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Immunization and the Convention on the Rights of the Child What would it take to achieve universal coverage?

Immunization and the Convention on the Rights of the Child What would it take to achieve universal coverage?. Daniel Tarantola M.D. Professor of Health and Human Rights School of Public health and Community Medicine University of New South Wales. Child Health.

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Immunization and the Convention on the Rights of the Child What would it take to achieve universal coverage?

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  1. Immunization and the Convention on the Rights of the ChildWhat would it take to achieve universal coverage? Daniel Tarantola M.D. Professor of Health and Human Rights School of Public health and Community Medicine University of New South Wales

  2. Child Health • CRC Article 24: Focus on primary health care • « States Parties shall pursue full implementation of this right and, in particular, shall take appropriate measures:… (c) To combat disease and malnutrition, through, inter alia, the application of readily available technology… (f) To develop preventive health care… »

  3. The right to the highest attainable standard of health • Art. 12 of International Covenant of Economic, Social and Cultural Rights • « The steps to be taken…shall include,,, (c) The prevention and treatment and control of epidemic, endemic, occupational and other diseases… » • General Comment 14: «… The control of diseases refers to…the implementation or enhancement of immunization programmes… »

  4. Causes of 10.5m early childhood (<5y) deaths Circa 2003 World Health Report (Annex table 2, unpublished data) 2004

  5. Leading causes of early childhood vaccine-preventable deaths, Circa 2002 72% of 2.6m VPD deathscan be prevented with 5 vaccines • Pneumococcal 28% • Measles 21% • Rotavirus 16% • Hib 15% • Pertussis 12% • Tetanus 8% • Yellow Fever <1% • Diphtheria <0.5% • Poliomyelitis <0.5% • Meningococcal<0.5% WHO/FCH/IVB/VAM, JUN04 (<5y, 2002 data)

  6. WHO, 2006

  7. The immunization gap WHO, 2006

  8. Countries where less than 50% of infants are vaccinated (2005) UNICEF/WHO 2005

  9. Five of 10 Countries with the largest population:each have more than 1 million infants unimmunized UNICEF/WHO, 2005

  10. Norms and standards Development of new vaccines Regulatory processes and quality Enhancing Immunization: from research to disease prevention Vaccine production, supply and financing Monitoring and disease burden assessment Immunization safety Vaccine delivery and accelerated programmes

  11. Low income countries use distinct products compared to other countries Diphteria Disease Haemoph. Measles Pertussis TB Hepat. B Polio Infl. B Vaccine Tetanus mono & combo with DTPw in combo with DTPw Low Income Countries mono BCG OPV wholecell in combo in combo Middle Income Countries wholecell in combo MMR BCG OPV with DTPw with DTPw High Income Countries* accelular in combo IPV in combo MMR none in combo in combo S. Jarrett, UNICEF Supply Division * Also use other vaccines: Pneumo. , Mening., Rotavirus, Influenza, Hep. A, Varicella and others

  12. The global vaccine market (Circa 2003) Industrialized countries Developing countries 15% 85% Population Disease Burden 7% 93% Vaccine market 82% 18% T=$6 Billion/y 90% 10% T= $500 Million/y Vaccine R&D Tarantola 2003

  13. MP Kieny, WHO, 2006

  14. Introduction of Hib immunization and Coverage (3 doses), 2004 Source: WHO

  15. Source: WHO

  16. Accelerating disease control • Polio • Measles • Maternal and neonatal Tetanus

  17. WHO, April 2006

  18. UNICEF/WHO, 2005

  19. Neonatal Tetanus Elimination 2004 WHO/UNICEF, 2005

  20. State Obligations • Highest attainable standard of health • « Every State Party undertakes to take steps, individually and through technical assistance and cooperation…to the maximum of its available resources, with a view to achieving progressively the full realization of the rights… » Art. 2 ICESCR

  21. Child rights and other human rights instruments Governmental obligations • To respect human rights • To protect human rights • To fulfill human rights The value of human rights: • Enshrined in national laws • Human rights principles help shape and monitor policies and programmes • International assistance and cooperation

  22. Moving towards universal coverage? • Political commitment • Health system strengthening • Research and development • Financing

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