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Vaccinations: challenges in both supply and demand

Sara Wolcott | Saturday 7th February 2009

Immunization: the simple act of stabbing a potentially squeeling child with a syringe has proven to be the second greatest advancement in global health - only after clean water. But the road to eradicating the diseases we have the technology to prevent has not been an easy one; its about far more than the miraculous technology in fluid-form spurting out of the needle. It's also about transportation, health workers, governments, wars, policy, and the parents, children and their respective cultures.

The Bill and Melinda Gates Foundation has rightly seized upon immunization as one of the major pathways to creating global health and thus significantly reducing poverty. They are largely focusing on the 'supply' side of immunization: both creating new and better vaccines and, importantly, creating vaccines that don't need refrigeration and, someday, might not even need a needle. This would dramatically increase the potential for vaccines to get into the children who desperately need them, especially in rural areas. They just announced a related breakthrough: the ability to freeze-proof vaccinations (some of which can be damaged by getting too cold, as well as by getting too warm). In the next couple of years, we might very well see the advent of vaccinations that don't need refrigeration.

But it's not just the 'supply' side that's necessary to pay attention to. There is also the 'demand' side. Even in much of West Africa with a high uptake of vaccines, it does not necessarily means that those caring parents understand why their babes are getting poked every three or six months. As any human might, they tend to put the science and technology of vaccination into their own world view, which does not necessarily differentiate between different diseases in the same way western science does, nor does it always appreciate the attempts at vaccination. It wasn't that long ag that prominent leaders (especially religious leaders) in Nigeria said 'no' to polio vaccines, suspecting it to be part of a anti-African/Islamic plot. Of course, this is not purely a third-world phenomenon: the Measles, Mumps and Rubella (MMR) vaccination suffered a dramatic drop (from 90%-60%) in 2004 when it was deemed questionable if the vaccination might, on occasion, lead to autism.

Focusing on health is key for any country - or any individual. If we had to choose between health and education, we necessarily choose health: brains reside in bodies, and the needs of the body must be met before the brain can function. In designing policy and thinking about health programs, especially in giving aid, we need to take the socio-cultural-political situation into account; we need to realize that even something as beneficial as vaccination has its politics, and we need to get local key leadership to help create the necessary avenues for vaccination uptake.

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Sara Wolcott 13 March 2009

I agree that clean water, sanitation and basic food/housing requirements is key. And in the UK/the west, I agree that big pharma really does benefit. I'm glad your children are doing well - I think choosing not to vaccinate takes a lot of courage, in our vaccination-obsessed society.

Sara Wolcott 13 March 2009

Thanks for your comment Barb. I didn't know the 'hygiene theory' of allergies. do you know if many children are developing allergies to common food (maize, rice, beans, etc.) in many third world countries?

barb gregory 26 February 2009

If you read the "hygiene theory" of allergies, "third world" countries do not have a problem with food allergies. Supposedly having childhood illnesses is good for us and keeps the immune system busy so it doesn't chase after innocent food particles. Basically it is a bunch of medical baloney and covers up the real cause of the "epidemic" of food allergies amoung young children. Food allergies are directly caused by injecting food protein into the body via vaccinations. Unknown to the general public and most physicians, vaccinations have secret ingredients protected by international trade law. What could be more tragic than children dying from measles in a third world country, is that same child dying from starvation because of suddenly developing a food allergy to common food.

Michael Contardi 10 February 2009

I'm one of the vaccination skeptics. My children are not vaccinated and are a lot healthier than most of their vaccinated friends who always seem to be on some antibiotic or another. The case for vaccination as historically responsible for the eradication of disease is dubious- conveniently happened to be the same time that society modernized and moved out of conditions of squalor. If we were to invest half the money we are putting into vaccinations into providing clean water, food, housing, sewers and toilets- the poor of the would be much better off. The only one who really benefits from these programs I think are the big pharma companies.