Strategies

Child survival began with Rotary addressing Polio throughout the world. They created a model for mass immunization that the Red Cross continued with the Measles Initiative. Already millions of children have been spared from Polio and Measles. What is next?

Rotavirus

Rotaviruses are universal. Rotaviruses cause diarrhea. The good news is that infection typically confers lifelong immunity. The bad news is that rotaviruses kill between 450,000 and 800,000 children per year, placing it among top infectious killers. With the decline in measles, rotaviruses move to 5th place. Only malaria and pneumococcus are deadlier for children.

"All humans are infected by the time they're 5 years old, …regardless of economic status." Remarked virologist H. Fred Clark of the children's hospital of Philadelphia . India suffers the most deaths from rotavirus. Significant numbers of deaths also occur in China , Southeast Asia, Africa and Latin America . The US loses only an estimated 50 children per year to rotavirus infections suffering a cost of a billion dollars or more in the process.

The other good news is that workable vaccines for rotavirus infections are on the way. The Chinese have a vaccination on the market, but the product is not universally accepted. Several American and European varieties are in Phase III testing, some with 75% or better positive results in earlier trials. Researchers expect workable vaccines by the end of 2005.

Rubella and Pneumonia

Additionally, Rubella vaccines exist. Vaccines for various subtypes of developing countries are under development. Plus, Pneumonia (Pneumococcus) vaccines exist. Vaccines for various subtypes of developing countries are under development.

First, do no harm…

The key is to make vaccines safe for children to take. It is not necessary for a vaccine to work 100% of the time to be useful. It is better to confer immunity on some or a majority of those who take it than that they have no immunity at all. Rotaviruses are killers. Even saving half the children dying from rotavirus-related diseases would save nearly a 1000 children a day. Current vaccines achieve double that. The typical path for vaccine development is to go from good to better to excellent over the course of several years. Additional research will make them better and better.

Rotaviruses are not only some of the biggest and deadliest diseases, but one of the hardest to crack. Rotavirus vaccine research started in the 1950's. Only in the last 20 years has science improved to the point where it could develop effective and safe vaccines. As with malaria, diversity of subtypes makes it even wilier a foe.

Yet with each new discovery and as each old disease is conquered, researchers can focus ever more talent, technology and insights on the remaining illnesses.

Beyond Mass Vaccination

What can replace mass vaccination campaigns? Integrated Management of Childhood Diseases (IMCI) . The initial results of the IMCI program indicate that childhood mortality can drop by 43% in children under five and 49% in infants up to age one. The results continue to improve suggesting a virtuous cycle where healthier people fend off disease better. Once healthcare systems are strengthened, local systems can deliver immunizations and treatments. Mass vaccination along with distribution of ITNs and other add-ons can help free up a system crushed by disease so that local communities can address their own disease burdens.

 

last updated 25 May 2006