Vaccines for neglected diseases in Africa
Another item out this week offers a cautionary note. In a PLoS Medicine article, Ayodele Samuel Jegede analyzes why three states in Nigeria boycotted the polio immunization campaign back in 2003. As Jegede describes it, there were a number of factors at play, including the rumor (fed by US military involvement in Iraq) that the vaccine would be used by the Western world to make people in the Muslim areas of Nigeria infertile or infect them with HIV. Another factor was the 1996 scandal of the Pfizer Trovan trial, where the experimental antibiotic trovafloxacin was tested against the standard of care during a meningococcal meningitis outbreak in Northern Nigeria. But the factor that struck me was that communities in Nigeria were reluctant to embrace the very idea of free vaccines. Jegede quotes from a report in the Baltimore Sun:
The aggressive door-to-door mass immunizations that have slashed polio infections around the world also raise suspicions. From a Nigerian’s perspective, to be offered free medicine is about as unusual as a stranger’s going door to door in America and handing out $100 bills. It does not make any sense in a country where people struggle to obtain the most basic medicines and treatment at local clinics.
Successfully vaccinating a population apparently involves more than just making it cheap. It remains to be seen whether GSK’s commitment extends to the nitty-gritty work of engaging with local communities to find appropriate ways of putting new high-tech drugs into the bodies of African children.