The rapid introduction of safe, effective, and affordable rotavirus vaccines is urgently needed in developing countries, where nearly 500,000 children a year die from the disease, according to the most recent mortality estimates reported at the Sixth International Rotavirus Symposium.
The symposium marked a watershed in the decades-long effort to bring such vaccines into use.For the first time, scientists, policy makers, economists, public health experts and the donor community together tackled the scientific, social, and economic issues that must be resolved for rotavirus vaccines to become widely accessible to the children who need them most—those living in developing nations.
First discovered by Dr. Ruth Bishop in 1973, rotavirus is described as a “democratic infection”afflicting nearly all children, whether rich or poor, by the age of 5.Yet it is the world’s poorest children who are most likely to die from rotavirus. More than 80 percent of rotavirus deaths occur in developing countries where resources are scarce and health care systems inadequate. By breaking with past practices and focusing clinical trials and licensure efforts in middle- and low-income countries,the global health community would save lives and change the lives ofchildren too chronically sick and weak even to attend school.
With two new vaccines nearing the completion ofclinical trials,the global rotavirus community finds itself at a pivotal juncture in the effort to overcome the devastating mortality caused by rotavirus. Successful, widespread introduction ofthese vaccines will hinge on the answers to three fundamental questions:
Efficacy:will the new vaccines work equally well for children in lower income countries as in upper- and middle-income countries?
Safety:will a few adverse events lead to the withdrawal of the vaccines?
Cost:will the new vaccines be priced and financed in a way to ensure long-term affordability and sustainability?
Without sustained political and financial commitment at the global,regional,and national levels, rotavirus will
continue to sicken and kill children around the world.Decisive action is urgently needed. In a declaration signed by health officials from 16 Latin American countries during the symposium,delegates agreed “to continue to support immunizations in the region as a common good in the region and as the highest political priority”and “to facilitate the introduction of the rotavirus vaccine, as soon as it becomes available at affordable price for the countries in the region.”