High-price vaccine for all SA kids

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Preschoolers on the way home from
kindergarten in Soweto, Johannesburg.
South Africa’s compulsory state-funded
immunisation programme has made a
major impact on childhood disease,
eliminating polio and drastically reducing
the incidence of measles. A new vaccine
in the programme is set to combat
another major child killer, pneumonia.
(Image: Chris Kirchhoff,
MediaClubSouthAfrica.com. For more
free photos, visit the image library.)

Tamara O’Reilly

To stop the spread of an infection that globally kills 2-million children every year, South Africa’s Department of Health is to include a pneumonia vaccine, previously available only to the wealthy, in its compulsory national immunisation programme.

The vaccine will not only save the lives of countless infants, but also reduce deaths from childhood illness in a country with one of the highest child mortality rates in the world.

The vaccine, Prevnar, was initially introduced into South Africa in 2005 – but only in private hospitals, with its price tag of R1 600 ($165) putting it beyond the means of most people. It will now be available at state-funded hospitals as part of the government’s routine immunisation programme.

Hospitals in the Eastern Cape province will be the first to benefit, with the vaccine to be rolled out across the country in 2009.

Prevnar immunises infant bodies against the bacterium Streptococcus pneumonia, preventing not only pneumonia but also sinusitis and blood and middle ear infections. The bacterium is the leading global cause of serious illness in young children. According to a 2006 United Nations’ Children Fund (Unicef) report, it kills 2-million children worldwide every year.

According to Unicef, 21 children die each minute every day, mainly from preventable causes. This translates to 11-million every year, and their research has shown that 6-million of these deaths could be prevented by low-cost interventions such as vaccines and antibiotics. Diarrhoea, malaria, neonatal infection, pneumonia, premature birth and lack of oxygen at birth account for 70% of child deaths.

Unicef has found that vitamin A supplements are highly effective and can reduce child deaths by 23%.

South Africa’s case

South Africa is a developing nation with a healthcare system that, although challenged, is far better than those of most African countries. Nonetheless, it has one of the highest child death rates in the world, being one of 12 countries globally in which child mortality rates have increased instead of falling since 1990. The child mortality rate has risen from 60 deaths per 1 000 live births in 1990 to 69 per 1 000 in 2006.

Each year in South Africa at least 1 600 mothers die due to complications of pregnancy and childbirth. Some 20 000 babies are stillborn and another 22 000 die before they reach one month of age. This totals to 75 000 children dying before their fifth birthday. HIV/Aids is responsible for around 57% of child deaths.

In order to meet the Millennium Development Goals (MDGs) set out by the UN to reduce the mortality rate of children under five by two thirds in 2015, South Africa will have to reduce the number of deaths to 20 per 1 000 live births by that year.

The MDGs are eight goals to be achieved by 2015 in response to the world’s main development challenges. A total of 189 nations have adopted the UN Declaration during the UN Millennium Summit in September 2000 to meet these goals.

A work in progress

Immunisation has saved millions of babies in the 20th century and is considered one of the greatest medical discoveries. It is certainly an innovation that has saved far more lives than any other.

In 1980, smallpox was the first infectious disease to be globally eradicated by immunisation. The World Health Organisation set a goal to eradicate polio worldwide by 2005. In South Africa, the last polio case was reported in 1989.

South Africa adopted the global strategies for polio and measles elimination, vaccinating 90% of children under than a year old, across the country.

The Department of Health also actively detects, reports and investigates suspected cases of polio. Mass immunisation campaigns are conducted routinely, to prevent any possibility of it the disease re-emerging.

In 2007 the Department of Health provided vitamin A supplementation every child aged six to 12 months examined at public health facilities. The number of children diagnosed with measles decreased from 829 in 2004 to only 31 in 2007, and no deaths from the disease have been reported since 2006.

Learning from example

One African country successful in preventing deaths from childhood illnesses is Tanzania. Key interventions have put the country on track to meet its goal of reducing child mortality from 141 deaths per 1 000 live births in 1990 to 47 per 1 000 by 2015.

Between 1999 and 2004, Tanzania more than doubled its public expenditure on health, began providing insecticide-treated nets to prevent malaria, vitamin A supplementation, immunisation, and encouraging breastfeeding.

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