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第1亿名接种脑膜炎救生疫苗的人 经济、安全、有效的疫苗 保护年轻人远离恶疾

2012-12-03

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 Feuary, 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.
日内瓦/香港,2012年12月3日──一个多世纪以来,脑膜炎一直困扰着非洲地区。为了对抗此致命流行病,研究人员遂研发出革命性的脑膜炎疫苗,本周,将会有第1亿名受惠者接种此疫苗。此举壮举将会在尼日利亚北部进行──位于非洲「脑膜炎地带」,该国目前正进行第二季防疫注射运动,全力防治脑膜炎。

此项歷史性的壮举,乃源于两年前,布基纳法索首度采用名为 MenAfriVac®的新型脑膜炎疫苗。自此,另外9个国家便相继展开防疫注射运动,为1至29岁的国民接种预防A型脑膜炎疫苗。

未来两星期,尼日利亚将为1,600万人接种疫苗;在本周,喀麦隆和乍得亦都同步推展疫苗接种运动,目标受惠人数分別达到550万和230万人。至今年底前,该疫苗将足以惠及逾1.12亿人,广泛地为人民带来期盼已久的保护。

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 Feuary, 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 outeak 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.
全球疫苗与免疫联盟(GAVI)的合作伙伴论坛,将于本周在坦桑尼亚首都达累斯萨拉姆举行。论坛匯集发展中国家、捐助者、民间团体、技术及科研机构、医疗衞生机构以及疫苗业界,一同见证这项伟大成就。

MenAfriVac®疫苗是由国际非营利衞生组织适宜衞生技术规划 (PATH)与世界衞生组织(世衞)共同研发的。PATH的总裁兼首席执行官史蒂夫.戴维斯表示:「最初研发这种疫苗时,我们己知道它的需求有多迫切。我们希望它能迅速地为广大民众提供援助,帮他们安然度过撒哈拉以南非洲的脑膜炎流行季节。」他续指:「对于非洲国家迅速采用此疫苗对抗脑膜炎,我们感到十分自豪,同时欣然看到已接种疫苗的地区,几乎再沒有致命及因脑膜炎引致患者身体衰竭的病例。」

在世衞负责家庭、妇女和儿童衞生事务的助理总幹事Flavia Bustreo博士表示:「这项里程碑之所以能实现,全赖各国政府的承诺,以及世衞和其他合作伙伴的支持。」她续说:「我们必须继续努力,在余下仍然在『脑膜炎地带』的国家实施防疫注射运动,确保广泛民众接种到MenAfriVac®疫苗。」

负责资助防疫注射运动疫苗的GAVI,总裁塞思.伯克利博士坦言:「脑膜炎是一种可怕的疾病,它会夺去年轻患者的性命,许多倖存者即使生还,亦会出现严重的神经损伤,为社区带来巨大的灾难。」他续说:「由GAVI资助的第1个『脑膜炎地带』脑膜炎防疫注射运动开展以来,相隔整整两年时间,便将有第1亿个人的生命因此得到保障,这实在是一项非凡的成绩。」

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.
「将MenAfriVac®疫苗发展为低成本的疫苗,对全球衞生界来说极为重要。」比尔及梅琳达.盖茨基金会的全球发展项目总裁克里斯.埃利亚斯表示:「疫苗能拯救生命,改善人民生活。在受脑膜炎影响的国家,政府推出这新型疫苗以保护年轻人的速度之快,实在值得仿效。」

联合国儿童基金会副执行主任吉塔.饶.古普塔表示:「在萨赫勒地区的国家,A型脑膜炎影响着最贫困的家庭。在最坏的情况下,A型脑膜炎甚至可夺去受影响社区三分之一人口的性命。」她指出:「但现在,防疫注射运动已为从前未能受惠的贫困家庭,带来希望,带动更多人接受这安全、有效及经济的防疫注射。」

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 eastfeeding and the promotion of hand-washing.
西起冈比亚,东至厄立特里亚,整个「脑膜炎地带」足以绵延 26个国家,属季节性传染病的A型脑膜炎就在此地带肆虐,威胁着当地4.5亿人的生命。此病会导致患者大脑和嵴柱周边的脑膜发炎,引发剧烈疼痛,在24至48小时之内致命。即使倖存,患者往往要面对严重学习障碍、失聪或截肢问题。而儿童和青少年正是此疾病的最高风险患者。

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 Feuary 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,非洲爆发史上最大规模的季节性A型脑膜炎疫症,当时导致25万人受感染,25,000人死亡。非洲国家的衞生部长遂在1997年,同时向世衞和其他合作伙伴发出唿吁,期望找出能长远对抗此顽疾的办法。

在2001年,PATH和世衞联合组成脑膜炎疫苗项目,研发一种对非洲国家而言,经济实惠的疫苗,用于应付会引起A型脑膜炎的脑膜炎球菌。过往的新型疫苗,要不未被设计成可应付发展中国家的变种疾病,要不就是过于昂贵,令发展中国家无法负担並用于其防疫注射计划。PATH 和世衞遂与印度血清研究所有限公司合作研发疫苗,並以每剂低于约港币3.9元(0.50美元)的成本生产,以应付庞大需求。

在此疫苗所及的地区,脑膜炎已显着受到控制。在2010年12月,布基纳法索推出首届MenAfriVac®防疫注射运动后,获接种疫苗的人士当中,均无出现A型脑膜炎感染个案。

伯克利博士表示:「对生活在世上最弱势地区的人来说,这疫苗大大改善了他们的生活。有份参与研发这疫苗的合作伙伴,确保这适当的疫苗能以合适的价格出售,实在值得我们称道。」

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, outeaks 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®疫苗更获认可,在40°C高温下,即使离开疫苗冷藏系统后,只要使用可调温疫苗冷藏系统 (controlled temperature chain),其有效期最多可保持4天,是首种在非洲获得此认可的疫苗,为其他耐热性疫苗所借鑑。

疫苗需存放在疫苗冷藏系统的限制,为MenAfriVac®或其他防疫注射项目带来物流上的挑战:项目成本上升、供货延误,以及令疫苗难以覆盖最偏远的社区,都令疫病持续爆发。贝宁在上月15至25日开展有关的防疫注射计划,便采用了此崭新的可调温疫苗冷藏系统,进行试点项目。

自MenAfriVac®疫苗在2010年推出以来,布基纳法索、马里、尼日尔、尼日利亚、乍得、喀麦隆、苏丹、加纳、贝宁和塞内加尔已先后进行疫苗接种运动。