Vaccine Ping-Pong: GAVI and MSF’s Advocacy Campaign for Vaccine Access

MSF (Médecins Sans Frontières, also known as Doctors Without Borders) recently posted a set of three animated videos about child vaccines as part of their latest advocacy campaign. The first one, titled “We Need Better Tools to Save Lives” is pretty straightforward – it’s a basic explanation of what is needed to vaccinate children, how MSF struggles to fill that need, and a quirky analogy about what it is like to not have that need filled. Simple enough.

The second video is a lot more direct. The show how the number of vaccines in the standard childhood vaccination battery, as well as the cost of those vaccines, have increased in the last decade. The video then takes a direct shot at pharmaceutical companies for keeping vaccine prices high in order to prioritize profits over saving lives. The debate on drug prices is a heated one, and everyone seems to have their own opinion on what “fair prices” for drugs are, but it is clear where MSF stands.

The last video was the one I personally found to be the most interesting. “Dear GAVI, Please Let Us Access Your Discounted Vaccine Prices” talks about how qualified governments are allowed to access GAVI’s low vaccine prices, but NGOs are not given access to them. MSF provides a more detailed description of their perspective on the issue in this press release:

MSF is also troubled by the fact that non-governmental organizations and humanitarian actors are excluded from accessing the GAVI-negotiated price discounts. MSF is often in a position to vaccinate vulnerable groups, such as refugee children, HIV-positive children, and older unvaccinated children who fall outside of the typical age range for standard vaccination programs. However, MSF has not been able to systematically access the lowest prices negotiated by GAVI, having to resort to lengthy negotiations with Pfizer and GSK over the last four years to access the pneumococcal vaccine. While the companies have offered MSF donations, this is not a sustainable, long-term solution for MSF as we work to respond quickly to needs in the field, and wish to expand vaccination of vulnerable groups in an increasing number of countries.

GAVI responded to the MSF campaign in this statement:

First, we agree with MSF – we do all want the same things. We want all children everywhere to be protected by immunisation. In fact, GAVI is proud to include MSF as a member of the GAVI Alliance. They are an active member of the steering committee of the GAVI Board’s Civil Society Organisation Constituency.

MSF first formally raised the issue of access to the same prices GAVI pays for vaccines at the GAVI Board meeting in December 2012. This issue is currently being discussed through the Alliance’s Governance channels. We find it disappointing that MSF, which knows and is engaged in the GAVI Governance process, has chosen to take on this issue as a public campaign.

MSF then offered this statement in response:

Thank you GAVI for publicly acknowledging our request for access to your vaccine prices. MSF has been frustrated by bilateral discussions, which have been ongoing for a few years now, with vaccine manufacturers and the GAVI Alliance on finding a solution for humanitarian actors to access pneumococcal conjugate vaccine at the GAVI price, and we anticipate that accessing GAVI prices for other new vaccines (for rotavirus, HPV) will also be a challenge. We ask GAVI to fast-track this process so that MSF can vaccinate more kids as soon as possible.

We often talk about issues of coordination (or lack thereof) and collaboration between different aid groups and funding organizations in the wake of natural disasters and humanitarian crises. It is interesting to see this kind of friction between different groups who are trying to do exactly that because of how complicated it can actually be.



To protect children right now, we have to use vaccines that aren’t well suited to the job they have to do. Vaccines can’t take the heat — they have to be kept at between 35 and 46 degrees at all times. But we need to use them in some of the hottest places on earth. For this and other reasons, we need better-adapted vaccines to protect children from life-saving illnesses.



Children are now protected with 11 vaccines; up from six vaccines a decade ago. The price of vaccinating a child has sky-rocketed. It cost $1.37 to vaccinate a child 10 years ago, now it’s $38.80. That’s a whopping 2,700 percent increase. So how do we decide how many vaccines children need? Is it based on how much money you can make, or on how many children’s lives can be saved?



The price to vaccinate a child has risen by 2,700 percent over the last decade. Countries where Doctors Without Borders/Médecins Sans Frontières (MSF) works will lose their donor support to pay for vaccines soon, and will have to decide which killer diseases they can and can’t afford to protect their children against. MSF is asking the GAVI Alliance to open up their discounted vaccine pricing to humanitarian actors that are often best placed to respond to vaccinating people in crisis.

The GAVI Alliance is an international public-private partnership whose stated mission is to increase access to immunization for children in poor countries. GAVI co-finances the cost of vaccines with qualifying countries. Participants include governments of developing and donor countries, the World Health Organization, UNICEF, the World Bank, the vaccine industry, research and technical agencies, the Bill & Melinda Gates Foundation and other philanthropic organizations.

MSF Videos on HIV/AIDS Treatment

Below are a series of videos from MSF on different aspects of HIV/AIDS treatment.



A first-of-its-kind study released today by Doctors Without Borders/Médecins Sans Frontières (MSF) maps progress across 23 countries on HIV treatment strategies, tools and policies needed to increase treatment scale-up. The results show that governments have made improvements to get better antiretroviral treatment (ART) to more people, but implementation of innovative community-based strategies is lagging in some countries.



