Nicaragua Combats Pneumonia in Country’s Young Via New Vaccine


bjbjLULU JEFFREY BROWN: And, finally, tomorrow
is World Pneumonia Day, highlighting a disease that continues to destroy lives around the
world. Ray Suarez recently traveled to Nicaragua to look at efforts to combat the problem there.
RAY SUAREZ: It’s an unlikely place to see the results of a multimillion-dollar business
deal, a one-room church in rural Nicaragua. Here, children in the tiny village of Timal
(ph) are receiving a lifesaving new vaccine, brought to market through a revolutionary
business model. The vaccine prevents bacterial pneumonia. It’s sorely needed in Nicaragua,
where pneumonia is the number-one killer of children under five. DR. BRIAN CHAVEZ, Nicaragua
(through translator): The main symptoms are difficulty in breathing, a fever, and loss
of appetite, which leads to malnutrition. But these towns are difficult to access and
families have a hard time traveling to a hospital, so for this illness, often death is the final
outcome. RAY SUAREZ: Even those babies who do make it to a hospital face daunting odds.
DR. FELIX SANCHEZ, Children’s Hospital, Managua (through translator): Twenty percent of the
children in this hospital are admitted for pneumonia, and more than half of them will
die. RAY SUAREZ: Infants, who don’t have a mature cough reflex, are most at risk. Globally,
pneumonia is the single biggest killer of children, accounting for nearly one in five
deaths among young children, with an estimated 1.8 million deaths annually. Ninety percent
of the pneumonia deaths each year occur in the developing world. Nicaragua is poor, the
second poorest country in the Western Hemisphere. Like other developing countries, Nicaragua
could not afford a new vaccine like the one for pneumococcal pneumonia for its children
without a steep price reduction. And that’s just what it got with this pneumonia shot,
a whopping 95 percent discount. How do you get the cost of a vaccine down from about
$100 a dose to less than $5? By assuring pharmaceutical companies a steady stream of revenue, by guaranteeing
that all the children in a country will be vaccinated. The pharmaceutical companies,
in this case, Pfizer and GlaxoSmithKline, were promised a huge market of customers if
they kept costs down. Dr. Orin Levine runs the International Vaccine Access Center and
teaches at Johns Hopkins University. DR. ORIN LEVINE, Johns Hopkins University: So the advanced
market commitment basically says, we will assure that there’s a market, that there is
money on the table, if you make a vaccine that meets the needs of developing countries
and if the developing countries demand it. RAY SUAREZ: The unusual pharmaceutical deal
was brokered by the Global Alliance for Vaccines And Immunization, now known simply as GAVI.
The GAVI Alliance, which includes the Bill and Melinda Gates Foundation, also a NewsHour
funder, donated $1.5 billion. Without that cash, new vaccines do eventually make it to
the poorest countries, but only after years of delay. Dr. Seth Berkley is GAVI’s CEO.
DR. SETH BERKLEY, GAVI: That takes 15, sometimes 20 years, and that’s usually the time lag
between when these products appear and they get into those living in the poorest countries.
What GAVI has tried to do is shrink that. And with pneumococcus, it’s one of the first
examples or best examples of a product that, a few years after it came out in the West,
it already was being rolled out in the developing world. And that is a really exciting intervention.
RAY SUAREZ: Nicaragua was the first developing country to roll out the pneumococcal vaccine
one year ago. It was a tragic case of bad timing for Diana Del Socorro Blanco Guevara
(ph), whose 17-month-old daughter, Angie (ph), got sick and became gravely ill just as the
vaccine was introduced here. DIANA DEL SOCORRO BLANCO, mother (through translator): My daughter
got worse suddenly. She got tired. She couldn’t get enough oxygen. They took her in a room
and told me they had to put a tube down her throat. They put I.V.s everywhere. RAY SUAREZ:
Angie died in early February, after weeks of struggling to breathe. DIANA DEL SOCORRO
BLANCO (through translator): I suffered when I saw my daughter in the hospital. People
said we should leave the hospital, but we stayed. We slept on top of cardboard, under
trees. I don’t want to see other mothers go through what I went through. I have never
lost something I loved so much in my life. DR. ORIN LEVINE: Pneumonia is an illness and
pneumococcus is a bacteria that infects everybody all around the world, but the consequences
are uneven. So in places like Nicaragua, where people live in poverty, the consequences of
the infection are more severe, because they may be undernourished, they may be living
in an essentially more dangerous housing and environment. And they oftentimes lack access
to the lifesaving antibiotics and oxygen therapy. RAY SUAREZ: For every one child who dies from
pneumonia in rich countries, 2,000 die in developing countries. DIANA DEL SOCORRO BLANCO
(through translator): It makes me feel good to know there is a solution now for the children,
so that mothers won’t have to suffer what I suffered with my terrible loss. I think
about her every day. You may not see it, but I am thinking of her. The memories, they are
there every day. RAY SUAREZ: Karla Maria Fonseca Cuadra (ph) is Blanco’s neighbor. Fonseca
saw how devastating the loss of Angie was to the baby’s mother, and made sure to vaccinate
her three children. One suffers from asthma. KARLA MARIA FONSECA (through translator):
He is very susceptible to getting sick. His asthma has left him weak, but I imagine now,
with the vaccine, he is much safer. DR. ORIN LEVINE: The beauty of science, when we make
a big breakthrough, is when it brings about social justice, when it essentially eliminates
the kind of disparities in risk that children in poverty face, and so by virtue of the fact
that now we can get lifesaving pneumococcal vaccines to children in Nicaragua the same
time we get them to children in Newark. RAY SUAREZ: But delivering health care, bringing
it to where people can get it when a government can only spend a few dollars a year per patient
is a challenge, sometimes made even harder by government corruption. So GAVI also requires
that countries like Nicaragua show in advance they can reach at least 70 percent of their
citizens. DR. ORIN LEVINE: In a way, it’s kind of a carrot. It encourages countries
to strengthen their systems and to reach every child in order to make themselves eligible
to qualify for these new vaccines. RAY SUAREZ: Nancy Vasconez is an immunization adviser
for the Pan American Health Organization, PAHO, part of the United Nations. She says
that promise of wide distribution is a huge undertaking for a developing country like
Nicaragua. NANCY VASCONEZ, Pan American Health Organization (through translator): It is commitment
the government makes. And the commitment doesn’t last one day or one year. The contract is
for 20 years. The government must pay personnel and supervisors to make sure the vaccine is
used correctly and gets to where people live. RAY SUAREZ: Nicaragua’s health workers fan
out, armed for battle with coolers filled with the vaccine. NANCY VASCONEZ (through
translator): I know we can’t measure the cost of death, but if we measure the number of
years by which we prolong life and prevent debilitating illnesses, we can measure the
cost of a life, and I believe the government of Nicaragua made the best investment. RAY
SUAREZ: The GAVI Alliance plans to continue its rollout to more than 40 countries, and
hopes to prevent 700,000 deaths by 2015, and seven million deaths by 2030. Oh, yes, it
hurts all right, but that man with the needle just may be saving your life. urn:schemas-microsoft-com:office:smarttags
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