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Hope for millions with a new meningitis vaccine

By Celia W. Dugger (The N.Y. Times)

For over a century, epidemics of bacterial meningitis have swept across Africa, arriving with the dry harmattan winds to kill with terrifying speed. But on Monday, a drive will start to inoculate tens of millions of West Africans with a new vaccine in what scientists hope will be the beginning of the end of ravaging meningitis epidemics.

The aim is for these immunization campaigns to spread from Senegal in the west to Ethiopia in the east and bring the disease under control in a belt of 25 nations that girds the continent, saving an estimated 150,000 lives by 2015.

Hundreds of millions more dollars are still needed to accomplish that goal in coming years, public health officials say. But the meningitis vaccine itself is a major milestone in developing inexpensive immunizations against neglected diseases that afflict poor countries, experts say.

More than a million cases of meningitis have been reported in Africa over the past two decades. The vaccine works against the group A meningitis strain that causes more than 8 out of 10 cases on the continent. Moreover, it costs less than 50 cents a dose. In the United States, Novartis and Sanofi Pasteur market a single dose of meningitis vaccine against multiple strains of the disease for $80 to $100.

"Wow, that’s remarkable!" exclaimed Dr. Gregory Poland, head of vaccine research at the Mayo Clinic in Minnesota, when he heard how little the new vaccine would cost.

Bill Gates, whose foundation largely financed the endeavor, contrasted the undertaking with the development of vaccines for measles, smallpox and polio.

"All those things were created because rich people got sick," the billionaire Microsoft co-founder said. "This is the first vaccine that went through the whole process where there was no rich world market, and it had to be optimized at a very low price."

The meningitis vaccine relies on a technology that was devised by researchers at the Food and Drug Administration and donated by the U.S. government at the cost of only token royalties. It is being manufactured by the Serum Institute of India, a major vaccine producer, and it was developed independently of the major American and European pharmaceutical companies.

The meningitis vaccination drives will begin Monday in Burkina Faso and will also get under way in Mali and Niger this month, but public health experts caution that the promise of the meningitis vaccine should not be oversold. It will not eradicate the disease because it is effective only against the group A strain most common in Africa.

 

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Will the G20 Deliver for the World’s Poor?

Children in a slum area
Children in a slum area
Ben Phillips,  Save The Children’s Asia Strategy Director (The Guardian)

With over 8 million children dying each year from preventable causes, a global financial transaction tax could be the solution

To be in South Korea as part of its hosting of the G20 summit which will be held on 11 and 12 November is to witness a piece of history.

In the lifetime of South Korea’s leaders, and in a triumph of development, the country has gone from having a GDP per capita lower than much of sub-Saharan Africa to being one of the world’s largest economies, and is now a larger aid donor than some European countries. It didn’t get here by following the “guidance” of the international financial institutions. Instead, South Korean growth came from redistributing wealth, managing market engagement and making massive public investment in human capital.

Indeed, the success of east Asia, and the failure of the Washington Consensus, prompted me to ask the G20 representatives attending the recent High-Level Development Conference in South Korea earlier this month whether we should swap the Washington consensus for a Seoul consensus. The eclipsing of the G7/G8 by the G20 marks a change in the global political economy. It changes the culture of global meetings too. I’m pretty sure, for example, that this is the first time a host government of such a meeting has had an official pop song.

But for those who had hoped that the expansion of the old colonial G8 into the more inclusive G20 would bring a greater focus on poverty, there will be some disappointment. The G20 do not want to discuss aid or debt for example, and it was a struggle to even get development on the agenda. Even with development now an official topic of discussion, I had one (western) government representative at the meetings confess: “I don’t know much about development, I’m an economist.” And though the chairman of the African Union is invited as an observer, the AU is still not a permanent, equal member of the forum. “There has to be a balance between efficiency and inclusiveness,” goes the mantra. Those who complained about the old G8 but made it into the G20 go along with this. All reminiscent of the natural human tendency that when you’re waiting for a bus in the rain, you shout at the buses that keep driving past; but when you get into the bus, you join in with the others shouting to the driver that the bus is too full to keep stopping at all the stops to let rain-drenched passengers in.

The civil society groups attending the meetings of Civil G20 have taken a different approach, with more than 100 participants from across the world. It is a wonderfully diverse group: in my first five minutes at a meeting I met an obstetrician, a teacher, a lawyer and a priest. But it is a hard group to organise. At times we got a little sidetracked. Discussing a civil society submission paper to the G20, someone asked another participant: “Are you upset because of the comma?”

For those focused on global poverty, the most important issue being discussed at the G20 is the idea of an FTT, a financial transaction tax to help raise the money needed to fight poverty. It sounds wonkish, but at a rate of just 0.05%, and applied globally, this could raise between £256bn and £446bn annually, roughly four to seven times the current level of overseas aid. Among the G20 representatives, opinion is divided. A senior official from a major economy told a group of community activists from Asia, Latin America and Africa that while the idea of taxing irresponsible traders may seem attractive, in the end the costs would fall upon “ordinary people like me and you”. In the middle ground was the government representative who acknowledged that the FTT was a good idea but declared that it would be “hard to do”. (Can the world’s “premier economic forum” not do hard things?) But a representative from another G20 country urged me: “Please keep pushing on the financial transaction tax. We need you to do so. It’s like with the landmines treaty. Governments said it couldn’t be done. You in the NGOs kept pushing. And it happened. This can happen too. It will happen – if you keep pushing us.”

Civil society advocacy stands little chance when all governments are opposed to us – but when an issue is in contention, like this one, we can be the force that makes the difference, that pushes an issue beyond the tipping point. The world is short of more than 3.5 million health workers, and an FTT could help pay for them. For some of the more than 8 million children who die every year from preventable causes, that could mean life instead of death. An FTT won’t be agreed this month or next month, but if we can keep it on the agenda, as the French start to organise for their chairing of the G20 in 2011, we can help to ensure that it does happen, and that we make another piece of history.

South Korea has gone from having a GDP per capita lower than much of sub-Saharan Africa to being one of the world’s largest economies by not following the “guidance” of the international financial institutions. What should African countries learn from that?

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