Despite the fact that the benefits of virological treatment monitoring are well established and that routine viral load testing is the standard of care in rich countries, access to viral load testing in resource-limited settings remains limited or non-existent. A number of cost-reducing strategies and implementation challenges must now be addressed so that virological monitoring can become the norm for all patients on ART. This will be important to prevent the development of drug resistance and preserve the use of first-line ART. This session presents the challenges and promise of scale-up of virological monitoring from a patient, health system, and market perspective. The session will be of interest to donors, policy makers, civil society representatives, and implementing organizations.



As HIV treatment is scaled up in developing countries, the lack of access to viral load monitoring—routine in wealthy countries—must be addressed. Increased access to viral load monitoring can help people stay on antiretroviral combinations as long as possible, and help stave off resistance.

Guinea: A New Approach to Fight Cholera (MSF Video)


More than 170,000 people in the Boffa region of Guinea recently became the first in Africa to receive a new two-dose oral vaccine for cholera. Doctors Without Borders/Médecins Sans Frontières (MSF), in collaboration with the Guinea Ministry of Health, led the vaccination campaign.

Global Health News Last Week

September 5 was Labor Day.

POLITICS AND POLICY

  • The State Department has announced the official US Delegation to the UN High Level Meeting on NCDs, which will take place September 19-20.
  • Access to affordable lifesaving medicines will be threatened where they are needed most—in parts of the developing world—if the U.S.insists on implementing restrictive intellectual property policies in the Trans-Pacific Partnership (TPP) trade agreement, says Médecins sans Frontières (Doctors without Borders).
  • Sarah Boseley shares the great news that Kenya has officially made female genital mutilation illegal.
  • A federal appeals court in Virginia has dismissed two lawsuits challenging the constitutionality of President Barack Obama’s health care overhaul.
  • United Nations chief Ban Ki-moon singled out sustainable development as the top issue facing the planet with the world’s seven billionth person expected to be born next month. Key to this was climate change, and he said time was running out with the population set to explode this century.
  • Thousands of proposed cuts in the US Congress could lead to significant cuts to USAID.
  • The Philippines reproductive health bill is still making its way through the senate.  Meanwhile, 7 villages in Bataan, the Philippines have banned “artificial contraception” amid national debate over the bill.
  • A report co-authored by an Australian academic highlights the need for healthy ecosystems as the basis for sustainable water resources and stable food security for people around the world.

PROGRAMS

  • Sometime this fall, the world’s population will reach 7 billion people. Experts now forecast that by 2050, the population could be 10 billion. Some say those numbers should force policy makers to focus more intently on making family planning much more widely available in the developing world.
  • The Institution of Mechanical Engineers has put together a one day conference bringing together innovators and health workers to share ideas about ways to more easily deliver interventions.
  • It has been commonly held that insecticide treated bed nets reduce the rate of malaria for people who use them. Now there is hard evidence to back up that assumption.

RESEARCH AND INNOVATIONS

  • A new study shows that less than three doses of the vaccine against cervical cancer can effectively protect women in the developing world where 80% of global deaths due to cervical cancer take place.
  • Only three African countries are on track to achieve MGD 5, according to an African Institute for Development Policy study.
  • Most efforts in the Western world seeking to find solutions for developing world problems tend to think of inventing new technologies or, at least, using the tools we typically use to fix things — modern drugs for diseases, improved seeds for crops, a better mousetrap. Sometimes, all you need is a newly geared donkey
  • Scientists may have developed a new TB vaccine after tests showed the elimination of TB from infected tissue in mice.
  • A socially active lifestyle can dramatically speed up weight loss through the burning of fat in mice, a study shows. Researchers at Ohio State University in the US identified a link between the amount of social interaction in a mouse’s environment and its weight.
  • An easy-to-use diagnostic chip for HIV could “give results in minutes” and be a game changer in the field of cheap diagnostics for remote regions, claim the researchers who developed it.

DISEASES AND DISASTERS

  • Having to contend with U.S.army drones and the crossfire between the Taliban and the Pakistani army, the residents of Pakistan’s tribal areas find access to treatment for HIV/AIDS harder than in most other parts of the world.
  • Three-quarters of a million people are facing death by starvation in Somalia according the United Nations, who declared Monday that famine had spread to a sixth southern region of the beleaguered Horn of Africa state.  Meanwhile, an investigation has revealed that masses of food meant for famine victims in Somalia are being stolen. There have also been reports of rioting and killings during food distribution at camps for famine victims.
  • A magnitude 6.6 earthquake struck 100km southwest of the city of Medan, Sumatra and 110km beneath the earth’s crust.
  • A New York Times editorial castigates the international community’s response to the cholera outbreak in Haiti.
  • The CEO of insulin manufacturer Novo Nordisk says the WHO should buy low cost diabetes drugs in bulk for the developing world.
  • Messages of good health and positive self-esteem for girls aren’t hard to come by in kid lit, so what’s the deal with all the attention for a not-yet-published rhyming picture book about an obese, unhappy 14-year-old named Maggie?

INFOGRAPHICS AND OTHER MEDIA