第1億名接種腦膜炎救生疫苗的人 經濟、安全、有效的疫苗 保護年輕人遠離惡疾

 

第1億名接種腦膜炎救生疫苗的人 經濟、安全、有效的疫苗 保護年輕人遠離惡疾

A boy grimaces as he receives a needle vaccination from a health worker during a two-day immunization session for all 5,000 people at the Wenela camp who have been displaced by the flooding, in the district of Chibuto, in the province of Gaza. Both children and adults are being vaccinated, as needed, against measles, tetanus and meningitis, and children are being given vitamin A capsules to boost their natural immune systems. By mid-March 2000 in Mozambique, relief and rehabilitation efforts were well under way in response to the worst flooding in 50 years that followed torrential rains in late February, affecting at least seven provinces, causing some 500 deaths and leaving more than 300,000 people homeless or without a livelihood. UNICEF is working with the Government, NGOs, other UN agencies and foreign governments to respond to the emergency and has also supported a Ministry of Health mass vaccination campaign targeting tens of thousands of children and adults in three provinces in the Limpopo River valley, one of the most severely affected areas. Providing vaccinations against measles, meningitis and tetanus, as well as vitamin A capsules (to reinforce immune systems) for an estimated 45,000 children, the two-week campaign demonstrated the logistical challenges faced to vaccinate people in remote areas.日內瓦/香港,2012年12月3日──一個多世紀以來,腦膜炎一直困擾着非洲地區。為了對抗此致命流行病,研究人員遂研發出革命性的腦膜炎疫苗,本周,將會有第1億名受惠者接種此疫苗。此舉壯舉將會在尼日利亞北部進行──位於非洲「腦膜炎地帶」,該國目前正進行第二季防疫注射運動,全力防治腦膜炎。

此項歷史性的壯舉,乃源於兩年前,布基納法索首度採用名為 MenAfriVac®的新型腦膜炎疫苗。自此,另外9個國家便相繼展開防疫注射運動,為1至29歲的國民接種預防A型腦膜炎疫苗。

未來兩星期,尼日利亞將為1,600萬人接種疫苗;在本周,喀麥隆和乍得亦都同步推展疫苗接種運動,目標受惠人數分別達到550萬和230萬人。至今年底前,該疫苗將足以惠及逾1.12億人,廣泛地為人民帶來期盼已久的保護。

A queue of people behind him waiting their turn, a boy is vaccinated against measles during a two-day immunization campaign to vaccinate all 5,000 residents of the Wenela camp for people who were displaced by the flooding, in the district of Chibuto in the province of Gaza. The two-day session is part of a week-long immunization campaign against measles, meningitis and tetanus, covering three of the provinces most affected by the flooding and carried out by the Ministry of Health with UNICEF supplies and logistics assistance. An estimated 45,000 children will also receive vitamin A capsules to reinforce their natural immune systems. By mid-March 2000 in Mozambique, relief and rehabilitation efforts were well under way in response to the worst flooding in 50 years that hit the country in late February, affecting at least seven provinces, causing some 500 deaths and leaving more than 300,000 people homeless or without a livelihood. The extensive damage to agricultural land as well as to the transportation, water and sanitation and housing infrastructures also heightened the risk of malaria or cholera outbreak and required immediate food, health and water and sanitation assistance. Working with government ministries, other UN agencies and NGOs, UNICEF is coordinating the water and sanitation emergency response; supporting a vaccination campaign targeting tens of thousands of children and adults in the Limpopo River valley; providing essential drugs, oral rehydration salts (ORS) packets and educational materials; promoting community mobilization campaigns in health and hygiene to prevent the spread of disease; and supporting the rehabilitation of schools in affected areas.全球疫苗與免疫聯盟(GAVI)的合作伙伴論壇,將於本周在坦桑尼亞首都達累斯薩拉姆舉行。論壇匯集發展中國家、捐助者、民間團體、技術及科研機構、醫療衞生機構以及疫苗業界,一同見證這項偉大成就。

