Are global vaccination programmes helping the most needy?
Wednesday, June 19, 2013
The debate on the skyrocketing price of vaccines is hotting up. Medecins Sans Frontiers have recently criticised the Global Alliance for Vaccines and Immunization (GAVI) for removing vaccine subsidies from countries that remain in need of aid. GAVI – a public-private partnership between UN organisations,the vaccine industry and the Bill & Melinda Gates Foundation amongst others -negotiates vaccine price reductions of up to 95% for developing countries. It also contributes to the cost of purchasing the vaccine. GAVI argues that withdrawing support from countries as their economic situation ensures their support is appropriately targeted. However, with a majority of the world’s poor living in middle income countries, does removing support from countries that make marginal economic advances really help those in greatest need?
In 2015 17 countries will ‘graduate’ from GAVI support, due to marginal rises in their per capita income. These countries will see dramatic increases in the amount they need to pay to pharmaceutical companies for their vaccination programmes. MSF highlight the case of Honduras, which will see a 1000% increase in the amount it pays for PCV and rotavirus vaccines (which prevent meningitis, pneumonia, and severe gastrointestinal illness). The country currently pays $1.43 for the vaccines, but this will leap to $15.50 in 2015.
The problem with GAVI’s approach is that it ignores distribution of income. Countries with high levels of economic inequality may see rises in their per capita income, but that revenue remains concentrated within a small section of society. According to the World Bank, Honduras has the world’s most unequal economy. Other countries set to lose GAVI support, such as Bolivia and Angola, are almost as unequal. By removing support from these countries, GAVI are making the poorest members of these countries liable for income enjoyed only by their wealthy elite.
A report from the Center for Global Development has pointed out the problems with this approach: “New vaccines that are often available in low income countries, such as those against rotavirus, pneumococcal disease, and Hib, have yet to be introduced in many middle income countries.”
- Health Care