Ganging up to defeat the world’s killers

9:11am Friday 25th April 2008

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Ten years ago we welcomed the first vaccine against meningitis C, one of the three variants of germs that cause this devastating infection of the brain.

In the years up to 1998, about 80 to 100 people a year - mostly teenage students - died from it, and it made many hundreds, sometimes thousands, of others seriously ill, leaving some with permanent brain damage.

Last year, there were no deaths and no cases of long-term disablement from it, and the numbers of cases identified in Britain had dropped by more than 94 percent. It's estimated that the disease will disappear completely within the next year or so.

That's a triumph in figures, but it's also wonderful that at least 80 families a year will not have to grieve for the loss of a promising student in the prime of his or her youth.

There's a difficulty, however. That is, that no-one knows, of course, who would have been the ones who would have died without the vaccine. So we don't feel the same gratitude, as, say, the people who have been cured of cancer or who have had their ailing hearts revived. We didn't know we had been saved, so we don't fully appreciate the benefit.

That has always been the case for the people who have researched and developed vaccines.

In the 18th century there was a huge anti-vaccination lobby against the new smallpox vaccines. Even the churches railed against it as interfering with the will of God'. Thankfully, they know better now.

Today, we don't have to worry about tetanus, which killed more First World War soldiers than did their wounds; diphtheria, which killed tens of thousands of children a year; and polio, which paralysed thousands every summer until the 1950s in Britain.

Soon we will have a vaccine against malaria, which still kills millions throughout the tropics annually, and a better one than the current BCG against tuberculosis, another multi-million killer. The one against HIV may take a little longer, but you can be assured that it, too, is on its way.

Vaccines are under development for several tropical diseases, and against hepatitis - it's estimated that 200 million people harbour the hepatitis viruses A and B around the world.

Hopefully all these diseases will go the way of smallpox (eliminated in the 1970s) and polio (to disappear shortly if African politics and pseudo-religious objections can be overcome) in the first half of this century.

But who funds, develops, manufactures and distributes these vaccines? Many organisations are co-operating to do so.

Governments in the developed world help a lot, but the main investment comes from rich entrepreneurs who have amassed so much money that they can afford to push billions of dollars, euros or pounds into the research.

Bill Gates has been one. Without him, the malaria and tuberculosis vaccine plans could never be fulfilled. Universities have provided the biological theory and laboratory know-how, and have shared their data freely with the pharmaceutical industry, whose expertise in development and manufacture is the essential final addition.

The industry, in turn, has promised to make their products freely available to the countries which need them most desperately.

We are witnessing a massive change in attitudes to medical research, with each of these organisations working together to a common aim - to ease the burden of illness carried by the poorest nations.

The barrier to that relief is not the lack of effective medicines and vaccines: it is that we can't get materials to those who need them most because of wars and misguided political opposition.

So here are three cheers for an African country that we don't often hear about - Tanzania. Between 1999 and 2004 its government tripled the money it spent on healthcare per citizen.

Since then the number of deaths among Tanzanian children has dropped massively - by more than 11 per cent per year. It is no coincidence that Tanzania is at peace and the government spent the money evenly around the country, between richer and poorer districts alike.

Wouldn't it be great if other African countries followed suit?