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Fri 1 Jun 2007 12:00 AM

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Vaccine blitz to target yellow fever

The GAVI Alliance, a public-private global health partnership, has donated US $58 million to the Yellow Fever Initiative.

The GAVI Alliance, a public-private global health partnership, has donated US $58 million to the Yellow Fever Initiative. The Initiative will use to money to carry out immunisation campaigns in a dozen West African countries at high risk of yellow fever epidemics.

According to a WHO statement, mass vaccination campaigns led to the almost complete disappearance of yellow fever in some African countries in the 1960s. However, immunisation campaigns slowed down and by the 1990s, the number of cases had risen to an estimated 200,000 per year, with 30,000 deaths. With urbanisation taking place across Africa, the threat of a major outbreak has increased.

With the grant from the GAVI Alliance, the world's 12 highest-burden countries aim to immunise more than 48 million people, including adults, over the next four years. "If we were to do only routine child immunisation for yellow fever, we would need decades to reduce the risk of epidemics and the international spread of the disease," explained Dr Mike Ryan, director of the WHO Department of Epidemic and Pandemic Alert and Response (EPR) in Geneva. "Now, however, thanks to the generous grant from GAVI, the Yellow Fever Initiative will be able to vaccinate at-risk populations and thus quickly reduce the risk of devastating outbreaks that could otherwise threaten the region and the world."

One reason for the falloff in vaccination rates has been cost and the myriad of public health challenges they face. In Nigeria, for example, the coverage rate in 2005 was an estimated 36%. However, it is recommended that, to stop yellow fever infections from spreading into an epidemic, immunisation coverage must be at least 60-80%.

"Yellow fever is a particularly dangerous disease, which kills up to 50% of those with severe illness," said Michel Zaffran, deputy executive secretary at the GAVI Alliance. "Every age group is at risk, and vaccination is our crucial weapon to prevent cases and epidemics.

"With the GAVI Alliance contribution, affected countries have an exceptional opportunity, and responsibility, to protect their populations. GAVI is committed to working with all our partners, both globally and in the field, to ensure the success of the Yellow Fever Initiative in Africa."

A recent vaccination campaign in Togo, under the umbrella of the Yellow Fever Initiative, is held up as an example of how even remote populations can be reached. In December 2006, WHO received notification of three cases of yellow fever in northern Togo. As the last mass vaccination there had taken place in 1987, the population was considered to be highly susceptible. By February 2007, the Togo Ministry of Health and WHO, with financial support from GAVI and from the Humanitarian Office of the European Commission (ECHO), and with the technical support of UNICEF and various NGOs, had vaccinated more than 1.5 million people. A similar campaign was then conducted in two districts in southern Togo after two cases of yellow fever had been reported there at the end of January.

Yellow fever is an acute, haemorrhagic, viral disease that is transmitted to humans by infected mosquitoes. Those infected may not fall ill, but 20-50% of those developing severe illness will die of the disease.

There is no known specific antiviral therapy, although the disease can be prevented by the 17D vaccine, which provides immunity for at least 10 years.

Yellow fever is endemic in tropical regions of Africa and South America, where 44 countries (33 in Africa and 11 in South America) are considered to be at risk.

Currently, 610 million people are considered to be at risk from the disease in Africa.

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