Vaccines offer opportunity responsibility

Vaccines offer both opportunity, responsibility

The editors of the British Medical Journal recently concluded that a 1998 study that rang alarm bells on a possible connection between vaccines and autism was actually an "elaborate fraud." It is the culmination of a more than decadelong controversy in which the charge was initially and frighteningly plausible, then embattled, then discredited by large-scale studies.

This is a particular blow to the parents of children with autism, who deserve more explanation and support than they are generally given. Autism has stubbornly resisted simple scientific explanation. This calls for more research and more practical help for parents - not less.

The vaccine controversy in America and Europe was made possible by the success of vaccines. If children in developed countries faced the serious prospect of contracting measles, mumps and rubella - leading, in some cases, to pneumonia, seizures, deafness, brain damage, infection of the spinal cord or arthritis - the value of vaccines would be more immediately obvious. During the 20th century, an average of 650,000 people died each year from measles, polio, rubella, smallpox and diphtheria. Now it is less than 100.

Only countries that possess herd immunity debate the importance of vaccines. Yet not every country enjoys such an advantage.

Vaccines are among the greatest scientific contributions to human welfare. They are also some of the largest humanitarian contributions of developed nations to the rest of the world. So it is unfortunate that a decade of vaccine controversy has overshadowed a decade of vaccine miracles.

In 2000, with startup money from the Bill and Melinda Gates Foundation, the Global Alliance for Vaccines and Immunization began operation, with the goal of introducing new or underused vaccines into poor countries. GAVI is an acronym that reeks of global bureaucracy, slow-moving secretariats and Geneva consultations. The organization, in contrast, has turned out to be innovative and effective.

The alliance - composed of foundations, donor governments, vaccine manufacturers, the World Bank and the World Heath Organization - has employed the free market instead of fighting it. It has raised private capital, and it has made advance commitments to purchase vaccines, in exchange for pledges by pharmaceutical companies to expand production and provide vaccines at lower prices. It has helped to strengthen the "cold chain" that allows for vaccine delivery at proper temperatures.

The result? By the end of 2008, 192 million children had received vaccinations against hepatitis B, and 41.8 million were protected against Hib (a type of bacteria that causes meningitis). During its first decade, GAVI-funded vaccines for these diseases - along with pertussis, measles, yellow fever and polio - prevented more than 5 million premature deaths.

When it comes to human lives, the word "million" should not be passed over without comment. It was the unit of measure for 20th century genocides. So it is remarkable that an organization, almost unknown to Americans, should count 5 million success stories. It is a demonstration, for anyone who doubted it, that foreign assistance can be effectively redesigned and focused on achievable outcomes. It is also living proof that science, guided by conscience, is one of the most powerful, hopeful forces of history.

Many global problems are desperate but seem beyond our ability to comprehend or resolve. Sufficient support for GAVI from governments, foundations and individuals would solve much of this problem. The answer for millions of dying children does not need to be invented, studied or tested. All this has been done. Their hope lies within a locked room. And those with keys gain responsibilities