MenAfriVac®疫苗是由國際非營利衞生組織適宜衞生技術規劃 (PATH)與世界衞生組織(世衞)共同研發的。PATH的總裁兼首席執行官史蒂夫.戴維斯表示:「最初研發這種疫苗時,我們己知道它的需求有多迫切。我們希望它能迅速地為廣大民眾提供援助,幫他們安然度過撒哈拉以南非洲的腦膜炎流行季節。」他續指:「對於非洲國家迅速採用此疫苗對抗腦膜炎,我們感到十分自豪,同時欣然看到已接種疫苗的地區,幾乎再沒有致命及因腦膜炎引致患者身體衰竭的病例。」

在世衞負責家庭、婦女和兒童衞生事務的助理總幹事Flavia Bustreo博士表示:「這項里程碑之所以能實現,全賴各國政府的承諾,以及世衞和其他合作伙伴的支持。」她續說:「我們必須繼續努力,在餘下仍然在『腦膜炎地帶』的國家實施防疫注射運動,確保廣泛民眾接種到MenAfriVac®疫苗。」

負責資助防疫注射運動疫苗的GAVI,總裁塞思.伯克利博士坦言:「腦膜炎是一種可怕的疾病,它會奪去年輕患者的性命,許多倖存者即使生還,亦會出現嚴重的神經損傷,為社區帶來巨大的災難。」他續說:「由GAVI資助的第1個『腦膜炎地帶』腦膜炎防疫注射運動開展以來,相隔整整兩年時間,便將有第1億個人的生命因此得到保障,這實在是一項非凡的成績。」

A health worker displays a vaccine against five common childhood illnesses – Hib, diphtheria, tetanus, pertussis and hepatitis B – at a storage facility in the south-western city of Khulna. Hib is a common cause of pneumonia and bacterial meningitis. In January 2009 in Bangladesh, a national campaign to vaccinate children against Haemophilus influenzae type b (Hib) was launched in Khulna District. Hib is a common cause of pneumonia and bacterial meningitis, causing an estimated three million serious illnesses and 400,000 deaths around the world annually. The country-wide campaign aims to immunize four million children under the age of five by year’s end, saving the lives of at least 20,000 children. The vaccine will also protect against diphtheria, tetanus, pertussis and hepatitis B, reducing the number and frequency of injections each child will need to build immunity against these diseases. The campaign is sponsored by the World Health Organization (WHO), UNICEF, the GAVI Alliance and the Hib Initiative. The GAVI Alliance is a public-private partnership among developing and donor governments, the vaccine industry and others, which funds immunization programmes around the world. The Hib Initiative is a body of experts on Hib vaccination from the Johns Hopkins School of Public Health, the London School of Hygiene and Tropical Medicine, WHO and the United States Centers for Disease Control and Prevention. WHO, UNICEF, GAVI and the Hib Initiative are working to extend Hib vaccine coverage to 72 developing countries by 2015. 「將MenAfriVac®疫苗發展為低成本的疫苗,對全球衞生界來說極為重要。」比爾及梅琳達.蓋茨基金會的全球發展項目總裁克里斯.埃利亞斯表示:「疫苗能拯救生命,改善人民生活。在受腦膜炎影響的國家,政府推出這新型疫苗以保護年輕人的速度之快,實在值得仿效。」

聯合國兒童基金會副執行主任吉塔.饒.古普塔表示:「在薩赫勒地區的國家,A型腦膜炎影響着最貧困的家庭。在最壞的情況下,A型腦膜炎甚至可奪去受影響社區三分之一人口的性命。」她指出:「但現在,防疫注射運動已為從前未能受惠的貧困家庭,帶來希望,帶動更多人接受這安全、有效及經濟的防疫注射。」

