Diarrhea is the third biggest killer of children under five years of age in Zambia (40 per day; 15,000 each year), and rotavirus, the most common cause of severe and fatal diarrhea in young children, is responsible for nearly one-third of those deaths. As in many countries in sub-Saharan Africa, the region with the highest rates of rotavirus mortality worldwide, rotavirus contributes heavily to the tremendous drain on the health and economic resources in Zambia:

Vaccines are the best way to protect children in Zambia and the rest of the world from severe rotavirus diarrhea and the deadly dehydrating diarrhea that it causes.

Rotavirus vaccines play an essential and life-saving role in comprehensive diarrhea control strategies and are already saving lives and improving health in the countries where they are in use. A coordinated approach that combines rotavirus vaccines with other prevention and treatment methods, including oral rehydration therapy, zinc, breastfeeding, improvements in water, sanitation and hygiene as well as proper nutrition, will achieve the greatest impact on diarrheal disease morbidity and mortality.

Last week, an innovative, multisectoral partnership between the Zambian Ministry of Health (MoH), the Centre for Infectious Disease Research in Zambia (CIDRZ), and Absolute Return for Kids (ARK) launched the Programme for Awareness and Elimination of Diarrhea (PAED) to strengthen Zambia’s capacity to provide comprehensive diarrheal disease prevention and treatment strategies, including the introduction of rotavirus vaccines in the capital, Lusaka, to reduce the huge number of child deaths from diarrhea.

PAED’s coordinated approach to addressing the substantial burden of diarrheal disease in Zambia includes:

PAED hopes that the introduction of rotavirus vaccines in Lusaka and the scale-up of health worker training and community-level education will provide the MoH with the implementation and public health experience necessary to expand its program and vaccinate all Zambian children. Zambia is a GAVI-eligible country, and the MoH aims to work with GAVI to support its nationwide introduction and sustained use of rotavirus vaccines.

In addition to the contributions of CIDRZ and ARK to PAED, the Bill & Melinda Gates Foundation will support PAED’s monitoring and evaluation efforts, and GlaxoSmithKline has donated vaccines for PAED’s Lusaka rotavirus vaccination program in 2012.

RotaFlash is an e-news alert that provides breaking scientific news and updates on progress made by PATH and partners (GAVI, WHO, UNICEF, US CDC, manufacturers, universities, countries) toward increasing global access to vaccines against rotavirus, the leading cause of severe and fatal diarrhea in young children worldwide. RotaFlash is produced by PATH and funded by the GAVI Alliance and is one of the main advocacy and communication vehicles used to support accelerated introduction and access to rotavirus vaccines where children need them most urgently. If you’d like to learn more about rotavirus or receive PATH’s periodic RotaFlash newsletter, email rotavirusvaccine@path.org.

During my years of practice in the largest pediatric hospital of Cameroon in Yaoundé, I remember that the 300 beds were rarely empty. I was in charge of the gastroenterology and paediatric nutrition ward, where 28 beds were occupied more than 90 percent of the time by infants who were dehydrated and suffering from severe diarrhea.

Our problem was not the diarrhea itself — its treatment protocols are well known; oral re-hydration salts, adequate re-nutrition, zinc supplementation, intravenous (IV) fluids for the most severe cases — but in making real the possibility of preventing severe diarrhea. It was and still is common for children in Cameroon and other parts of Africa who are suffering from severe diarrhea to die due to limited access to oral re-hydration salts, IVs, clean drinking water, or even the inability to reach a hospital in time.

Rotavirus is the leading cause of severe diarrhea in children under five years of age worldwide, killing more than half a million children each year and hospitalizing millions more. Nearly 50 percent, or 230,000 of those rotavirus deaths, happen in Africa. Worldwide, more than one third of the 1.34 million diarrhea deaths in children under five years of age, and 40 percent of the 9 million diarrhea-related hospitalizations are due to rotavirus disease. In Africa, the percentage of rotavirus-related hospitalizations is even a bit higher at 41 percent. These facts may be little-known, yet diarrhea remains the primary cause of child mortality in Africa. In Cameroon, diarrhea is the third highest cause of death in children under five years old. Thirty percent of those diarrheal deaths are due to rotavirus.

