News

    Vaccine to Save a Generation of South African Children

    South Africa's Dr. Petro Basson says the pneumococcal vaccine will save thousands of lives... but she hasn't seen it in the Free State province, where she works.
    South Africa's Dr. Petro Basson says the pneumococcal vaccine will save thousands of lives... but she hasn't seen it in the Free State province, where she works.
    Darren Taylor

    A swirling gale raises red dust in the crumbling streets of Dithlake, an impoverished township in the west of South Africa’s central Free State province. The same warm wind flattens nearby wheat fields, almost iridescently golden, and seemingly endless pastures of bright yellow sunflowers.

    But Dithlake is far from a rural idyll.

    Many of the area’s children get pneumonia. Some die, their bodies buried under simple slabs of concrete in the local graveyard. Public health facilities in the district are scarce.

    Three-year-old Daniel Petrus lives with his parents in a small shack in Dithlake. The two-roomed building is made out of corrugated iron and soggy wooden panels. Daniel’s father has placed old tires on top of the rusty roof to prevent it from blowing off.

    A doctor immunizes a baby
    A doctor immunizes a baby
     

    The Petrus family is poor. Daniel’s only toy is a bald, graying tennis ball, which he rolls across a dirty makeshift floor of loose bricks. But the child appears happy, laughing as his sticky fingers once again collect his ball.

    Yet just a month ago, his mother says, Daniel was almost dead. “He couldn’t breathe,” she whispers.

    Fortunately, a relative was able to rush Daniel to hospital in the nearest large city, Bloemfontein. He was diagnosed with pneumonia, but he survived after treatment.

    Prof. Shabir Madhi, a top South African pediatrician, says Daniel’s a “very lucky” boy. He could easily have become one of the estimated 300,000 African youngsters killed by pneumococcal disease every year.

    Youngsters on the continent die in particularly tragic circumstances, since these illnesses are completely preventable. Due to medical advances, deaths from pneumococcal disease have become rare in the developed world, but are still common across Africa.

    Leading cause of death

    “Pneumococcal disease is probably the leading cause of death in children from any single pathogen,” says Madhi, the co-director of the University of the Witwatersrand’s respiratory and meningeal pathogens research unit.

    The illnesses are so common, he says, because pneumococcus bacteria are present in six out of every ten people’s mouths. But while most healthy adults are strong enough to resist adverse effects, babies and very young children – and HIV-infected people with weak immune systems - aren’t.

    “It’s a bacteria which can cause serious ear infections (sometimes leading to deafness), and infections of the chest or the lungs – which we call pneumonia – as well as infections around the brain, which is known as meningitis,” Madhi explains.

    He says when a child first falls ill with pneumonia it often seems as if it just has a mild cold, with a runny nose and a fever. “But quite a few of those children eventually end up developing a superimposed pneumococcal infection. And when they develop this, over and above the underlying viral infection, that’s when they become really ill,” Madhi says.

    Prof. Shabir Madhi, South African expert on early childhood diseases, has tested a vaccine against pneumococcal sicknesses and delivered "astounding" findings.
    Prof. Shabir Madhi, South African expert on early childhood diseases, has tested a vaccine against pneumococcal sicknesses and delivered "astounding" findings.

    The infected child has a bad cough, battles to breathe, and grunts. Eventually, the lips of a baby that’s severely affected will turn blue, because it can’t get enough oxygen.

    “The problem with pneumococcal pneumonia is that if there’s not good access to health care, it’s a disease which can be extremely fatal,” Madhi tells VOA. “In rural areas in South Africa or in other settings in Africa….children that can’t get to health care facilities (soon after) they develop pneumonia, there’s a very high mortality rate.”

    The scientist also specializes in meningitis. Again, in the case of this illness, an infected child will experience a fever, but also accompanied by a headache, blurred vision, vomiting, and neck stiffness. Even with access to good care, says Madhi, three out of every ten people who get pneumococcal meningitis, die.

    Over the past two decades, the professor explains, it’s become especially difficult to treat pneumococcal disease in South Africa, as the pneumococcus bacteria has developed resistance to antibiotics that were once successful in fighting it.

    This “major obstacle,” says Madhi, spurred him on to do intensive research to prevent the disease from occurring, rather than relying on antibiotics to actually treat it. International health experts consider the work completed by the South African professor and his team in this regard as groundbreaking.

    The Soweto trials and the HIV link

    Madhi’s unit is at the Chris Hani – Baragwanath Hospital, the largest hospital in the southern hemisphere, in Soweto on the outskirts of South Africa’s biggest city, Johannesburg. About two million people reside in the area where poverty is rife. Every day, more than 2,000 patients check into the facility…. with almost a quarter of them being HIV-positive.

    About 22, 000 of the 30,000 children born annually in Soweto are delivered at the hospital locals call ‘Bara,’ which has made it an ideal setting for Madhi’s life-saving mission.

    A Rwandan nurse prepares a dose of Prevenar, a pneumococcal vaccine. The South African government has also made the vaccine part of its national immunization program.
    A Rwandan nurse prepares a dose of Prevenar, a pneumococcal vaccine. The South African government has also made the vaccine part of its national immunization program.
     

