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Community Health Nurse Amy Beck injects a patient with H1N1 vaccine in Calgary, Oct. 26, 2009.

Jeff McIntosh/The Canadian Press/Jeff McIntosh/The Canadian Press

Millions of people in the developing world die needlessly or are put at risk of contracting preventable diseases each year because of a lack of access to vaccines, prompting experts from around the world to issue an urgent call for better funding and more research.

A series of articles published in the medical journal The Lancet on Thursday identifies the high cost of immunization programs, problems with new vaccine development and eroding public trust as the main obstacles to more widespread use of vaccines in 72 of the world's poorest countries.

The series was published ahead of a major conference on Monday of the GAVI Alliance, a global group that helps to deliver vaccines and immunization programs. Donor countries, vaccine makers and others are meeting in London to address the $3.7-billion (U.S.) funding gap the GAVI Alliance says it needs to expand vaccination programs in poor countries over the next four years.

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Why are vaccines important?

Vaccines help to shield people from illness by exposing them to dead or weakened forms of disease-causing organisms, which stimulate an immune response. The widespread use of vaccines is responsible for wiping out or dramatically reducing the incidence of diseases such as small pox, polio, diphtheria and measles. But vaccines are only effective at reducing the spread of a particular disease if many people are vaccinated. The disease will continue to surface and outbreaks will occur unless there is widespread coverage around the world. Public health experts say declining rates of vaccination against measles, for instance, are responsible for outbreaks of the disease in Europe and North America. Quebec is currently fighting a measles outbreak.

Economic effects of vaccination

Worldwide vaccination is not a cheap endeavour, but the return on investment is enormous. The cost of vaccinating to eradicate smallpox, the only significant human disease ever to have been wiped out, totalled an estimated $300-million (U.S.), according to the World Health Organization. But the annual savings from no longer having to fight the disease are about $1-billion, the WHO says. In addition to health care savings, vaccination programs improve productivity by reducing work days lost to illness. Two studies published Thursday in the journal Health Affairs found that if vaccine delivery were expanded in 72 low- and middle-income countries, 6.4 million child deaths could be prevented in the next decade, which could save $6.2-billion in treatment costs and $145-billion in lost productivity.

The challenges ahead

Despite the success of vaccination programs, experts worry about the magnitude of the challenges ahead. Although major drug companies announced earlier this week that they would slash the prices of certain vaccines for low-income countries, newer vaccines are expected to become more complex and increasingly expensive in the years ahead, putting them out of reach for many. The GAVI Alliance helps to increase access to vaccines in poor countries, but it faces serious funding gaps. At the same time, countries that are considered to be "middle-income," such as Pakistan, China and Indonesia, don't qualify for GAVI funding. The new Lancet series argues that better and more permanent funding is needed, but also that low and middle-income countries themselves must start to make vaccine programs a top priority.

The future possibilities

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Development of new vaccines has come a long way in recent decades, but many experts predict the coming years will hold even more promise. Drug makers are setting their sights on creating new and increasingly complex vaccines to tackle some of the world's toughest diseases. Experts hope to one day be able to vaccinate against HIV, malaria, tuberculosis, leprosy and even non-infectious diseases, such as diabetes and high blood pressure. A major obstacle to their development is adequate research funding. In the Lancet series, vaccination experts have called for urgent action to make vaccine research a critical priority.

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About the Author

Carly Weeks has been a journalist with The Globe and Mail since 2007.  She has reported on everything from federal politics to the high levels of sodium in the Canadian diet. More

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