A baby girl receives a pentavalent vaccine at the Kaniya Peripheral Health Unit in the village of Kaniya, in Bo District. The pentavalent vaccine protects against five common diseases: diphtheria, tetanus, pertussis (whooping cough), hepatitis B and Haemophilus influenza type b (also called Hib, a cause of pneumonia and meningitis). [#2 IN SEQUENCE OF TWO] In April 2010 in Sierra Leone, child and maternal mortality rates remain among the highest in the world. Nearly one out of every five children dies before the age of five, and a woman’s lifetime risk of maternal death is one in eight. Many health clinics lack ambulances, electricity, skilled personnel, and essential supplies, and many people simply cannot afford basic health services. Maternity services are particularly poor, with only 43 per cent of women giving birth in the presence of a skilled birth attendant, such as a doctor, nurse or midwife. The high prevalence of malnutrition, malaria, acute respiratory infections, preventable diseases, poverty and gender inequality also contribute to the high rates of death and illness among children and mothers. On 27 April, the Government inaugurated a programme that abolishes fees for primary health services to pregnant and lactating mothers and children under the age of five. Support for this programme comes from UNICEF, the United Nations Population Fund (UNFPA), the World Health Organization (WHO), the World Bank, the African Development Bank, the European Union, Irish Aid and other partners. UNICEF is building clinics, supporting ambulance services, and providing essential drugs and supplies for obstetric care. UNICEF also supports preventative and curative health programmes, including vaccination campaigns, the distribution of insecticide-treated mosquito nets, the practice of exclusive breastfeeding and the promotion of hand-washing.西起岡比亞,東至厄立特里亞,整個「腦膜炎地帶」足以綿延 26個國家,屬季節性傳染病的A型腦膜炎就在此地帶肆虐,威脅着當地4.5億人的生命。此病會導致患者大腦和脊柱周邊的腦膜發炎,引發劇烈疼痛,在24至48小時之內致命。即使倖存,患者往往要面對嚴重學習障礙、失聰或截肢問題。而兒童和青少年正是此疾病的最高風險患者。

Pentavalent vaccines are kept in a cold box at the health centre in Kaniaka Village, Katanga Province. The pentavalent vaccine protects against five common diseases: diphtheria, tetanus, pertussis (whooping cough), hepatitis B and Haemophilus influenza type b (also called Hib, a cause of pneumonia and meningitis). Cold boxes are a critical part of the ‘cold chain’, the series of temperature controls required to maintain vaccine potency from manufacture through inoculation. In February 2011 in the Democratic Republic of the Congo, women and children remain vulnerable to maternal and neonatal tetanus (MNT), an infection that has no cure but is preventable with routine immunization. MNT threatens the lives of 130 million women and babies in 38 countries around the world, including D. R. Congo, where the disease sickened at least 1,038 babies and killed 483 last year. Globally, the disease kills 59,000 infants within their first month of life, the equivalent of one death every nine minutes, every year. Limited access to basic health services and poor hygiene conditions during birth are the major contributors to MNT mortality: Many infections take place when women give birth at home, alone or in the presence of an untrained birth attendant. Delivery on unclean surfaces and handling with unclean hands or instruments increase the chance of MNT infection in both mother and baby. Yet three doses of the tetanus toxoid vaccine – one of the world’s safest and least expensive vaccines – protects almost 100 per cent of recipients from the disease. Additionally, children born to immunized women are protected from the disease for the first two months of life. Since UNICEF re-launched its MNT Elimination Initiative in 1999, at least 20 countries have achieved the goal of eliminating MNT, and since 2006, private-sector partner Pampers has donated funds for 300 million vaccines. In D. R. Congo, this initiative is promoting vaccination among girls and women of child-bearing age, particularly in southern provinces where health infrastructure is weak and vaccine shortages are common. The goal of the initiative is to eliminate cases of MNT from the world by 2015.1996至1997年,非洲爆發史上最大規模的季節性A型腦膜炎疫症,當時導致25萬人受感染,25,000人死亡。非洲國家的衞生部長遂在1997年,同時向世衞和其他合作伙伴發出呼籲,期望找出能長遠對抗此頑疾的辦法。