    Over the past few years, the researcher has evaluated the efficacy of medicine designed to prevent pneumonia and meningitis. Madhi has given the pneumococcal conjugate vaccine (PCV) - which included the ingredients of the commercially available drug, Prevenar - to 40,000 babies, of whom 2,500 were HIV-positive.

    In South Africa - at 5.5 million, the country with the highest number of HIV-infected people in the world – Madhi says it’s “impossible” to separate pneumococcal disease from HIV. “Largely because of the HIV pandemic, there’s a huge child and infant mortality rate in Soweto. But the real reasons why these children die are complications because of HIV and AIDS. And one of the major complications of HIV and AIDS is in fact death due to pneumonia,” he explains.

    Because their immune systems are so weak, HIV-infected children are particularly susceptible to pneumococcal illnesses, with three-quarters of all cases in South Africa occurring in youngsters with HIV.

    Madhi’s work in Soweto has yielded tremendously positive results.

    “By vaccinating children we were able to reduce severe invasive pneumococcal disease due to those strains included in the vaccine by 85 percent in HIV-uninfected kids, and by 65 percent in HIV-infected kids,” the professor enthuses.

    South Africa's Dr. Petro Basson says the pneumococcal vaccine will save thousands of lives... but she hasn't seen it in the Free State province, where she works.
    South Africa's Dr. Petro Basson says the pneumococcal vaccine will save thousands of lives... but she hasn't seen it in the Free State province, where she works.

    In April 2009, largely as a result of Madhi’s team’s efforts, the South African government became the first in Africa to introduce the pneumococcal vaccine – trade-name, Prevenar - into the country’s public immunization program.

    The scientist says South African babies are now receiving the inoculation in three doses, injected at six and 14 weeks of age, and finally when the child is nine months old.

    Vaccine is ‘invisible’ in some poor areas

    Even South Africa’s notoriously anti-government health activists have praised the state for budgeting millions of dollars to save children’s lives. But challenges remain. In isolated, under-resourced areas of the country – such as Dithlake - Prevenar is invisible.

    “I must say, working in the rural communities of the Free State….the communities that really need this vaccine are ignorant about its existence,” says Dr. Petro Basson, a highly-qualified nurse who regularly visits health facilities to care for children with “life-limiting” conditions, including HIV.

    Madhi, who’s also a member of a government task team on immunization, acknowledges that there were initially “some hurdles” in terms of introducing the vaccine throughout South Africa. But he says these have largely been overcome and that “full national coverage” will soon be achieved.

    Basson maintains, though, that it’s “hard” for people in particularly the nation’s isolated rural areas to immunize their children, especially in light of the fact that three separate injections at different stages of a baby’s early life have to be administered for the vaccine to be effective.

    “They stay 20 kilometers from the nearest clinic. So this makes it very, very difficult. It’s hard for them to visit a clinic even once. There isn’t an ambulance that can pick the child up because it isn’t an emergency situation (to get a booster injection),” the nurse laments.

    The only solution, Basson insists, is for the South African government to build more clinics. But some health economists say the authorities are already short of cash, with the state’s pneumococcal immunization program costing at least 600 million rand (US $ 85 million) a year.

    Extreme expense of Prevenar

    However, South Africa is fortunate. Without donor funding, the vaccine remains out of reach for most African countries.

    Babies awaiting immunization that could save their lives
    Babies awaiting immunization that could save their lives

    “It’s extremely expensive,” says Madhi. In the private sector in South Africa, the cost of one dose of Prevenar is almost US$ 200, with each child needing three doses.

    Madhi adds ruefully, “That’s basically more than the income of families in many African countries, for an entire year or even two.”

    But the Global Alliance for Vaccines and Immunization – or GAVI – is coming to the rescue of some of the extremely resource-poor countries that are in dire need of Prevenar. GAVI has provided support to Rwanda, for example, to introduce pneumococcal vaccine into its national immunization program. GAVI is partly funded by a number of industrialized countries, and South Africa itself contributes to the initiative, as does the Bill Gates Foundation.

    South Africa, explains Madhi, doesn’t qualify for GAVI assistance, since its per capita income is more than $1,000 a year – hence its state support for pneumococcal immunization.

    GAVI aims to introduce Prevenar into at least 45 eligible countries within the next five years.

    “That’s a very ambitious program. And if that does happen, it would save close on four to five hundred thousand children dying each year,” Madhi states. But he adds that it’ll be a “major challenge for these countries to sustain these immunization programs when the donor money dries up.”

    At the moment though, Madhi is choosing to reflect on the positive aspects of South Africa’s initiative. “By preventing children from dying today, what we’re basically investing in is allowing those children to actually develop their potential and hopefully to be productive members of society into the future,” he says.
     

