Strategies

Why Vaccines, Malaria Control and Water First?

Why do we suggest providing vaccines, malaria control, and water first? Deeper analysis brings up several questions. Where would you get the highest impacts? What is do-able? What is being done already? What is cheapest? Better: what is already paid for? We strongly urge the other inputs to come at the same time. If you had only enough resources to provide limited inputs, where would you start? These are systemic inputs that enable the system to cope with the other diseases better.

What do we mean by systemic? Systemic solutions go to the root cause. Systemic help has multiple effects. Through fixing one item you help to fix several problems, or you help the system to cope better with the remaining problems.

In America , studies prove that communities that reduce domestic violence reduce several other problems such as juvenile delinquency, teen pregnancy, and drug abuse. Systematic inputs.

The Rotary Model

The Rotary Model is now proven to be able to deliver multiple public health goods, like vaccines and Insecticide Treated mosquito Nets (also known as ITNs or bednets) quickly, cheaply and efficiently. The Rotary Model consists of three parts:

• Mass Social Mobilization to get people out to vaccination stations,
• Logistics to handle vaccines and vaccination of masses of people and
• Establishment of Surveillance Clinics to track diseases and eradication efforts.

The Rotary Model delivers essential goods and builds the capacity of the health care system to deal with the local problems and address opportunities. The vaccines and medicines save lives and improve health immediately. The Surveillance Clinics provide bricks and mortar laboratories and trained personnel who can readily apply their skills to new challenges. The Rotary Model creates progress in the most fundamental way, by showing and training the local professionals and volunteers how to deal with their own issues.

The Rotary Model seeks to assure that along with vaccines come the system building activities that set the stage for building infrastructure - both physical and intellectual. The Virtuous Cycle is ready to be put into place.

Behind the Rotary Model is the desire to leave a legacy of a healthy independent and local health care system with trained people and adequate laboratories serving a healthy population.

PolioPlus: Anytime vaccinators go out, they deliver several vaccines and often medicines. The idea of 'Several inputs in one carry" lowers costs for all parties and changes the outlook.

In 2001 the Red Cross/Crescent Societies adapted the Rotary Model to their Measles Initiative. The Measles Initiative is virtually a copy of the Polio Campaign with a different little bottle. The Measles Campaign has dropped death rate from Measles by over 90% every place it has been. Bottom line: the Measles Initiative regularly reaches over 90% of the children in a given country.

History of the Rotary Model

Rotarians undertook their PolioPlus Campaign in 1985. The goal was to raise enough money to provide vaccine for free to any country in the world that asked for it. It was early 1986 when Rotarians contacted the World Health Organization with the exciting news that they had indeed raised enough money, that they had just passed the goal.

The scientists at the WHO called a meeting to decide, privately, what the absolute best result was that they could hope for. The answer: reduce Polio to a mere 1000 new infections per day. Absolute best hopes for the disease. In 2003, the world number of infections for the whole year was under 300.

In 1988 the successes of the early campaigns led the WHO to declare that Polio could in fact be eradicated! Many scoffed. Now the campaigns are focused on a couple provinces of Nigeria and India, and to where the virus escapes to from there.

Thank you Fidel and Chinese Communists

Back in 1962 Fidel Castro ordered what may have been the first vaccination day for an entire nation. They vaccinated for polio. Lo and behold, polio rates went to zero, with a little mop up. There are virtues to governments that can order everyone out on a given day, especially when it is to do something that is good for them.

The south of Communist China had long suffered from malaria. In the early 1990's the government strongly suggested that people sleep under mosquito nets treated with insecticides. Between that and screening for malaria, they essentially removed malaria from the area.

The Vietnamese have cut malaria rates dramatically, in part because health officials retreat nets with insecticide for free.

Now largely capitalist Rotarians use the methods, adapted, of course, to deliver polio vaccine (and now for nets and insecticides) to whole populations at one time. Outsiders might feel that Rotarians would be horrified at using 'Communist' methods. Most Rotarians, however, chuckle and say, "Whatever works! We'll steal the best ideas from anyone."

HOW MANY CHILD DEATHS CAN WE PREVENT THIS YEAR? by Gareth Jones, Richard W. Steketee, Robert E. Black, Zulfiqar A. Bhutta, Saul S. Morris, and the Bellagio Child Survival Study Group begins with the statement:

In the 42 countries with 90% of global child deaths, 9.7 million children under five years of age died in
2000. An estimated 6.4 million (66%) of these deaths could have been prevented through full implementation of selected interventions. This is a conservative estimate. Mounting evidence suggests that remarkable progress could be made in all countries by the use of interventions that are available today and feasible for implementation in low-income countries.

And furthermore:

Breastfeeding and oral rehydration therapy (ORT) alone are estimated to be able to prevent 13% and 15% of all under-five deaths, respectively. Six other interventions could each further prevent a significant percentage of under-five deaths: insecticidetreated materials (7%), complementary feeding (6%), antibiotics for sepsis (6%), antibiotics for
pneumonia (6%), antimalarials (5%), and zinc to reduce diarrhea and pneumonia deaths (5%).

They go on to say:

It is important to note that some of the most promising interventions may be delivered at the household
level, with limited need for external material inputs; these include promotion of breastfeeding, ORT,
education on complementary feeding, and insecticide-treated materials. These interventions could
cumulatively prevent over one-third of all deaths.

last updated 25 May 2006