African Woman and Child Feature Service

Kenya has been selected as one of the countries set to introduce free anti-pneumonia vaccine to help tame a disease that is now the number one killer of babies and children in the country.

The rolling out of this vaccine will be significant as it will be the first time parents who have been unable to afford the close to Ksh 12,000 charged by private hospitals for the recommended three doses of vaccine will get it at no cost.

For the private sector, it is bad news as they will have to cut down their prices to attract clients who are likely to shift to the government programme.

Health experts are excited the vaccine will help avert the deaths of more than 30,000 Kenyan children, majority from poor backgrounds, who die every year due to pneumonia attacks and complications.

This new development has been made possible following the acceptance of the government’s proposal by the Global Alliance for Vaccines and Immunization (GAVI).

Under the new arrangement known as Advance Market Commitment, this vaccine will be sold to countries like Kenya at US$ 3.50 (Ksh 260 per dose).

The deal is even sweeter for the country since GAVI will meet US$ 14.55 of the US$ 15 total cost of three doses while the government is to contribute a paltry US$ 0.45 under the agreement.

“GAVI has agreed to support us and now we are finalizing the legal, financial and regulatory procedures before the vaccine is delivered to us,” says Tatu Kamau, the Head of Division of Vaccines and Immunization in an exclusive interview with Saturday Nation.

If things work as planned, the first batch of the vaccine is expected in the country early next year. The vaccine, which is registered for use locally, has been available in few leading private hospitals at exorbitant prices.

To help the poor people access these and other vaccines and reduce the high child mortality, the World Health Organization (WHO) recommends their inclusion in the individual country’s national vaccination programmes.

Although highly preventable when a vaccine and other practices are used, pneumonia is the leading cause of death among children aged under five years in districts where malaria is not endemic, while is rated as the second childhood killer in malaria endemic areas such as Kilifi, Kisumu, Kakamega, Kabarbet and Migori districts.

The government estimates the introduction of the vaccine is likely to cut by 70 percent the childhood pneumonia related deaths.

Globally, pneumonia accounts for one in every four child deaths, making it the leading cause of death among young children in poor countries, according to GAVI.

In early 2007, the WHO recommended the inclusion of pneumococcal conjugate vaccines in national immunization programmes, particularly in countries with under five-mortality of greater than 50 deaths per 1000 live births or more than 50,000 child deaths annually, and in countries where HIV is a significant cause of death.

Kenya’s under five child mortality stands at a high of 115 deaths per 1,000 live births, according to Kenya Demographic Health Survey 2003. Recent statistics by UNICEF puts at 127 deaths per 1,000 live births in 2007.

Hence, with the introduction of this vaccine, Kenya is likely to towards the attainment of the Millennium Development Goal number four on reducing child mortality by two thirds by 2015.

The good news on pneumonia front comes when the country is struggling to find resources for procuring another vaccine to prevent the Rota Virus, which causes severe diarrhea, vomiting, fever, dehydration and eventually death if not managed well. World Health Organization estimates that 7,541 children die in Kenya every year due to Rota virus infection.

At the moment, thousands of children are unable to access a new Rota virus vaccine that would cut significantly the number of deaths arising from diarrhoea and other complications.

The vaccine, which is available in the local market, can only be accessed in the private hospitals at Ksh 5,200 for the recommended two doses.

With such a charge, it has so far remained accessible only to those who can afford it, leaving out millions of poor children.

At the current price, the government will need Ksh 7.8 billion to vaccinate an estimated 1.5 million children born each year. Such a mount is just 0.18 per cent of what was allocated to the department of defence in this year’s budget.

Some Ministry of Health official admit that although the vaccine can be accessed from GAVI at much cheaper price, they are not pushing for it because they have other child killer they want managed as well. Rota virus, they argue, can be tackled through proper hygiene practices.

This dilemma facing the people in-charge of vaccination program is one of the many difficulties they have to deal with and which explain why vaccination coverage remains low in some parts of the country.

The intervention to bring on board the pneumococcal vaccine is therefore a big relief for the Kenyan children.

The new vaccine to be used in the programme is the pneumococcal conjugate vaccines-10 (PCVs), which has shown great effectiveness in controlling pneumonia. It is able to offer protection of over 80 percent against the pneumonia causing bacteria.

The vaccine is designed to prime the body’s immune system to be able to prevent infection by two killer bugs, Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (pneumococcus).

A couple of years ago, WHO estimated that these two bacteria accounted for more than 50 per cent of pneumonia deaths among children aged one month to five years. Pneumonia was also found to contribute to between 56 percent and 86 percent of all deaths attributed to measles.

A preventive vaccine has therefore remained the most potent arsenal against the pneumonia causing bacteria. Indeed, studies have shown vaccines against leading child killer diseases to play crucial role in child survival especially in difficult and remote areas where it is difficult to access curative services.

A recent study in South Africa showed that children vaccinated with nine-valent PCV were 31 per cent less likely to be hospitalized for pneumonia and 45 per cent less likely to be hospitalized with pneumonia associated with influenza type A or B viruses.

But scientists cautions that vaccines for preventing pneumonia target certain bacterial and are less than 100 percent effective. This means, for the pneumococcal vaccine to be completely effective, it must be complimented by curative care and other preventative strategies.

Health experts say while African governments know of the strategies to reduce child mortality and other deaths resulting from these diseases by using cost-effective methods, they are not doing it.

They blame the lack of political will, having wrong priorities, inadequate staffing of health personnel, and poor health messaging and dissemination as the root cause of what is happening now.