The GiveWell Blog

Some thoughts on the yellow fever vaccine

There’s news today that the Yellow Fever Initiative is facing a budget shortfall and may be unable to purchase needed vaccines in the near future (h/t Christine Gorman):

Emergency supplies of yellow fever vaccines are set to run out next year, and there is no funding to continue immunisation campaigns after that, World Health Organisation experts said on Tuesday.

The mosquito-borne yellow fever virus infects 206,000 people a year and kills 52,000, mainly in tropical regions of Africa and the Americas.

Recent outbreaks in Brazil, Central African Republic and elsewhere have drawn down the 6 million doses of yellow fever vaccine reserved for emergency response, and a $186 million shortfall has left the WHO unable to vaccinate high-risk people in Ghana and Nigeria as it had planned.

“For 2011, the Yellow Fever Initiative has no funding for either the emergency stockpile or the continued roll-out of preventive campaigns,” she told a news briefing in Geneva.

“As we look beyond 2009, we already see serious funding constraints,” Dr. William Perea, the WHO’s epidemic readiness and intervention coordinator, said in a statement after a two-day meeting of U.N. and aid groups.

Is there a real possibility of the program stopping because of lack of funds?

Is this the type of funding gap that will eventually be filled by donors (by governments or the Gates Foundation)? It seems like donors have a good deal of time before 2011 to give more money. Or, alternatively, can the WHO reallocate funds from a program that has adequate funds to the Yellow Fever Initiative which does not?

The history of Yellow Fever in Africa may shed some light on this:

Between the 1940s and 1960s, widespread mass vaccination campaigns in some African countries had resulted in the almost-complete disappearance of yellow fever. However, as immunization campaigns waned, a generation of people grew up with no immunity to the disease, and by the 1990s the number of annual cases had risen to an estimated 200 000 per year, with 30 000 deaths, and urban outbreaks were starting to occur.

Yellow fever had returned as a major scourge and, as urbanization progresses across Africa, the threat of a major epidemic looms ever larger. WHO estimates, for example, that this highly transmissible disease could infect around one third of the urban population, or up to 4.5 million people, in Lagos, Nigeria alone.

We’re interested in learning about programs that stopped because they just couldn’t raise enough money. Is that what happened with Yellow Fever? Are there other examples of this happening?

How can an individual donor support immunization programs?

I don’t know much about the Yellow Fever Initiative. How does it compare to GAVI or VillageReach (both on our list of top contenders to be a recommended charity in our upcoming report) as a means for donors to support expanded immunization programs, a proven, cost-effective method for improving health and saving lives in the developing world.

In 2007, GAVI supported the Yellow Fever Initiative with a grant of close to 60 million dollars. Is this grant subject to the same reporting and evaluation requirements of GAVI grants through its “regular” channels (which includes funding for Yellow Fever vaccines)?

There’s little information about the Yellow Fever Initiative online (its main page is here).


  • Erica | Non Profit on August 13, 2009 at 6:55 am said:

    It would be so awesome, if there where more people giving to things like this that is a worthy cause, but there doesn’t seem to be any more.

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