Speaker: Michelle Childs, Médecins Sans Frontières International
Médecins Sans Frontières welcomes the focus on immunisation brought by the Decade of Vaccines.
We are concerned, however, that the Global Vaccine Action Plan’s draft monitoring and evaluation framework omits two essential targets.
First, the framework is not ambitious enough in terms of bringing new vaccine delivery technologies to immunisation programmes. In places where MSF works, we see that the current tools are inadequate for reaching children who are disproportionately affected by vaccine-preventable diseases: they require refrigeration, are difficult to transport, and need trained health staff. More than 112 million children remained unimmunised in the last five years. The question of vaccine adaptability is therefore critical. We need new vaccine products that can be delivered through innovative technologies, more suited to the places where vaccines are most needed – needle-free, oral, heat-stable vaccines. Yet the monitoring and evaluation framework aims for only one “new platform delivery technology” by 2020. This is not ambitious enough.
Second, the Global Vaccine Action Plan must consider vaccine affordability. The cost of fully vaccinating a child has increased by 2,700% since 2001, and promises to increase. Many member states at the WHA last year articulated concerns about the sustainability of immunisation programmes, calling for greater affordability. It is alarming that the monitoring and evaluation framework contains no indicator at all on vaccine pricing. Initial estimates put the cost of the Decade of Vaccines at between 42 and 51 billion dollars. A significant portion is due to the cost of vaccines themselves; we are therefore compelled to track prices. An appropriate indicator would be a percentage change of the cost of a fully-immunised child as per WHO-recommended EPI schedule.
MSF therefore urges member states to call for a more ambitious target on new delivery technologies, and to insist on including a vaccine pricing indicator. This would acknowledge the challenges faced by countries in implementing vaccination programmes, and put concrete metrics to critical aspects for the Decade of Vaccines.