We need to draw attention to the devastating role of rotavirus in causing death to millions of young children. My hopes of delivering a rotavirus vaccine across all of Africa must one day become a reality, not only to prevent hundreds of thousands of unnecessary deaths, but to boost our fight against poverty.

And let’s not forget the economic costs of diarrhea; of hospitalization, of medications, of parents or caregivers who must stop work, and of young lives lost. This leads to a vicious circle, where diarrhea that is inadequately treated can cause malnutrition, which can decrease immunity and lead to further re-infection with diarrhea or other diseases. Vaccination offers the best hope for preventing severe rotavirus disease and the deadly dehydrating diarrhea that it causes.

I am proud that in July 2011, with the support of the GAVI Alliance, Cameroon introduced a vaccine against pneumococcal disease, the leading cause of pneumonia, and aims to introduce the rotavirus vaccine in 2013. None of this would be possible without political will, the active contribution of donors, and the efforts of the Government of Cameroon and its Immunization Programme, which have made the environment conducive to helping these life-saving vaccines reach the children who need them most.

I am delighted that our children are finally going to be protected against the main causes of diarrhea and pneumonia, the world’s two biggest killers of children under five and the leading killers here in Cameroon. There is no reason for such unjust deaths, and we now eagerly await the rotavirus vaccine to reach us in 2013.

Dr. Clarisse Loe Loumou, pediatrician and member of the Steering Committee of the GAVI Civil Society Organization Constituency.

The government of Benin, as well as those of the Central African Republic (CAR) and Cameroon, announced today that they are working with GAVI to introduce vaccines to combat pneumonia, one of the biggest killers of children worldwide. As the vaccines come in, countries will have to work with many kinds of people — government officials, NGOs, community leaders, health care workers, and yes, even shamans — to guarantee a successful roll out.

This good news comes off the back of a recent GAVI victory. Just a few weeks ago, donors around the world committed a whopping $4.3 billion in additional funding to GAVI over the next five years to support the roll-out of new and underutilized vaccines.

“The introduction of this vaccine represents a major milestone for our young generation. This new vaccine gives them hope today that they will grow up healthy and lead a productive future,” says Dr. Jean Michel Mandaba, minister of Health of the Central African Republic.

Pneumococcal disease, the leading cause of pneumonia, is the major cause of death among children under the age of five. It is also responsible for meningitis, which can leave survivors with disabilities like mental retardation and seizures.

The roll-outs of these vaccines in the CAR, Benin and Cameroon will start taking place next month and will help make a positive impact on the mortality rates of of children in these countries. Undoubtedly, the roll-outs will face challenges and will take a great deal of effort from many actors—but we know from past vaccination campaigns that the work is doable and the results are incredible.

So, congratulations to GAVI and the governments of these three African nations. We wish you the best on your vaccine roll-outs. And if you haven’t watched our “Vaccines and Voodoo” documentary yet, watch it here.

This great news made headlines all over the world. You can read some of this week’s US media coverage of the pledging conference below including a mention of ONE’s statement in a White House blog post and an article from TIME magazine on how the vaccine conference was a victory for global health.

Renewed Commitment to Global Vaccines and Immunizations Will Save Lives – Blog post on the U.S. commitment to global vaccines and immunizations with mention of ONE’s statement of support.

Why the London Vaccine Summit Is a Triumph for Global Health – Article on how money pledged will help save 4 million lives

Day of the Child: 250 Million Kids to Receive Lifesaving Immunization – Information on USAID’s involvement with the U.S. commitment of $450 million

GAVI Pledging Conference Tops Funding Target – Article on public and private donors commitment total of $4.3 billion

Music to the World’s Ears - Bill Roedy, former chairman and CEO of MTV Networks International calls on CEOs and corporate executives outside the vaccine industry to help GAVI deliver life saving vaccines.

On Monday morning, ONE members woke up to the fantastic news that the Obama administration had pledged $450 million over the next three years to the Global Alliance for Vaccines and Immunizations (GAVI), making clear that GAVI is a priority in the president’s global health agenda.

