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around 31 countries had introduced the pneumococcal vaccine and 15 others had applied for support from The Global alliance for Vaccines and Immunisation (GAVI) to fund the vaccine. Hib vaccine (Haemophilus Influenzae type b) is another highly effective vaccine and 136 countries have introduced it either nationwide or partly, and 102 countries have introduced it widely. 42 million children had received the vaccination. The vaccine is not routinely available in India (and many Asian countries), although available in Central and South America and most of Africa. In low income countries pneumonia kills 7320 out of 1000000 children under age 5, as compared to just 34 children in high income countries. Poverty remains a persistent barrier to immunization at the country and community levels. Mere availability of the pneumonia vaccines in the private pharmaceutical market does not ensure its use, primarily because of the prohibitive costs and also because of lack of information. 93% of the worlds children121 millionhad not received a pneumococcal vaccine and 71% or 93 million children had not received the Hib vaccine as of 2008. According to Dr Dinesh Chandra Pandey, a Specialist in Paediatric Medicine at Nelson Hospital of Paediatrics and Neonatal Medicine, Lucknow, Many multinational pharmaceutical companies are producing pneumonia vaccines, but their costs are prohibitively high and common public cannot afford them. Such a situation cannot work in India where 80% of the population lives in villages and is poor. So where the incidence of disease is high, availability of medicines is poor. Vaccines like Preminar strepto pneumonia are available in the market, but are very costly. The Hib Influenza vaccine, which prevents pneumonia, is not available in government programmes. Another influenza vaccine for prevention of HINI flu is also not there at affordable prices. Dr Ajay Misra, Managing Director of Nelson Hospital of Paediatrics and Neonatal Medicine, Lucknow, also airs similar views. He laments that There are no pneumonia vaccines included in the government public health immunization programmes. Although pneumococcal vaccines available in the market, but they are very costly. Many people are not even aware of the vaccines available in the market. Timely access to medical care, including vaccines, and proper awareness of the disease is an important issue in increasing the survival rate of children from childhood pneumonia and other diseases. The burden of vaccine preventable diseases falls on the poor. According to the Acute Respiratory Infections Atlas, broader use of the Hib vaccine could save 400,000 lives, and the pneumococcal vaccine could prevent 262,000 deaths a year in 72 of the worlds poorest countries.
The GAVI is spearheading international efforts to increase access to pneumonia vaccines. It currently funds immunization campaigns in 72 low income countries. Millions of lives can be saved by 2015 if GAVI could implement its $7 billion campaign to distribute three vaccines: a 5 in 1 vaccine against Hib disease, diphtheria, tetanus, pertusis and hepatitis B; pneumococcal vaccines and vaccine to prevent rotavirus diarrhoea. But as of 2010, the organization had a shortfall of $3 billion, to implement its noble objectives. Increasing immunization will depend not only upon availability of vaccines but also on a strong vaccine delivery infra structure, leadership and political will to integrate immunization programmes with other healthcare services, community awareness about the value of vaccines, and a much greater commitment from the international community to make universal immunization against childhood pneumonia and other diseases a dream come true for the indigent populations. Shobha Shukla, CNS October 2011
This article is part of a Citizen News Service (CNS) series in lead up to the World Pneumonia Day, 12 November 2011. The project was managed by Abhinav Bharat Foundation and funded by the 2011 Small Grants for World Pneumonia Day Advocacy Program. We are grateful to the International Vaccine Access Center (IVAC), John Hopkins Bloomberg School of Public Health, GAVI Alliance, Global Alliance for Clean Stoves, and Best Shot Foundation for their support. We would like to thank all those who were interviewed as part of this project and who took the time to share their views.
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