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Gavi and Ghana's government are rolling out vaccines against diarrhoea and pneumonia, a major threat to children under five”
Afua Hirsch, West Africa correspondent
In Accra's Independence Square, a baby cries as a few drops of liquid are squeezed into its mouth, watched closely by a jostling crowd of journalists and officials. The child is the first in Ghana to receive a new rotavirus vaccine – designed to protect children from a major cause of deadly diarrhoea and dehydration. The woman administering the vaccine is not a nurse or health worker, but Ghana's first lady, Ernestina Naadu Mills.
Mills was keynote speaker at the highly choreographed launch of the latest achievement by Gavi – the Global Alliance for Vaccines and Immunisation – which brings together the World Health Organisation, the UN Children's Fund, the World Bank, civil society, the vaccine industry, research and technical agencies, the Bill & Melinda Gates Foundation and other private-sector philanthropists.Gavi, which raises funds and stimulates the development of new vaccines for the developing world, has worked with Ghana's government to organise the rollout of the rotavirus vaccine and, to much acclaim, a new vaccine against pneumococcal infections, making Ghana the first country in sub-Saharan African to introduce two new vaccines at the same time.
The two vaccines are expected to save thousands of lives. Rotavirus, which causes gastroenteritis, can lead to severe dehydration and causes the deaths of more than 2,000 Ghanaian children each year, accounting for 40% of all diarrhoea-related deaths. Diarrhoea and pneumonia, the most common form of serious pneumococcal disease, each account for 10% of deaths among Ghana's under-fives.
"Ghana is showing the way. Here we have the capacity, a degree of self-confidence, and locally grown and maintained infrastructure that is needed," said Lord Paul Boateng, a member of the UK House of Lords who was born in Ghana and travelled to the country to witness the vaccine launch.
That Gavi has deemed Ghana able to introduce rotavirus and pneumococcal vaccines together is a vote of confidence in the country's ability to establish a "cold chain". The cold chain is central to the ability to administer vaccines, requiring a seamless system to keep vaccines at a temperature of 2-8C.
In Koforidua, the capital of Ghana's eastern region, the regional vaccine cold storage facility has been upgraded from a room crammed full of fridges to a hi-tech walk-in cold room – a donation from the Japan International Co-operation Agency. Emelia D Okai, the regional disease control officer, who looks after the facility, says all that is missing now is a cold van, so they can deliver the vaccines to sub-district health centres.
But power outages cause problems. "We have outages every week, sometimes twice a week," says Okai. "We have a generator that has a manual switch. So we are always ready – if there is [an outage] there is always someone responsible for switching on the standby generator."
Access to healthcare
Despite the new vaccines, access to healthcare remains a major problem for rural communities, with only about 50% of under-fives who contract pneumonia taken to an appropriate healthcare provider, and only 60% of infants under six months exclusively breastfed.
The Asenema community health planning services unit, in Akuapim North district just outside Accra, has no electricity and has to store its vaccines in fridges powered by gas. A solar panel unit sits on the floor beside the gas cylinders – the nurses explain it was provided by a Dutch company but no one has ever come to connect it.
At nearby Awukugu Nyensi village, where Asenema health unit conducts a monthly vaccination programme, 18-year-old Phyllicia's two-month-old daughter is getting the rotavirus vaccine. "I'm happy – I want my child to be strong and fit. I want her to be a nurse when she grows up," she says.
Women come to the monthly gathering in the village when told a vaccination day is approaching. Rebecca Ahiabu knows only too well the effects of the diseases being vaccinated against. She buries her head in her hands as she describes how she lost her 18-month-old daughter Emmanuella to pneumonia. For Ahiabu, the new immunisation programme means the difference between life and death. But it is far from a catch-all solution to the problems of poverty.
Seth Berkley, the chief executive of Gavi, is quick to dismiss suggestions that persistent problems associated with poverty make vaccination any less meaningful. "If you trace a baby that gets measles, you will see that as it gets sick it gets more malnourished, its growth may be stunted, it may suffer some brain damage," he says. "The family will have spent a lot of money – that could have been spent on school fees – on medical treatment. It is a huge issue for families when kids get sick."
One problem of developing the pneumococcal vaccine has been that the strains prevalent in the developing world were different from those being vaccinated against in richer countries. To develop the vaccine, GlaxoSmithKline and Pfizer got an advanced market commitment (AMC), a method of stimulating the development of vaccines needed in low-income countries. Gavi mobilises donors to make a legally binding commitment to subsidise buying vaccines at predetermined terms, creating an artificial market for the vaccine industry so they increase investment in these products.
But working with the private sector to create artificial markets, forming buying consortiums, and making massive purchase orders from the world's largest pharmaceutical companies has led to accusations that Gavi is encouraging business to profit from the poorest.
"Could the price be cheaper?" Berkley asks. "Probably. But there are children today who are alive because that vaccine was developed. Do you wait for other companies to come, and would the other companies have been interested if it wasn't for those big guys? I would love to use the AMC again."
