PHL vaccination drive vs. diarrhea virus leads the way for Asia

When the Department of Health (DOH) starts the nationwide vaccination next year against rotavirus, which causes severe diarrhea among young children, the Philippines will lead the way for other Asian countries in lowering infant mortality from the preventable ailment, health experts said Tuesday. “I think it is significant in terms of the recognition that rotavirus vaccination is very important. We know that no other Asian country has introduced the rotavirus vaccine," said Dr. Tony Nelson, a professor in The Chinese University of Hong Kong’s Department of Pediatrics and a recognized expert on vaccines. “Many Asian countries have been slow to introduce the rotavirus and pneumococcal vaccination. Once a country introduces a vaccine, more countries are likely to follow," Nelson said in an exclusive interview on the sidelines of the two-day 12th Philippine National Immunization Conference in Manila that ends Wednesday. An estimated 3,500 Filipino children below five years of age die each year from severe diarrhea, half of which are directly caused by rotavirus, according to DOH statistics. The virus causes inflammation of the stomach and severe watery diarrhea often accompanied by vomiting and fever, leading to loss of body fluids and, in extreme cases, death among babies and young children. “Every child needs to be protected. Vaccination saves lives," Health Secretary Enrique T. Ona said in a speech at the conference. “When the Department of Health introduces rotavirus vaccine next year along with the routine Expanded Immunization Program vaccines, it will cost the taxpayers 1.8 billion pesos and earn for the Philippines the distinction of becoming the first country in the region to introduce it," Ona said in the speech, which was read for him by Health Assistant Secretary Eric Tayag. According to the latest statistics from the World Health Organization, some 527,000 children under five years old die annually from vaccine-preventable rotavirus infections in low-income countries. Asia and Africa account for more than 85 percent of rotavirus-related deaths, which are preventable through vaccinations that greatly reduce diarrhea and child mortality. The agency “strongly recommends" the introduction of rotavirus vaccine in countries where diarrheal deaths account for more than 10 percent of the mortality among young children. Tayag, who is also the DOH National Epidemiology Center director, told GMA News Online that the vaccine against the diarrhea-causing virus will be given free of charge along with other children’s vaccines regularly administered in all government health centers. The DOH first announced the rotavirus vaccination last August, with officials saying the immunization schedule will involve four doses: the first to be given between the sixth and 12th weeks of age, the second at four to 10 weeks after the first dose, the third at four to 10 weeks after the second dose, and the last dose administered within 32 weeks of age. Latin American model Dr. Nelson said vaccination should be on the top of the list as one of the “most cost effective interventions" for governments that want to decrease health costs, but he acknowledged that most countries are slow to implement national vaccination drives due to uncertainties. “With vaccination, we don’t know whose death we are preventing. For example, with cancer treatment, we know who may have been cured by the treatment. There is a tendency to put more money on the curative aspect than into prevention. So you could not say that you would have died if you were not vaccinated. Or you would have survived if you were vaccinated," he said. “This is the reason why a lot of governments have not invested in vaccines as much as they would have wanted to," he added, noting that countries investing “heavily in vaccines are making a very good investment." Dr. Nelson cited the Sri Lankan experience as an example. “Sri Lanka is not a very rich country but it puts more money into preventive health. Its economic growth is more rapid than its neighbors who have invested in other things. If you have a healthy population, children go to school, they perform better, they have better cognitive performance, better academic performance, they attend school longer," he said. He said the Asian region could follow the South American model of close cooperation in solving health concerns and problems. “The Pan American Health Organization (PAHO) is very united and it has a lot of regional advocacy. They also have a revolving fund which is used to buy vaccines at the lowest price. The revolving fund negotiates with industry very aggressively to get vaccines very cheaply," Dr. Nelson said. “Asia does not have such a system. No other region except Latin America has such a system. I think we should have such a system. If we have an Asian revolving fund, this will speed up things very quickly," he said. Lowering infant mortality In his speech, Dr. Ona said each of the 2.5 million children delivered in the Philippines every year is at risk for vaccine-preventable diseases. The current Philippine infant mortality rate per 1,000 live births is 26. Dr. Ona said the DOH invested P635 million between April and June this year to ensure that the measles elimination drive is on course by vaccinating 15 million children between nine months to below eight years old. In a separate interview, Tayag said the rotavirus vaccination to combat severe diarrhea among children is on top of the existing immunization program that covers tuberculosis, diphtheria, pertussis, tetanus, polio, measles, pneumonia, and Hepatitis B. The program also covers pneumococcal Haemophilus influenza type b, a bacteria that causes meningitis and pneumonia among children under five. Meningitis is an infection of the brain and spinal cord coverings that can lead to lasting brain damage and deafness. Since 2000, the Philippines has managed to be polio-free but the country has “become at high risk for wild polio importation" at present, Tayag said. Last month, China reported wild polio importation originating from Pakistan. – YA, GMA News