What you may not know is that Congress helped elevate GAVI on the president’s agenda. Democrats and Republicans in both the House and Senate weighed in, expressing their support for this program which has delivered vaccines to more than 288 million children since 2000. Several members, including Rep. Heath Shuler and a bipartisan handful of senators sent letters of support.

In the House of Representatives, Rep. Chris Van Hollen led a bipartisan the effort of 62 members to make a strong showing of their support for GAVI in a letter to USAID Administrator Rajiv Shah saying, “Childhood vaccines in particular are one of the most cost-effective ways to save lives and prevent disease for a lifetime… GAVI now has an exciting opportunity to make significant advances.” The letter emphasized GAVI’s importance and success in having “directly prevented over 5.4 million future deaths since 2000.”

Thanks to their support and yours, US funding will provide GAVI new capability to tackle the two leading killers of children under the age of five: pneumonia and diarrhea. GAVI aims to administer a pneumonia vaccine to 90 million children and a diarrheal vaccine to 53 million children. The 62 representatives who signed the letter include:

We thank you all your hard work to win this victory. And if your representative or senator sent or signed a letter in support GAVI, please take a few minutes to call or write and thank them for supporting GAVI, too.

ONE members at the GAVI conference yesterday

For months now, we’ve been asking our ONE members to give it all they have on our vaccine campaign. We asked our members to use every advocacy tool and skill they had to make sure that we won this important fight to save 4 million children in five years. We all worked so hard to generate more than 150,000 signatures on our petition, we placed thousands of calls, we wrote thousands of letters and emails, and we used Twitter to make sure our voices were heard.

Because of your skill at advocacy, your hard work and a ton of determination, it worked. We won!

Yesterday in London, USAID Administrator Raj Shah announced that the Obama administration is committing $450 million over the next three years to the GAVI Alliance — the exact amount of funding we asked for. That money will help immunize more than 250 million children, averting 4 million premature childhood deaths.

Your hard work was incredibly effective but, you know what, don’t take it from me — take it from Administrator Shah himself! He was kind enough to share a video message to our ONE members on the US’ pledge to GAVI. (Hat tip to Nadeem Javaid for snagging this video).

Joseph Powell from our global policy team had a chance to congratulate Mr. Shah on the US GAVI pledge during a Q&A session this morning. Mr. Shah said he’ll be relying on ONE to help him get it through Congress. So you know what that means: we still have work to do.

And Bono, ONE’s cofounder, summed it up nicely in a quote from today’s press release:

“In most parts of the world diarrhea is a nuisance. In Africa, it can be a death sentence. Too many kids are lacking the medicines we can find at any corner drug store. Vaccines are a global health game-changer. And today, President Obama has said he is in it to win it. Along with strong commitments from others, the goal of saving four million kids in the next few years is within reach. The UK’s David Cameron deserves great credit for leading this powerful effort. Vaccines are simple, powerful, cost-effective tools that can save millions of lives. It’s crazy just how much sense it makes.”

As the US campaign director for ONE, I can’t tell you how proud I am of each and every one of you. All of you are champions!

It just goes to show that when we use our voices and work together, we can make amazing, lasting change in the world. So, give yourselves a well-deserved pat on the back and tell us how you feel in the comments below. Thanks to you, millions of kids around the world have a brighter future.

Photo courtesy of GAVI

In fact, in spite of tough economic times, donors collectively pledged $4.3 billion between now and 2015 — surpassing GAVI’s $3.7 billion funding gap — setting GAVI and its partners on the path toward saving nearly 4 million children’s lives in the next five years.

Some notable pledges from the donor pool:

For a full breakdown of who committed what, visit GAVI’s website.

Of course, as advocates and legislators know well, pledges made do not always equal money in the bank, and so today marks just the first, critical step in our efforts to improve access to new and underutilized vaccines.

Today we can celebrate, though, after world leaders have affirmed with their pledges what we’ve been campaigning on for months: investing in vaccines for the world’s poorest children is a smart, cost-effective way to save lives.