Source: The Guardian UK, 03 May 2012
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Oil, national pride at stake in the Falklands
Interests in oil and other natural resources have led to renewed tensions over the Falkland Islands. The confrontation between Argentina and Great Britain is about strategic interests - and wounded pride.
It's become a kind of ritual: with each major anniversary of the 1982 Falklands War comes renewed saber rattling. The months ahead of the 30th anniversary of Argentina's occupation of the disputed archipelago on April 2 have been no exception.
Argentina and Great Britain trade off in charging one another with colonialism or imperialism, both insisting on their right to the small group of islands that are shared by around 3,000 residents, 1,200 British military troops and half a million sheep. London recently sent its HMS Dauntless destroyer and, according to media reports, a nuclear submarine to the South Atlantic.
Argentina's President Cristina Fernandez de Kirchner responded by issuing a protest to the United Nations that the British deployment represents "a major risk to international security."
'On a crusade'
"The Argentine president is on a personal crusade," said Sukey Cameron, the UK representative of the Falkland Islands government. "I think the issue of the island is very high up on her agenda."
In fact, Argentina has been increasing pressure for two years. Starting in 2010, ships in Argentinean waters were told they needed special authorization if they were headed toward the archipelago.
At the end of last year, four of the countries in the South American economic union Mercosur agreed to close their harbors to ships flying the Falklands flag.
The move is little more than symbolic, but islanders fear further sanctions such as an embargo against companies active in the Falklands. Some speculate that Kirchner could convince Chile to shut off the only flight connection between the archipelago and South America.
"We very much hope not," said Falkland representative Cameron, appealing somewhat helplessly to Argentinean patriotism, as it's a step that would prevent Argentinean war veterans and family members of the victims from visiting the islands.
A royal stir
London reacted to the pressure earlier this year by sending one of its future heads of state to the Falklands. Prince William, the grandson of the queen and a helicopter pilot in the Royal Air Force, was stationed for six weeks at the Mount Pleasant airfield on the islands. The Ministry of Defence stressed that his presence was routine and long planned, but few believe those claims.
"The difficulty I have with that argument is that his deployment was never going to be just routine," said Klaus Dodds, an expert for geopolitics at the University of London's Royal Holloway College. Dodds added that it's not at all surprising for Argentina to see the move as a pointed provocation.
Natural resources are part of the reason why the islands are such an object of interest. Many expect to find oil near the approximately 200 islands, even though test drills have so far delivered no results. Dodds believes the long-term prospect of reserves of raw materials is a more important factor.
"The proximity to Antarctica is huge. To my mind it's one of the big factors that hasn't really been sufficiently discussed because so much of what Britain does in the Falklands is driven in large part by the British Antarctic Territory," he said.
The islands serve as a jumping off point to that territory, an enormous chunk of land on the icy continent under British control.
"I am not saying anybody any time soon is going to be exploiting Antarctica for oil, gas, uranium, zinc or whatever," Dodds noted. But, he added, the provisions of the Antarctic Treaty System, an environmental protocol which currently forbids exploitation, could be revised at a conference in 2048.
Foreign policy victory
From the Argentinean side, national pride is a major component in the conflict. Many consider the British control of the islands an enduring humiliation, and the topic was an important part of Argentina's foreign policy throughout the second half of the 20th century.
Rightly so, argues Marcelo Leiras, a political scientist at the University of San Andres in Buenos Aires, who says the issue touches on Argentina's sovereignty.
"Sovereignty is not something you measure in square kilometers or riches," said Leiras. "Either you exercise it or you don't and any challenge to sovereignty is seen as a sign of political weakness."
With that in mind, the approach President Kirchner has taken makes sense, he said.
"The president has a stronger personal interest and different take on the issue and a different idea of what might work to better advance Argentina's interest," said Leiras, adding that the harbor closures represent a "significant victory for Argentina's foreign policy."
'Sovereignty is not up for negotiation'
The archipelago was once in the hands of the French and Spanish, and it has been a British territory since 1833. But the distance between the islands and the countries that have ruled it are reason enough to question the British claim to the region, according to Leiras.
However, the political scientist considers Argentina's 1982 invasion a mistake. He describes the war that cost 900 people their lives as a desperate attempt by the military junta to hold on to power.
Both of the involved countries, along with independent observers, rule out the possibility of a renewed war over the islands, but many also think it's unlikely the conflict will be resolved soon. The UN issued a resolution in 1965 calling on both sides to take up negotiations, but Great Britain has insisted on maintaining the status quo. Argentina is only interested in negotiations that would affect the status of the Falklands, said the island's UK representative.
"We are happy to discuss anything with them except for sovereignty," said Cameron. "Sovereignty is not up for negotiation."
Those stances represent nothing new, says Falkland expert Dodds. "UN resolutions get taken seriously by more powerful nations when it suits them."
Author: Dennis Stute / gsw Editor: Martin Kuebler Source: Deutsche Welle
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