South-East Asia Regional Conference on Epidemiology

<strong>South</strong>-<strong>East</strong> <strong>Asia</strong> <strong>Regional</strong> <strong>Conference</strong> on Epidemiology | 101
revealed by selections from the most recent annual morbidity and mortality data available (list is
exemplary, not inclusive, of all vaccine preventable diseases):
• an estimated 745 000 children die of the complications of measles each year5 ;
• 600 000 tetanus deaths, 126 000 (21%) of which are neonatal;
• an estimated 45 million cases of pertussis with approximately 409 000 deaths;
• invasive Hib disease (meningitis and pneumonia) still results in 400 000 – 700 000 child
deaths annually
• WHO's conservative estimate for the meningococcal meningitis disease burden is 300 000 to
350 000 cases and more than 30 000 deaths per year;
• acute respiratory infections kill an estimated 2.6 million children less than five years of age
annually; the pneumococcus causes over 1 million of these deaths, most of which occur in
developing countries.
So, while the public is kept almost breathlessly informed of each new increment of progress
in developing long-awaited vaccines against malaria, HIV, tuberculosis, rotavirus and human
papillomavirus, the regrettable under-use of existing vaccines receives scant attention.
The following excerpts from especially poignant works by a Nigerian (Chinua Achebe) and a
Ugandan (Okot p’Bitek) speak volumes about the conditions under which much of humanity lives
even today in the 21st century:
“…As I stood in one corner of that vast tumult waiting for the arrival of the Minister, I felt intense
bitterness welling up in my mouth. Here were silly, ignorant villagers dancing themselves lame and
waiting to blow off their gunpowder in honour of one of those who had started the country off down
the slopes of inflation. I wished for a miracle, for a voice of thunder, to hush this ridiculous festival
and tell the poor contemptible people one or two truths. But of course it would be quite useless.
They were not only ignorant but cynical. Tell them that this man had used his position to enrich
himself and they would ask you – as my father did – if you thought that a sensible man would spit
out the juicy morsel that good fortune placed in his mouth…” 6
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“…And while the pythons of sickness
Swallow the children
And the buffalos of poverty
Knock the people down
And ignorance stands there
Like an elephant,
The war leaders,
Are tightly locked in bloody feuds
Eating each other’s liver…” 7
The vision that I have is of a different world, a world in which every child is appropriately vaccinated
as per his/her age against the major killers mentioned above. While it remains an impossible dream
to provide every household on earth with running water and sanitary waste disposal, the ‘other’ things
5 We have had today’s measles vaccine since 1978.
6 From A Man of the People by Chinua Achebe, 1966.
7 From The Song of Lawino by Okot p’Bitek, 1966.