rotavirus
This blog post is reprinted from the Manila Times with permission from the author. For more information about the enormous burden of rotavirus disease in Asia and the introduction of rotavirus vaccines in the Philippines, check out PATH’s RotaFlash.
DIARRHEA is a leading killer and cause of illness in children in Southeast Asia, and many do not realize that a major cause of childhood diarrhea is a virus called rotavirus. The Philippines will soon become the first country in the region to provide rotavirus vaccines to its most vulnerable children. Rotavirus mainly causes illness in young children living in areas where there is a significant risk of dying from severe diarrhea and vomiting. The good news is that most of these deaths can be prevented with vaccines and managed with simple treatments, if available and accessible.
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Dr. Clarisse Loe Loumou of GAVI’s Civil Society Organization Constituency makes a major announcement that will affect the health of millions of children around the globe.
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.
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This is a guest blog by Dr. Amani Abdelmoniem Mustafa, manager of the Expanded Programme on Immunization for Sudan. Read the original version on the Global Health Council’s Blog 4 Global Health.
The first child in Sudan to be vaccinated against rotavirus drew a big crowd at Samir Health Center.
KHARTOUM, Sudan — The day that we were waiting for arrived. The children of Sudan have long suffered terrible, sometimes deadly, diarrhea caused by rotavirus. Fortunately, there is a vaccine that can save our children from so much suffering. After years of waiting, it was finally delivered to Sudan.
The first stop was the Khartoum International Airport. It was a great event.
The Martinair flight landed at 7:45 at night. The media with their cameras huddled in the non-permitted area where the flights land. They were accompanied by cars with generators to light up the runway. Those of us on Sudan’s Expanded Programme on Immunization (EPI) team crowded into the packed VIP hall. We had the challenging and exciting job of making sure this new vaccine travels the length and breadth of the country to reach all the children. At that moment, we wanted to be as close as possible to watch the vaccine coming to Sudan.
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Election raises concerns about suppression of rights – Rwandan president, Paul Kagame, is set to win another term Tuesday in an election marred by killings, a lack of credible political opponents and censorship. Critics are calling the leader the continent’s latest strongman, suppressing human rights to deepen his grip on power. (Sudarsan Raghavan, Washington Post)
American leadership crucial at MDG Summit – President of Bread for the World, Rev. David Beckmann, argues that by showing leadership on foreign assistance reform at the upcoming Millennium Development Goals Summit, President Obama will “attach actions to his words on development“ and hopefully lead others to empower the world’s poorest people to realize a brighter future. (Huffington Post)
U.S. plan fails to end Africa’s trade isolation – Ten years after the U.S. adopted the African Growth and Opportunity Act (Agoa) – a program that boldly proclaimed it would help end Africa’s isolation from world trade – American officials are being candid about its failures, emphasizing its modest results despite “the highest of hopes.” (Alan Beattie, Financial Times)
Sierra Leone taking initiative for maternal health – Health advocate, Mary Robinson, highlights the major steps Sierra Leone has taken in promoting maternal health and gender equality, both for its people and globally as a model of leadership and initiative in this critical area. She calls for other nations to look to Sierra Leone as an example as we move toward review of the Millennium Development Goals.
Rotavirus vaccines save poorest children, say reports – Trials in Asia and Africa show rotavirus vaccines can prevent between 39 to 48 percent of infections among children in some of the poorest countries in the world, with new reports urging governments of developing nations to make the vaccines a priority. (Maggie Fox, Reuters)
Today a lot of people (including us at ONE) are celebrating the big news– via The Lancet– that two sets of clinical trials in Asia and Africa showed that new rotavirus vaccines can significantly reduce child deaths. Among those celebrating: Melinda Gates.
You might recall last October, Melinda Gates talked a bit about rotavirus in the Gates’ “Impatient Optimists” presentation:
Today she took to the Foundation Blog to write a bit more about the disease:
Knowing that we have simple, cost-effective ways to prevent something that rarely kills children in the developed world breaks my heart.
Let’s face it – no one likes talking about diarrhea. But we should be doing just that because we have the opportunity to save 4,000 children’s lives every day by preventing diarrhea-related illnesses. We have the tools to combat diarrheal disease and the fatal dehydration it can cause – and it’s my goal to see them used in much higher numbers than they are today.
While deaths from diarrhea have decreased globally due to vaccines, antibiotics, oral rehydration therapy, and improved water and sanitation, diarrheal diseases remain the second-leading cause of childhood death. Each year, diarrhea causes more than 1.5 million deaths in children under 5—nearly all of whom live in low-income countries.