Thanks to ONE members for your hard work on behalf of this campaign. Stay tuned for more GAVI analysis and commentary from ONE staff in London!

One of the key commitments to come from G8 meetings is to provide funding. These are some of the world’s wealthiest nations, and their commitment to helping the world’s poorest can mean life and death for millions –- literally. So, it’s sad to note that the G8 members’ own accounting from last week shows it’s about $19 billion behind in commitments already made. That will mean more people getting infectious diseases, fewer kids getting vaccines and education, and delays in helping small farmers compete in a global market.

A bit of a bright spot in all this is the honesty and integrity of UK Prime Minister David Cameron, who has steadfastly defended his government’s commitment to meeting its aid obligations -– even against withering criticism from some in his own party. The BBC quotes him as saying, “The UK will not balance its books on the backs of the poorest.”

Wouldn’t it be nice if President Obama made that kind of statement, and backed it up with real political leadership? So far, in the global health sphere, there’s been a lot more talk than action. Frankly, the White House-announced Global Health Initiative is looking like all of the Bush initiatives packaged together with less funding and little coordination. The President’s Emergency Plan for AIDS Relief? The President’s Malaria Initiative? The Neglected Tropical Diseases initiative? All President Bush, not President Obama. And funding for these and other key efforts look pretty flat. The one bright spot looks like the Global Fund to Fight AIDS, TB and Malaria which the Administration has agreed to increase –- though well below what it should be.

In a few weeks, there’s another opportunity for President Obama to step forward and put his own imprint on global health. Prime Minister Cameron is hosting a donor meeting on June 13th to close a funding gap for the Global Alliance for Vaccines and Immunization (GAVI). If donors step up, GAVI can help countries expedite access to two great new vaccines for rotavirus and pneumococcal, which help prevent two of the leading killers of children in the developing world. So far, all we’re hearing is tired protestations of budget woes. Well, look across the pond. The UK has plenty of problems, but its leader is leading. President Obama, it’s your turn. The ONE request is clear: pledge $450 million over three years to GAVI, and help save 4 million kids.

Growing up in a Ghanaian coastal village, the dry and dusty trade winds that blew in from the Sahara were associated with Advent, Christmas and happiness.

But as I moved inland with my work, they also became linked with meningococcal meningitis A (men A), Ghana’s most common form of meningitis, which brought major epidemics every eight to 12 years.

Men A strikes children and young adults suddenly, causing severe headaches, fever and a stiff neck. Patients can die within 48 hours.

I still remember the hospital wards where I used to work. Meningitis patients were usually on the floor because their seizures made them fall off the bed. As a medical student, I often had to bend the rigid patients into a fetal position so that I could extract the cloudy fluid from their spinal cord and confirm the suspected diagnosis. Year after year, we gave intravenous antibiotics every four hours and prayed the patient would survive without major complications.

In 1989, I became the district medical officer responsible for preventive health of a city of one million people. On one memorable occasion, with an epidemic threatening, a terrified crowd of people nearly broke down the vaccine cold store door in an attempt to get the vaccine. The fear on their faces was palpable.

Then, in 1997, the biggest-ever Men A epidemic struck, not just in the four northern regions as usual, but throughout the country, hitting about 20,000 people.

And just a few years later, in 2001 a close relative of mine, a healthy 20 year old, began complaining of a headache. He later collapsed and was given intravenous antibiotics. Within 48 hours, he was dead.

His death devastated my family, with rumors amok about the role of evil spirits. A decade later, my extended African family is still coming to terms with the loss.

I’m proud to say the GAVI Alliance has just committed another US$100 million to support the roll-out of a new conjugate vaccine, MenAfriVac, to rid the region of these men A epidemics. If our pledging conference is successful on June 13, GAVI will be able to roll this vaccine out to all African countries at risk.

This Christmas, I am taking my children back to Ghana. The new men A conjugate vaccine gives us the opportunity to celebrate without fear of this ancient scourge. It provides us hope for the future.

- Mercy Ahun, managing director of GAVI’s Program Delivery Team

Crossposted on Bill & Melinda Gates Foundation’s Foundation Notes blog