News

Children’s charity criticises global immunisation initiative

Fiona Fleck Geneva
217, 200, 198
A global initiative that seeks to
save millions of children’s lives by
immunisation is in danger of sad-
dling the world’s poorest coun-
tries with expensive vaccine
regimes they cannot afford and
perhaps do not need, a new study
has found.
The study, conducted by the
UK charity Save the Children and
the London School of Hygiene
and Tropical Medicine, criticised
the Global Alliance for Vaccines
and Immunisations (GAVI) for
including managers from pharma-
ceutical companies on its govern-
ing board, saying that this created a
potential conflict of interest.
“GAVI needs to ensure that it
can focus on the most appropriate
assistance to an immunisation sys-
tem without the risk of commer-
cial, product-oriented pressure,”
the UK charity said in a statement.
The alliance, based on part-
nership between the public and
private sectors, was launched in
1999 to combat falling immuni-
sation levels by providing vac-
cines to 74 of the world’s poorest
countries. Dubbed the “billion
dollar fund” after a contribution
of $750m (£517m; €839m) from
Microsoft’s founder and chief
executive, Bill Gates, it seeks to
achieve this by incorporating
new vaccines into national health
systems while promoting existing
immunisation programmes.
The study, reported on Tues-
day in Geneva, was based on
research conducted in Mozam-
bique, Ghana, Lesotho, and Tan-
zania. It concluded that although
the initiative had succeeded in
raising the profile of immunisa-
tion programmes in developing
countries, it had failed to ensure
that additional resources were
provided to countries with weak
health systems before they take
on expensive new vaccines.
It warned that raising poor
countries’ awareness of immuni-
sation programmes without
detailed advice and financial sup-
port in implementing such
schemes could end up creating
markets for costly new vaccines
while doing little to tackle the
biggest killer diseases.
The report said, for example,
that refrigerators for storing vac-
cines were poorly maintained
and often broke down. It also
said that Ghana was given only
10 days to decide whether to
accept a new high tech vaccine
for hepatitis B without any evi-
dence that this was actually need-
ed—a decision that more than
doubled the cost of the country’s
immunisation programme.
It concluded that although
the funding gap would initially be
covered by the alliance, the long
term sustainability of the pro-
gramme was in question.
“Due to lack of funding and
the added burden of the HIV cri-
sis, many countries’ health sys-
tems are on the verge of
complete and utter collapse,”
said Regina Keith, a senior health
adviser at Save the Children in
the United Kingdom.
“Money must be spent on
the upkeep of equipment, as
well as on training and paying
the salaries of health workers. If
the billion dollar fund goes bust,
developing countries will be left
footing the bill for costly new
vaccines that are of no use to
the children whose lives they are
meant to save,” she said.

The ruling caused an outcry
France outlaws the right to sue among disability groups in
for being born France, who argued that it
implied it was better to be dead
the view that no one has a right
not to be born. For people with
a disability it was insulting.”

than to be born handicapped.

Lynn Eaton London
72, 215, 164, 346, 117, 68
A new law has been introduced
into the French Assembly to try
to clarify the thorny question of
whether doctors should be held
responsible when a child is born
disabled.
The bill, passed in an emer-
gency session and due to go to
the upper house on 22 January,
would forbid a child from seek-
ing damages simply for being
born. However, it would still
allow parents to seek compensa-
tion if the condition had been
missed in prenatal examination
through a serious medical error.
The controversy arose after
was born with severe brain dam-
age because his mother had
rubella during pregnancy. She
could have had an abortion had
she been aware of the risk, so
Nicholas was able to claim com-
pensation for being alive.
Effectively, it opened the
floodgates for any child to claim
compensation for being born
with a disability if the mother
had not been informed of a risk
that could have been evaluated
during pregnancy.
Subsequently two similar
judgments followed, for children
with Down’s syndrome. The
They also feared it would
encourage eugenics, as doctors
might recommend abortions at
the slightest sign of a problem
during pregnancy, rather than
face a huge compensation bill.
Doctors, meanwhile, threat-
ened strike action as they faced
higher insurance costs to cover
the increased risk of compen-
sation should they fail to warn
a mother of the potential risks
to a fetus. They had begun to
refuse ultrasound scans on
pregnant women, arguing they
could be sued if the baby was
born disabled.
David Congdon, director of
public affairs with the UK
AFP/ JACK GUEZ

the so called Perruche ruling, a
decision in November 2000 by
France’s highest court, the Cour
de Cassation. Judges ruled that a
17 year old boy, Nicholas Per-
ruche, could claim damages as he
judges ruled that in both cases
amniocentesis should have been
offered and that the mothers,
once informed of the risk, could
have opted for an abortion
(15 December, p 1384).
charity Mencap, said the charity
was delighted at the French
assembly’s decision. The origi-
nal decision of the court of Protesters demonstrating
appeal was “a nonsense.” He against the right to sue for
added that “most people take being born
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