Rotavirus is the most common cause of severe diarrheal disease in children worldwide and is responsible for the deaths of more than 500,000 children each year. The rotavirus vaccine, common in the US and other developed countries, has been introduced in a few developing countries, and we hope that it will soon be available in many more.
Photo credit: Bill and Melinda Gates FoundationWe’ve dedicated a lot of space on this blog to rotavirus — a disease that is the most common form of childhood diarrhea.
Diarrhea is something we often think of as gross or annoying, but it’s easy to forget that diarrhea is deadly, causing nearly 500,000 deaths each year primarily in Asia and Africa.
We’ve also dedicated a lot of blog posts to the GAVI Alliance, because among other things, they’ve been a driving force behind an effort to accelerate access to a vaccine for rotavirus to children in the developing world, alongside partners like Merck, GlaxoSmithKline, PATH, the WHO and the CDC.
But developing a new vaccine for resource-limited settings is a challenging process that takes years of hard work and a lot of money — and it’s a process that’s certainly not guaranteed to work. Which is why today we’re celebrating big news out of medical journal The Lancet: two sets of clinical trials in Asia and Africa showed that new rotavirus vaccines can significantly reduce child deaths.
The Asian trial took place in Bangladesh and Vietnam, testing the efficacy of the vaccine (essentially, how well it protects against disease) in more than 2,000 infants. The study showed that the vaccine had 48.3 percent efficacy against severe disease. When combined with other efforts to improve child survival — oral rehydration salts, zinc, exclusive breastfeeding and improved hygiene and sanitation — diarrheal deaths could be reduced even more.
The African trial, which took place in Ghana, Kenya and Mali, also demonstrated that the rotavirus vaccine offered significant protection for young children. In fact, vaccination reduced severe cases of rotavirus by 64 percent in the first year of life. These findings were consistent with those from a previous study conducted in Malawi and South Africa.
While the percentages from the studies may not seem overwhelmingly high (We’re using a vaccine that works only half to 60 percent of the time?), the vaccine actually represents a critical tool that will help control one of the major killers of children around the world. Even with these lower efficacy rates, we have to remember that the rotavirus vaccines will still have a huge impact on reducing severe disease in Africa and Asia because so many more children are dealing with disease there than in the United States or Europe.
But how well a vaccine prevents against disease doesn’t tell the whole story, either, because the health care systems in the developed and developing world are vastly different. If a child gets diarrhea in the U.S., a parent can easily access medicines to treat him or her and — in worst case scenarios — take their child to the hospital for emergency care. But because medicines and health facilities are tough to access in much of the developing world, rotavirus vaccination can be a child’s only chance at survival against diarrhea in Africa and Asia.
Major congratulations are due to all who have worked on rotavirus vaccine development and studies to date, and an additional debt of gratitude is owed to the parents who volunteered their children for the trials. We’re thrilled at the news and for what it means for the health of children and families across the developing world. We’ll keep you posted with more on the vaccine and efforts to deliver it in the field in the coming months!
ONE co-founder Bono’s most recent column for the New Year Times, on 10 ideas for the next 10 years, was published today. I wanted to share it because it calls attention to a few ideas that are in our area of work, including the rotavirus vaccine and the upcoming World Cup in Africa.
Below is an excerpt. You can read the full column here.
Happy New Year!
-Kathy McKiernan
Taking the Fight to Rotavirus
The thing is, they exist, these vaccines. They’re not a mere hope, like an AIDS vaccine. And one of the brightest bits of news in 2009 is that rotavirus vaccines have been shown to work not only in nations with low child mortality, but in the poorest countries, where diarrhea (not a killer in our house) caused by rotavirus infections takes the lives of 500,000 children a year. The World Health Organization just this summer issued a strong recommendation that rotavirus vaccinations be part of every nation’s immunization program. From this vantage point, I like the look of the next decade.
The World Cup Kicks Off the African Decade
It’s getting easier to describe to Americans the impact of the World Cup — especially the impact it will have in Africa, where the tournament is to be held this summer. A few years ago, Ivory Coast was splitting apart and in the midst of civil war when its national team qualified for the 2006 jamboree. The response was so ecstatic that the war was largely put on hold as something more important than deathly combat took place, i.e. a soccer match. The team became a symbol of how the different tribes could — and did — get on after the tournament was over.
This time round, for the 2010 World Cup, naysayers thought South Africa could not build the stadiums in time. Those critics should be red-faced now. South Africa’s impressive preparations underline the changes on the continent, where over the last few years, 5 percent economic growth was the average. Signs point to a further decade of growth to come. Canny investors will put more capital there. This in turn has the potential to shore up fragile young democracies across the continent.
It would be fitting if Nelson Mandela, who has done more than anyone for Africa’s rising, would kick off the opening ceremonies. If he shows up, the world will weep with joy.
