Adegoke Falade
4 April 2008
Lagos — This month, Uganda announced that it has nearly eliminated deadly Hib meningitis in young children through the use of a single vaccine. This comes just five years after that vaccine was first introduced into the country's immunization programme.
As a result, Uganda prevented an estimated 28,000 cases of pneumonia and meningitis and 5000 deaths, each year. This is a dramatic example of how this childhood vaccine can save thousands of young lives and save thousands more children from life-long suffering. When it doesn't kill, Hib meningitis, a dangerous inflammation of the lining of the brain and spinal cord, can still cause deafness, paralysis, mental retardation and learning disabilities.
As a paediatrician, I have witnessed these tragedies first-hand. They are made all the more devastating by the fact that this disease strikes children in the first five years of their lives, when they are at their most vulnerable. Yet Uganda's Hib vaccine program has eliminated this public health threat with speed and determination.
Hib disease is caused by the bacterium Haemophilus influenzae type b, or "Hib." In addition to causing meningitis, Hib along with Streptococcus pneumoniae are the two leading causes of childhood pneumonia - the world's largest killer of children under 5. For every child with Hib meningitis, there may be five to ten others with Hib-related pneumonia.
Hib kills almost 400,000 children every year, the vast majority in developing nations. It is also linked to about 3 million cases of serious childhood illnesses. Yet evidence has shown that both Hib pneumonia and meningitis are preventable with the same vaccination.
This is why, for all the headlines it has sparked around the world, Uganda's success is not surprising. Across the globe, vaccination programs have helped eradicate diseases like smallpox. Vaccines have also made dramatic progress toward eliminating measles and polio. Uganda has given us further evidence that when vaccination programs are carefully implemented and closely monitored to ensure their success, millions benefit.
Hib is only one of the sources of disease that threaten child survival. Yet it is a source that can clearly be defeated. Uganda's announcement follows similar results in Kenya, the Gambia, Bangladesh, Chile, Britain and the United States, where studies demonstrated that Hib vaccine cut disease incidence by 88 percent or more in five years or less.
Reducing childhood mortality can be a difficult and tragic task, because limited resources often prevent us from addressing every disease that puts our children at risk. Yet for all its benefits, the Hib vaccine has proven to be extremely cost-effective. Last year, a study in Kenya demonstrated that widespread use of the Hib vaccine has saved the government approximately US$871,539 each year in averted treatment costs. This while preventing 4,033 meningitis cases and 10,166 pneumonia cases and saving the lives of about 5,408 infants and young children.
In Uganda, the government obtained 16.5 million doses of a 5-in-1 vaccine that also protects against diphtheria, pertussis, tetanus and hepatitis B at a discounted price, through the support of the GAVI Alliance, an international donor. 83 percent of countries in Africa that are eligible for this support have or will soon include Hib vaccine in their national immunization programs. Of the 36 GAVI-eligible countries in the region, Nigeria is the only country that has not yet moved forward to adopt the vaccine.
Nigeria is the most populous country in Africa, yet one out of every five children does not make it to their fifth birthday. Like Uganda, we have the opportunity to save our children from some of the most common, deadly and debilitating diseases. For our children, pneumonia causes over 200,000 deaths each year and it is the vaccines for Hib and Pneumococcus that can eliminate a large portion of these deaths. It is interventions like this that will help the world achieve Millennium Development Goal number 4, to reduce by two-thirds the mortality rate among children under 5. Uganda's success is admirable, because it demonstrates that we have the knowledge and the means to protect these most precious of lives. Discussions in Nigeria regarding implementation of this and future vaccines are promising, but let's hope a decision can be made soon to start saving our children from preventable disease.
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