new vaccines, he noted that the initiative also funds basic health system strengthening and believes that the nature of the initiative’s funding (which rewards measurable increases in immunization rates and declines in disease rates) provide governments in poor countries with the incentive to invest in basic public health.
Rowland further said that the Global Vaccine Action Plan does not emphasize new vaccines.
“It provides a roadmap to scale up routine immunization efforts, support accelerated disease control programs and introduce new vaccines and vaccine technologies as they become available,” he said. The stated goal of the plan is to improve immunization coverage overall, Rowland said, so it’s not clear what MSF is targeting there for criticism.
MSF’s Elder and Berman said the strategy is clearly based on continuing the status quo approach — emphasizing new vaccines — rather than shifting to a stronger emphasis on improving basic health services and immunizations. And there is little evidence, both said, that the incentive approach taken by GAVI has led poor governments to invest more in their public health systems.
“Clearly, the emphasis remains on introducing new vaccines,” Berman said.
By issuing this report, he said, MSF hopes to challenge the Gates Foundation, the World Health Organization and others in global health leadership to take a much harder look at what’s really working — and what’s not working — in the effort to prevent child deaths in the developing world.
Here is a similar report by Nature News on MSF’s criticism of the Gates-backed global vaccine strategy.