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Immunisation and Human Rights



In the comfortable confines of the world's industrialised democracies, the cause of human rights provokes virtually no dissent. That is in part because most people think of torture and imprisonment, and perhaps rape, when picturing a violation of human rights, and few individuals would fail to line up with the forces fighting for respect for the rule of law.

But affirming an individual's human rights involves a broader commitment, and one that wealthy nations can easily address, as they begin to act on the G8's recent promise to alleviate poverty and disease among the world's poorest residents.

Consider the United Nations Convention on the Rights of the Child, which has been ratified by 191 countries. It states quite clearly that among other things, "every child shall enjoy special protection" and be given the opportunity to "develop physically, morally, spiritually and socially in a healthy and normal manner."

For many children in developing countries, these words have little meaning. According to the World Health Organisation, there are 10.5 million children who die each year before reaching their fifth birthday. Almost all of them are from developing countries and more than half are from Africa. A child from Sierra Leone is 100 times more likely to die before turning five than a child born in Germany or Japan.

There are many reasons for their misery. Poor children lack access to clean water, basic health care and proper nutrition, among other things. Many of them-some 27 million-also miss out on vaccines against common diseases, such as measles and whooping cough. As a result, some 1.4 million of them-approximately three each minute-die every year from infectious diseases we have the power to prevent easily, diseases that that, thanks to universal immunisation, have little impact on the children of wealthy countries.

A vaccine as a human right? Actually, it's hard to imagine a more basic infringement of children's rights than to deliberately put them at risk of dying. Yet that is essentially what we do every day we allow poor children to be exposed to deadly diseases that can be prevented with immunisations.

Few would argue that something should be done to close the vaccination gap between rich and poor. At the recent Gleneagles Summit, G8 leaders agreed to continue working on a British plan for using capital markets to fund vaccines for millions of the world's poorest children over the next ten years-recognition of the key role of immunisation in alleviating poverty and disease in developing countries. But even among those who would support vaccine initiatives, there may be a tendency to view immunisation as an act of charity.

Some might wonder whether it really makes any difference whether vaccines are considered charity or a right. There is, however, a practical reason for changing the terms of the discussion, and for viewing vaccines not as charity but as a human right, as a matter of fundamental equity and beyond that, a moral imperative.

Last year, a report on health and human rights by the United Kingdom's Commonwealth Medical Trust and the American Association for the Advancement of Science argued that when vaccines are characterised as a human right, as opposed to a hand-out, governments are more likely to provide children with immunisations.

"Within a human rights framework, immunisation is not simply a necessary medical requirement for children and a responsible public health measure; it is a right of all children with corresponding government obligations," the report states. "A government's immunisation program cannot within this framework be bargained away because of financial constraints or of other priorities as to how money should be spent in the health sector. The bearer of rights, in this case the child, is the focus. The protection to which the child is entitled through immunisation cannot be regarded as a 'charity' and therefore be dependent on the goodwill of the government."

Access to vaccines is, of course, not the only issue facing poor countries that should be brought under the banner of human rights. Access to adequate nutrition, clean water and education, among other things, also should be considered a basic right. Immunisations are particularly primed for such a philosophical shift because vaccines can make a dramatic difference in quality of life, and, logistically and scientifically, the only thing impeding progress is commitment to action.

GAVI (The Global Alliance for Vaccines and Immunisation) and its partner organisation, The Vaccine Fund, have established successful programs that are already at work delivering life saving jabs and shots-and developing new vaccines-for previously neglected populations. Spurring overall access to healthcare, they are providing an incentive for governments to make more investments, in healthcare and immunisation programs that can be quickly and efficiently scaled up to exponentially increase their reach.

For countries that profess to hold human rights sacred, the availability of proven solutions to save more lives and the prospect of closing the immunisation gap should be viewed not as a burden but as a unique opportunity. It offers us, the citizens of the world's rich countries, and our governments the chance to show the world that we are ready to breathe life into our human rights commitments, which too often seem to exist only on paper.