Vaccines Without Borders to Latin America

Since their discovery by Edward Jenner, vaccines have not been free of controversy. In 1802, Anti-Vaccine Society, published a cartoon that reflected the fear that people would acquire cattle appendages if they were immunized.^[1] A century later (1902), the famous Pfeiffer incident occurred in the USA;^[2] the doctor, strongly opposed to vaccination, tried to prove that the smallpox vaccine was ineffective, entering a ward with smallpox patients. Despite becoming ill with smallpox and being on the brink of death, he continued to support the anti-vaccine movement. More recently, the controversy regarding the Wakefield article linking the MMR vaccine and autism^[3] caused a very negative impact on public health, when thousands and thousands of people became infected with the measles virus, suffering from this severe disease and its consequences.

Because of their effectiveness in preventing and controlling diseases, vaccines are considered one of the best public health interventions. Immunization strategies have been credited with a 10- to 15-year increase in life expectancy worldwide. Together, vaccination and assuring universal right to water and sanitation are the two strategies that have brought the greatest benefit to global health.^[4]

Despite its benefits, vaccines do not come with fairness and opportunity for all those who need them; there are still large disparities in access to modern and safe vaccines depending on the country. This gap, although it has been narrowing, remains wide open while the introduction of new vaccines in developing countries takes up to 10 years to be achieved.^[5] Among developing countries, the introduction of new vaccines is not only an economic issue, it is also a political matter based on the priority level and relevance of disease prevention in each country. Despite multiple efforts, children under 5 are still contracting and dying from rotavirus diarrhea and pneumonia.^[6] The initiative of the Bill and Melinda Gates Foundation 'Decade of Vaccines' launches an unmistakable message to the people, public and private institutions, governments, civil society and funders about the importance of supporting both the distribution of current vaccines and the research and development of new vaccines.^[7]

Efforts focus on the world's poorest countries, but what about middle-income countries? This is the case for the population in Latin America, and because of this, the Latin American Pediatric Infectious Diseases Society (SLIPE) in conjunction with American Health Foundation launched the initiative 'Vaccines Without Borders to Latin America' in Costa Rica on 7 June 2013. This aims to reposition vaccines as a human right, rather than a pharmaceutical product and urge all countries in the region to invest in this strategy. The opportunity for children to access vaccines, involves social equity and ability for children to grow up healthy and develop properly. Positioning vaccines, as a generator of development, is a decision based on scientific evidence, given the strong association between infectious disease and IQ.^[8,9] Healthier children tend to stay in school and if conditions are favorable, they will successfully complete their studies.

'Vaccine Without Borders' aims to generate a long-term vision, where vaccines are included in the various programs as a political and social priority. To achieve this objective, we need to assign resources in a sustainable way, and to implement interventions based on the epidemiological situation of each country. To improve health, the approach should be based on the determinants of health, through intervening in the causes of disease.

Why should immunization programs be supported and why should vaccines be considered as a human right? The answer lies in the analysis of the global health progress achieved as a result of the implementation of vaccination strategies. It is estimated that vaccines have saved the lives of 20 million boys and girls during the past two decades. Its benefits have reached approximately 77% of children under 18 years of age living in the poorest countries, who have been immunized against diphtheria, tetanus and pertussis. Vaccinating children against these three diseases and meningitis saves about 2.5 million lives a year. Vaccines are therefore health products that offer highly effective overall results, which do not compare with any other health tool. Furthermore, availability of vaccines against diarrhea and pneumonia, diseases that cause 40% of infant mortality, enhances the contribution of vaccines to global health.^[10,101,102]

In the speech to launch the initiative of 'Vaccines Without Borders', the Nobel Peace Prize winner and twice President of Costa Rica, Dr. Oscar Arias Sanchez said: "The bodies of young people should not bear the scars of war, marks of the indifference of a government that places little value on their lives. Instead, they bear a scar of peace, the mark that every person should have on his right arm from a vaccination administered a few months after birth. That is the symbol of a government genuinely concerned about the wellbeing of its people, a government that invests in the promise of its children and young people. Politicians, like the doctors, should be concerned about the health of people. Every time someone dies anywhere in the world because of a preventable disease, the scientific community receives a warning. But above all, the political community receives a reminder."

And that is precisely why SLIPE aims to call the medical community's and policy makers' attention to invest in vaccines, to recognize that if the disease does not respect borders, healthcare should also not respect borders. Health, prevention, access to vaccines should not be determining childhood differences between countries. From the technical and scientific point of view, Latin America has highly trained and prepared health professionals. Therefore, we now need to take the next step; we need to move forward to achieve the political and social support that we owe to our children, who are expecting a better world that guarantees their right to health.

Expert Rev Vaccines. 2013;12(11):1239-1240. © 2013  Expert Reviews Ltd.