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Johns Hopkins Bloomberg School of Public Health


Keyword: global health

By Dr. Kate O’Brien, Executive Director, International Vaccine Access Center (IVAC)

Yesterday we were saddened to learn that former President George H.W. Bush was hospitalized with pneumonia. While the majority of people affected by pneumonia in the US are adults, around the world each day this condition claims the lives of an estimated 2,500 children under age 5. 

Back in September, when Secretary Hillary Clinton suspended her campaign due to pneumonia, I wrote about the under-recognized toll this illness takes on communities around the world. As we find ourselves on the eve of a new presidential administration, it’s imperative to repeat the message and remind policymakers of the common needs of families around the world.

Pneumonia, an infection of the lungs, is exceedingly common around the world, with an estimated 450 million cases annually. In the US, we have ready access to trained physicians with the know-how and equipment to make a diagnosis and, when necessary, we have antibiotics and oxygen therapy to treat illness. These interventions have been proven effective, and the vast majority of people who contract pneumonia in the US make a full recovery.

Sadly, this is not true everywhere. In impoverished countries, timely, appropriate, and affordable treatment is often not available, especially for young children whose course of illness can take a downturn very quickly. In parts of Africa and Asia resources are scarce, and HIV infections, crowding, and indoor air pollution are prevalent and put people at risk. The prevention measures we take for granted, such as vaccines and hand washing, are too often not available. The price of pneumonia in these countries is higher infection rates, more illness and, sadly, more deaths, especially in children younger than 5 years of age.

Over the past 15 years, public health professionals and policymakers have been able to assure significant progress. Vaccines to prevent the deadliest causes of pneumonia are rapidly being deployed in countries in most need—thanks to Gavi, the Vaccine Alliance, and country governments. Gavi, to which the US government is a major contributor, makes it possible for low-income countries to buy and deploy tens of millions of doses of life-saving vaccines, including against pneumonia, to millions of children. As more children have access to vaccines and medicine to prevent and treat pneumonia, we see less disease, fewer lives lost, more families climbing out of poverty and fewer families thrown back into the downward cycle of poverty which is otherwise incurred simply by trying to get medical care to save their child’s life.

Yet, much work remains. More than 900,000 young children still lose their lives to pneumonia each year. These children need access to the same tools as our own children to prevent, diagnose, and treat this common illness.

More than anything else, we must put pneumonia on our collective radar as a global health problem that requires attention—not just when there’s a new media headline. How many people know that globally pneumonia is the leading cause of death for children under 5 years of age? Pneumonia is so common that it’s nearly invisible.

Can this change? Absolutely. We have the opportunity to raise the profile of this illness and reveal just how pervasive it is. We hope President Bush makes a speedy and full recovery. Meanwhile we continue to advocate for adequate resources for families, governments, and communities everywhere to prevent and treat this illness. What improves the lives of people in countries around the world is also good for the US. It’s simple: Hopeful, healthy communities create a world where we all thrive, including here at home. 


Kate O’Brien, MD, MPH, is the Executive Director of the International Vaccine Access Center and Professor at the Johns Hopkins Bloomberg School of Public Health. She is a pediatric infectious disease physician, epidemiologist and vaccinologist.

Judging from a recent slew of national announcements and media coverage, it sure looks like 2011 is going to be an exciting year for pneumococcal vaccine access. In the past 2 weeks, I’ve gotten emails and read articles from literally every corner of the world in which people are getting ready to introduce pneumococcal vaccines.

First, it was an email from a former colleague at IVAC who is now working in Mali and reported that the government has started training field workers to deliver pneumococcal conjugate vaccine beginning this year. Then it was an email about efforts to publicize the launch of the vaccine in Sierra Leone and an email from a colleague in Kenya where they had just started vaccinating at his local clinic.

Below is a really nice profile by the Baltimore Sun of our work at IVAC with kind words of recognition from our colleagues at the GAVI Alliance & a few relevant press announcements from newly introducing countries from Pakistan to Qatar to Chile & New Zealand.

Baltimore center leads fight to provide vaccines to world's children
IVAC hopes to save the lives of 5 million children over next 20 years. By John-John Williams IV, The Baltimore Sun, January 21, 2011.,0,7297449.story

Introduction of pneumococcal conjugate vaccine in routine immunization endorsed (Pakistan)

Vaccine to reduce mortality among kids

Chile, NZ to use GSK pneumococcal vaccine

Welcome to the brand-new IVAC Blog! We’re pleased to launch this forum where experts, policymakers, advocates, students and other impassioned individuals can share ideas, thoughts and analysis on the latest in global health and vaccine access.

As students and practitioners of public health know well, delivering health interventions is often just as important as discovering them. Despite advances in science that allow us to prevent the world’s deadliest infections, those advances will never bear fruit in a majority of the world’s countries without the evidence base to prove the need, backed up by an advocacy effort that spurs decision makers to act. 

It was this compelling need that inspired the establishment of IVAC at Johns Hopkins Bloomberg School of Public Health just one year ago.

Simply put, IVAC is dedicated to ensuring that safe and effective vaccines reach those who need them most—like children in developing countries, where the disease burden is high and health interventions are tremendously scarce. Though great strides have been made in recent years to fund and improve vaccine delivery in the world’s last-mile communities, there is much work left to be done—and there are many barriers to implementation that remain stubbornly intact. 

Being housed at the Bloomberg School of Public Health allows IVAC to draw upon the tremendous expertise of the faculty as well as other scientific and policy leaders in building the credible case for expanding vaccine access. Our projects are made possible through grants from the Bill & Melinda Gates Foundation, the GAVI Alliance, the US Centers for Disease Control and others and we partner with international organizations, in-country advocates, industry leaders, civil society and others to ensure smart collaboration and accelerate progress. 

Thanks to the work of IVAC and our partners, nearly 50 developing countries have introduced Hib vaccines in the past decade, protecting millions of children and millions more will be protected in the years ahead from pneumococcal and other diseases. For us at IVAC, our aim is to do the same with other vaccines for diseases that claim the lives of children unnecessarily.

The IVAC Blog launches at a particularly important time for its mission. At Johns Hopkins Bloomberg School of Public Health, our third-annual Vaccine Day is tomorrow, Friday, October 29—and globally, the second-annual World Pneumonia Day will take place November 12. We invite you to participate in both events so that we can continue to find innovative and sustainable ways to deliver lifesaving vaccines to children who need them.

As any global health organization knows, the breakthrough in the lab is only half the battle. To be effective, we always need to know what works on the ground and what doesn’t. So please use the comments section to share your thoughts and ideas and highlight the topics and resources you’d like to read and discover in this blog.

--Dr. Orin Levine