在2001年,PATH和世衞聯合組成腦膜炎疫苗項目,研發一種對非洲國家而言,經濟實惠的疫苗,用於應付會引起A型腦膜炎的腦膜炎球菌。過往的新型疫苗,要不未被設計成可應付發展中國家的變種疾病,要不就是過於昂貴,令發展中國家無法負擔並用於其防疫注射計劃。PATH 和世衞遂與印度血清研究所有限公司合作研發疫苗,並以每劑低於約港幣3.9元(0.50美元)的成本生產,以應付龐大需求。

在此疫苗所及的地區,腦膜炎已顯著受到控制。在2010年12月,布基納法索推出首屆MenAfriVac®防疫注射運動後,獲接種疫苗的人士當中,均無出現A型腦膜炎感染個案。

伯克利博士表示:「對生活在世上最弱勢地區的人來說,這疫苗大大改善了他們的生活。有份參與研發這疫苗的合作伙伴,確保這適當的疫苗能以合適的價格出售,實在值得我們稱道。」

Immunization supervisor Nestor Sindimwo removes icepacks to reach measles vaccines in a ‘cold box’, in the dispensary of Hôpital Muyinga (Muyinga Hospital), in Muyinga, capital of the north-eastern Muyinga Province. 'Cold boxes' play a critical role in preserving the ‘cold chain’, the series of temperature controls required to maintain vaccine potency from manufacture through inoculation. The dispensary is serving as a district vaccine depot during the campaign. Health districts, classified by the Ministry of Public Health, are distinctive from administrative divisions. From 18 to 21 June 2012 in Burundi, an integrated measles vaccination campaign is being held as part of nationwide Maternal and Child Health Week activities. The campaign aims to vaccinate more than 1.4 million children aged 6 months to 5 years old against the easily preventable but highly contagious disease, which can cause severe complications and death. Worldwide, the disease remains a leading cause of death among young children: in 2010, an estimated 139,300 people – mainly children under the age of 5 – died globally from measles. But significant progress has been made: from 2001 to 2011, measles deaths worldwide decreased by 74 per cent, with the largest decline (about 85 per cent) in sub-Saharan Africa. Measles coverage in Burundi had surpassed 92 per cent by 2010. Nevertheless, outbreaks of the disease continue, with 8 districts affected in 2011. The nationwide campaign is being implemented by the Ministry of Health, with support from UNICEF and other partners. Children under age 5 are also receiving vitamin A, which has been shown to reduce the number of measles deaths by half. Children and women are also receiving deworming tablets. Burundi’s campaign is also part of the Measles & Rubella Initiative, a global partnership led by the American Red Cross, the United Nations Foundation, the United States Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and UNICEF.

2012年10月31日,MenAfriVac®疫苗更獲認可,在40°C高溫下,即使離開疫苗冷藏系統後,只要使用可調溫疫苗冷藏系統 (controlled temperature chain),其有效期最多可保持4天,是首種在非洲獲得此認可的疫苗,為其他耐熱性疫苗所借鑑。

疫苗需存放在疫苗冷藏系統的限制,為MenAfriVac®或其他防疫注射項目帶來物流上的挑戰:項目成本上升、供貨延誤,以及令疫苗難以覆蓋最偏遠的社區,都令疫病持續爆發。貝寧在上月15至25日開展有關的防疫注射計劃,便採用了此嶄新的可調溫疫苗冷藏系統,進行試點項目。

自MenAfriVac®疫苗在2010年推出以來,布基納法索、馬里、尼日爾、尼日利亞、乍得、喀麥隆、蘇丹、加納、貝寧和塞內加爾已先後進行疫苗接種運動。