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Vaccinations: challenges in both supply and demand

Vikrant Labde | Friday 12th June 2009
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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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