The journal The Lancet embarks on a Series on the future of vaccines that coincides with the pledging conference for the Global Alliance for Vaccines and Immunization (GAVI) in London on 13th June. Some of the world’s leading vaccine experts come together in this Series to discuss what needs to be done to realize the enormous potential of vaccines during the next ten years. The Series consists of 5 papers, a call to action, and 5 Comments.
The Series concludes with a call to action. Professor Richard Moxon, University of Oxford and John Radcliffe Hospital, Oxford, England, and team point out four crucial elements that need to be prioritized in order to fully reduce the burden of vaccine preventable diseases.
Firstly – more investment into R&D, including funding and prioritizing of Phase 3 trials.
The authors write:
“We need to find the requisite funds for the research and development of about 20 improved or novel vaccines in the next decade and beyond. Most important are vaccines for tuberculosis, AIDS, and malaria, but several tropical diseases are inexcusably neglected, including leprosy, trachoma, onchocerciasis, lymphatic filariasis, leishmaniasis, and common helminthic infections such as hookworm. We must also consider vaccines beyond classic infections, such as insulin-dependent diabetes, cancers, and degenerative diseases.”
Secondly – the writers call for advocacy at the highest level to mobilize the donor community. Vaccines have a distinguished track record in advocacy, thanks to such organizations as GAVI and UNICEF. However, these movements have not been consistent. Stronger leadership is required over the longer-term, not simply short-lived efforts.
The authors write:
“Any successful movement in global health needs a defining idea around which to mobilise. For vaccines, the idea is simple: vaccines save lives, prevent suffering, and create wealth. For example, if the GAVI Alliance was fully funded (with an additional $3.7 billion), 4 million lives could be saved between now and 2015, through immunisation programmes that reach more than 240 million children worldwide.”
Thirdly – developing nations should take on more of the funding for vaccination programs, especially as many of them gain in wealth.
The authors write:
“Most developing countries accord too low a priority to health in their budgets. They must be persuaded to take more of the burden themselves on behalf of their poorer citizens. Ultimately, expansion and sustainment of access to the benefits of immunisation requires ownership of the programme by developing-country governments and the communities that they serve.”
Finally – more effort should be made to explain the benefits of vaccines, not just to relevant health professionals, but also to the general public and decision-makers.
They write:
“The challenge is that between development of a vaccine and its public consummation there is a so-called black box within which a multiplicity and heterogeneity of human factors must be negotiated to realise the public health gains of immunisation. If trust and confidence in vaccines is not secure, our efforts to advocate increased resources to make possible the necessary research, development, and supporting clinical investigation will be a bridge too far. Clearly we do not have answers to many basic questions. What is needed? What motivates people to be immunised? What deters them?
(conclusion We have the knowledge base, expertise, and methodology with which to investigate what needs to be done to increase public trust and confidence in immunisation… There is a way forward and we need to grasp the opportunity. “
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Written by Christian Nordqvist