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sexta-feira, 29 de janeiro de 2010

Gates Foundation to Double Spending on Vaccines



The New York Times
By DONALD G. McNEIL Jr.
Published: January 29, 2010

Endorsing vaccines as the world’s most cost-effective public health measure, Bill and Melinda Gates said Friday that their foundation would more than double its spending on them over the next decade, to at least $10 billion.

The change could save the lives of as many as eight million children by 2020, Mr. Gates calculated. He said he hoped his gift would inspire other charities and donor nations to do the same.

“Vaccines are a real success story,” Mr. Gates said in an interview before the announcement, which he made at the World Economic Forum in Davos, Switzerland. “The cost is tiny, and yet it saves more lives than any other component of a health care system.”

Julian Lob-Levyt, the executive secretary of the GAVI Alliance, a partnership among drug companies, health agencies and charities bringing vaccines to poor countries, said he “hugely welcomed” the announcement.

“If other donors follow the lead of the Gates Foundation and step up their funding for vaccines,” Dr. Lob-Levyt said, “GAVI has the ability to immunize millions of children against the world’s two biggest childhood killers, pneumonia and diarrhea.”

Vaccines already get more financing from the Gates Foundation than any other cause, and Mr. Gates said no money would be shifted away from other projects, like improved crops, assistance to small businesses and, on the domestic front, schools and libraries. Instead, he and Warren Buffett will increase their annual gifts to the foundation, and about 30 percent of all spending, up from 20 percent, will be for vaccines.

In calculating that eight million lives could be saved, Mr. Gates cited a computer model developed for the foundation by public health specialists at Johns Hopkins University.

Whether such an optimistic prediction comes true depends on several factors that are still uncertain.

For starters, Mr. Gates wants to make sure that 90 percent of the world’s children get shots for routine childhood diseases like measles, diphtheria, whooping cough and polio. Right now, almost 80 percent do. But with 134 million children born each year, it is a constant struggle to keep up, and efforts can be interrupted by factors like war, natural disasters, bad roads and corrupt officials.

Then he assumes that two new vaccines against rotavirus and pneumococcal disease, which are major killers of malnourished children, are adopted as routine immunizations in most poor countries and reach 80 percent of all children by 2020. Even in wealthy countries, the introduction of any new vaccine can be tricky because of bureaucratic and logistical delays and because unexpected rumors can spring up, like the persistent one that polio vaccine is a plot to sterilize Muslim girls.

Mr. Gates’s model also assumes that a malaria vaccine now in development by GlaxoSmithKline will be approved and will by 2014 reach at least some of the one million children, mostly in Africa, who die annually of the disease.

Yet the vaccine, known as RTS,S, is still in the testing phase. And as Mr. Gates acknowledged, “you can always be surprised” during clinical trials.

On the pessimistic side, his model assumes that no vaccine against AIDS or tuberculosis will be licensed during the decade — something that virtually all public health specialists ruefully agree with because progress on those has been very slow.

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