Nature: Vaccination lags behind in middle-income countries
Seth Berkley, chief executive of Gavi, the Vaccine Alliance

“…[H]ow do we increase access to vaccines, primary health care, and other essential health interventions in countries that can — at least according to their gross national incomes — afford them? … Despite success in the poorest countries, an analysis [Gavi, the Vaccine Alliance] carried out this year found that since 2010, routine immunization levels have either stagnated or dropped in 54 of 85 [middle-income countries (MICs)] too prosperous to qualify for Gavi support. … [B]y 2030, almost 70% of the world’s under-immunized children will be living in countries ineligible for Gavi’s vaccination programs … MICs need support to strengthen their health systems and to improve how they procure vaccines and regulate them. They need access to information technologies to monitor who is getting vaccines, to target at-risk communities, and to evaluate strategies. And mechanisms are needed that set prices according to what countries can reasonably pay. Prosperous countries should pay more for vaccines. But according to World Health Organization data, the pneumococcal vaccine, for example, costs, on average, eight times more in never-supported MICs than in countries receiving Gavi support, even though the MICs’ gross national incomes and ability to pay might not be commensurately larger. … It is time for the global health community to adapt: we must not leave behind vulnerable populations in middle-income countries” (5/14).