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Doctors Without Borders criticizes Gates-backed global vaccine strategy

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Bill Gates at World Health Assembly

The global health strategy to expand childhood immunizations, largely backed by the Bill & Melinda Gates Foundation, is too focused on new vaccines and neglects the fundamental need to improve basic public health and immunization programs in poor countries.

So says Medicins Sans Frontieres (MSF), aka Doctors Without Borders, in a new report issued today by the organization entitled The Right Shot: Extending the Reach of Affordable and Adapted Vaccines.

The medical relief and aid advocacy organization is critical of a new, 10-year, multi-billion dollar “Global Vaccines Action Plan” expected to be adopted by global health leaders at the World Health Assembly meeting next week. The plan is largely funded by the Gates Foundation.

MSF says it favors expanding access to new vaccines — just not at the expense of basic immunizations.

“Twenty percent of the world’s children aren’t even getting the basic vaccines,” said Kate Elder, MSF vaccine policy adviser. The Gates Foundation is driving much of the global health policy decisions around vaccinations, Elder noted, and “Bill Gates’ priority is new vaccines.” The philanthropy’s influence is distorting the agenda to favor new vaccines over basic improvements, she said.

Daniel Berman, MSF’s deputy director for access, cited a recent initiative to distribute a new $7-per-dose pneumococcal vaccine in DR Congo in the middle of a measles outbreak. Why, Berman asked, are donors and health agencies pushing this new, expensive vaccine in Congo if Congolese children still aren’t getting a 30-cent measles vaccine?

The approach appears aimed more at supporting drug industry desires to promote new products than at finding the most efficient and sustainable means for fighting the diseases of poverty, he said.

UNICEF

The Right Shot may be a new report from MSF, but it is hardly a new criticism of the Gates Foundation’s approach to vaccines. Others have criticized the philanthropy before for a tendency to place industry interests above the concerns of poverty advocates.

The Seattle philanthropy, though contacted in advance of the report’s release, declined to comment or respond today to the MSF criticism – or to the group’s call for a new global strategy with more emphasis on beefing up basic, routine immunizations. The organization sponsored by the foundation to promote the new global strategy, the Decade of Vaccines collaboration, also did not respond.

Jeffrey Rowland, spokesman for the Global Alliance for Vaccines and Immunization, GAVI, did respond to the criticism. Continue reading

Gates initiative on “neglected diseases” advances cause, but neglects key questions

The Bill & Melinda Gates Foundation today announced, together with more than a dozen drug makers and others, a new initiative aimed at fighting a select group of mostly developing world ailments called “neglected tropical diseases” such as river blindness, parasitic elephantiasis and others.

Uniting to Combat NTDs

These diseases affect an estimated 1.4 billion people, killing perhaps half a million a year, but have not been high on the global health radar screen. As Dr. Peter Hotez writes for Huffington Post, for only 50 cents per child many of these diseases may now be eliminated.

The new public-private initiative aims to rid the world of 10 of these diseases by 2020.

It’s widely regarded as a positive step forward for global health, but there are some important questions that went unanswered:

  1. What is a neglected disease? This is actually a hotly debated question in global health circles right now.
  2. Many think the solution to fighting diseases of poverty should be to focus on poverty as much as on disease. Will this initiative get at the root problem or just address symptoms?

We’ll get back to the neglected issues of neglected diseases in a bit. First, more on the news:

For this initiative called the London Declaration on Neglected Diseases, the Gates Foundation pledged $363 million to support research into new treatments. Drug makers like GlaxoSmithKline, Merck, Johnson & Johnson and others have likewise pledged to step up research as well as to expand donation programs of medications to poor countries.

Others involved in the initiative include the World Bank, the United Arab Emirates as well as the U.S. and U.K. governments The total estimated commitment is $785 million. Continue reading

Three reasons not to get too excited about the Gates-Glaxo malaria vaccine

Last week, the biggest news out of the Gates Foundation’s Malaria Forum were some interim results of an ongoing test of an experimental malaria vaccine.

Many, if not most, media reported the findings in somewhat hyperbolic fashion as a “major milestone,” a “breakthrough” or “world’s first malaria vaccine.”

Google News on the malaria vaccine

Despite the hype and fanfare, many experts at the Seattle meeting said this experimental vaccine (known as RTS,S) actually so far represents only incremental progress — a scientific achievement which may still turn out to have little practical utility in the real world. They usually only said so privately, given that the Gates Foundation preferred to hear “optimistic” assessments rather than cranky ones.

1. No breakthrough. Let’s first put to bed the claims that these findings represent a major milestone. In fact, the findings largely repeat earlier ‘interim’ results that have continued to find the vaccine protects only half of those immunized — and appears to wane fairly rapidly over time.

So that’s the first reason — a point also made in this (terribly titled) Huffington Post article A vaccine that works only half the time is not the shot in the arm malaria needs. The author, Tido von Schoen-Angerer, director of Médecins Sans Frontières‘ essential medicines campaign says:

But while the latest advance toward the development is scientifically important, there are several reasons to be cautious about the difference this vaccine could make, on the basis of current results.

2. The cost question. The second reason this halfway effective malaria vaccine may not work is cost. The manufacturer GlaxoSmithKline has refused to say what it thinks it will have to charge for the vaccine, other than to say it would be “at cost” plus 5 percent. Neither the PATH Malaria Vaccine Initiative, which is working with GSK on the malaria vaccine trial, or the Gates Foundation (which funds the PATH initiative) will say what price they think is feasible. Many say anything over a dollar might be too much for poor countries.

3. The science. It is promising that researchers have shown a vaccine against malaria is possible. But there’s a lot of other research out there indicating why it may be quite difficult to get a malaria vaccine that can perform as well as most of us expect a vaccine to perform — providing ideally something like 90 percent protection but hopefully not lower than 70 percent. Continue reading