    This is part 15 of our 15 part series, A Healthy Start: On the Frontlines of Maternal and Infant Care in Africa

    « Prev: Fetal Alcohol Syndrome Series Index Back to Beginning »
    This forum has been closed.
    Comments
         
    There are no comments in this forum. Be first and add one

    Featured Videos

    Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
    Tensions Rising Ahead of South China Sea Rulingi
    X
    May 03, 2016 5:16 PM
    As the Philippines awaits an international arbitration ruling on a challenge to China's claims to nearly all of the South China Sea, it is already becoming clear that regardless of which way the decision goes, the dispute is intensifying. VOA’s Bill Ide has more from Beijing.
    Video

    Video Tensions Rising Ahead of South China Sea Ruling

    As the Philippines awaits an international arbitration ruling on a challenge to China's claims to nearly all of the South China Sea, it is already becoming clear that regardless of which way the decision goes, the dispute is intensifying. VOA’s Bill Ide has more from Beijing.
    Video

    Video Painting Captures President Lincoln Assassination Aftermath

    A newly restored painting captures the moments following President Abraham Lincoln’s assassination in 1865. It was recently unveiled at Ford’s Theatre in Washington, where America’s 16th president was shot. It is the only known painting by an eyewitness that captures the horror of that fateful night. VOA’s Julie Taboh tells us more about the painting and what it took to restore it to its original condition.
    Video

    Video Elephant Summit Results in $5M in Pledges, Presidential Support

    Attended and supported by three African presidents, a three-day anti-poaching summit has concluded in Kenya, resulting in $5 million in pledges and a united message to the world that elephants are worth more alive than dead. The summit culminated at the Nairobi National Park with the largest ivory burn in history. VOA’s Jill Craig attended the summit and has this report about the outcomes.
    Video

    Video Displaced By War, Syrian Artist Finds Inspiration Abroad

    Saudi-born Syrian painter Mohammad Zaza is among the millions who fled their home for an uncertain future after Syria's civil war broke out. Since fleeing Syria, Zaza has lived in Lebanon, Egypt, Jordan and now Turkey where his latest exhibition, “Earth is Blue like an Orange,” opened in Istanbul. He spoke with VOA about how being displaced by the Syrian civil war has affected the country's artists.
    Video

    Video Ethiopia’s Drought Takes Toll on Children

    Ethiopia is dealing with its worst drought in decades, thanks to El Nino weather patterns. An estimated 10 million people urgently need food aid. Six million of them are children, whose development may be compromised without sufficient help, Marthe van der Wolf reports for VOA from the Metahara district.
    Video

    Video Little Havana - a Slice of Cuban Culture in Florida

    Hispanic culture permeates everything in Miami’s Little Havana area: elderly men playing dominoes as they discuss politics, cigar rollers deep at work, or Cuban exiles talking with presidential candidates at a Cuban coffee window. With the recent rapprochement between Cuba and United States, one can only expect stronger ties between South Florida and Cuba.
    Video

    Video California Republicans Weigh Presidential Choices Amid Protests

    Republican presidential candidates have been wooing local party leaders in California, a state that could be decisive in selecting the party's nominee for U.S. president. VOA's Mike O’Sullivan reports delegates to the California party convention have been evaluating choices, while front-runner Donald Trump drew hundreds of raucous protesters Friday.
    Video

    Video Kurdish Football Team Helps War-Torn City Cope

    With the conflict still raging across much of Turkey’s predominantly Kurdish southeast, between the rebel PKK and the Turkish state, many Kurds are trying to escape the turmoil by focusing on the success of their football team Amedspor in Diyarbakir. The club is increasingly becoming a symbol for Kurds, not only in Diyarbakir but beyond. Dorian Jones reports from southeast Turkey.
    Video

    Video ‘The Lights of Africa’ - Through the Eyes of 54 Artists

    An exhibition bringing together the work of 54 African artists, one from each country, is touring the continent after debuting at COP21 in Paris. Called "Lumières d'Afrique," the show centers on access to electricity and, more figuratively, ideas that enlighten. Emilie Iob reports from Abidjan, the exhibition's first stop.
    Video

    Video Florida’s Weeki Wachee ‘Mermaids’ Make a Splash

    Since 1947, ‘mermaids’ have fascinated tourists at central Florida’s Weeki Wachee Springs State Park with their fluid movements and synchronized ballet. Performing underwater has its challenges, including cold temperatures and a steady current, as VOA’s Lin Yang and Joseph Mok report.
    Video

    Video Somali, African Union Forces Face Resurgent Al-Shabab

    The Islamic State terror group claimed its first attack in Somalia earlier this week, though the claim has not been verified by forces on the ground. Meanwhile, al-Shabab militants have stepped up their attacks as Somalia prepares for elections later this year. Henry Ridgwell reports there are growing frustrations among Somalia’s Western backers over the country’s slow progress in forming its own armed forces to establish security after 25 years of chaos.
    Video

    Video Nigerians Feel Bite of Buhari Economic Policy

    Despite the global drop in the price of oil, Nigerian President Muhammadu Buhari has refused to allow the country's currency to devalue, leading to a shortage of foreign exchange. Chris Stein reports from Lagos businessmen and consumers are feeling the impact as the country deals with a severe fuel shortage.

    Special Report

    Adrift The Invisible African Diaspora