Goats and soda: NPR

In South Korea, there is a long corridor bordered by refrigerators without an appointment. Inside there are boxes filled with oral vaccines with cholera. This is the stock of emergency cholera vaccine – and boxes fly shelves towards places such as Angola, Sudan and South Sudan.

“For the moment, we are sending approximately 5 million doses each month, so it means that as soon as the box arrives, another spell,” explains Allyson Russell, epidemiologist at Gavi, alliance vaccination, and a senior program manager for epidemics and world health security. Gavi, a global public-private organization, finances the stock and aims to have just over 5 million doses available at any time, although it has had Problem in the past achieve this goal.

There are similar stocks around the world. In freezers in Switzerland, there are Ebola vaccines. Elsewhere, there are stored meningitis vaccines; Ditto with yellow fever vaccines. While some are kept at ultra-strong temperatures, such as Ebola vaccines, most only have to be refrigerated.

“Imagine yourself sticking your hand in a refrigerator to take out your shopping,” said Russell.

The world’s leading stocks were created in 1997 when the main meningitis epidemics in Africa caused a public health crisis. Vaccines are available for any country in the world. These stocks are now under the spotlight because, for the first time, the researchers quantified the number of saved lives based on stored vaccines. But this news comes in the context of uncertainty. There are new concerns about what the future of these world stocks will look like a major drop in global health funding.

How much “game changer” exactly?

Russell spends his immersed days in the details of the stock system. She knows which countries have sent an email under the form to request doses in the stock. She knows if the doses are common to an epidemic by charter flight or in the cargo of a commercial aircraft.

And one thing is clear for her. “You can see how vaccines change the trajectory of what’s going on (in an epidemic),” she said. “The vaccine can really change the game.”

But, she said, she has never known how much these stocks are “for the moment.

The researchers criticized the figures. They have examined more than 200 epidemics in the past 20 years, modeling what would happen without vaccines. Nick Scottco-author of the study published this month in the British medical newspaper – Global HealthSaid that the results were exciting: a 60% reduction in cases and deaths due to epidemics due to the stock.

“This is a pretty incredible thing,” said Scott, chief of modeling and biostatistics at the Burnet Institute in Melbourne, an independent medical research group. This 60% drop means that around 6 million cases have been avoided and that 300,000 deaths have been avoided.

“This study was really supposed to ask the question, do Gavi’s stocks are worth it? Is it worth having them?” said Dr Ruth KarronWho is director of the Johns Hopkins Initiative Vaccine and was not involved in the study. “And I think the answer – very robust – is absolutely.”

Research – which was financed by Gavi and started at the beginning of 2024 in order to help to shed light on its strategic planning – found more than $ 32 billion in stock economic advantages, since there was less death and less disability in the 200 epidemics considered.

The researchers say that this is a significant underestimation and that the real economic advantages are probably much higher. Indeed, this calculation does not take into account things such as the cost of the response to epidemics which are avoided or the economic disturbances created by large epidemics. Based on Gavi Financial planning documentsPurchases for stocks cost less than $ 100 million a year.

The Scott team also found that speed really matters.

“When there is an epidemic, the more the vaccine’s response can start quickly, the more it will have an impact,” he said. This intends because containing a propagation of a disease can mean avoiding enormous social disturbances.

“What we have seen is that these vaccines are really essential to prevent things like school closings, business closings, travel restrictions,” said Scott.

The importance of speed is one of the reasons why stocks exist first.

“He can easily take up to a year to do these vaccines. Ebola vaccines take a year. Meningitis vaccines take around four to six months,” said Russell. “If you were to place the order and then make the vaccines, who knows what would happen to the epidemic.”

However, says Scott, the preparation of vaccines is not sufficient. There must also be mechanisms in place to bring the doses to the epidemic, then administer them to people who live and work in the affected area. While international aid organizations are faced with historical financing cuts, these stages could become more difficult.

“ Everything is question ”

Karron says that the results take place at a particularly important time.

Global health funding falls to a 15 -year hollow, according to a study published this month in the medical journal The Lancet. And this obliges international health organizations to fight against what they can afford to keep and what they must let go. These days, everything is on the table, including global stocks of emergency vaccines, explains Karron.

Gavi is nearly $ 3 billion in its budgetary target for the next five years. Part of the deficit comes from American announcement Last month, he will reduce Gavi’s support until he was able to “rearore public confidence”. The Secretary of Health and Social Services, Robert F. Kennedy Jr., explained the decision saying that Gavi had neglected the security problems of vaccines, a Gavi accusation vigorously denies. Critics indicate that the RFK Jr. study cited as proof is imperfect.

This week, the organization’s board of directors will meet to understand what to prioritize.

“So, of course, everything is in question,” explains Karron.

A challenge with stocks is that stored doses can expire, explains Karron. The doses made for routine immunizations are generally used quickly and do not come up against their expiration dates. It is not a guarantee with the stock. Gavi has a system where once the vaccines in the stock reach a year remaining in their shelf life, they can be used in a preventive program – for example in a high -risk location where researchers predict meningitis epidemics. However, says Karron, it is not always possible.

“So, the question is: is it worth the investment knowing that you could have a waste vaccine?” she asked. She says that the clear response of this study is that it is in the interest of everyone to maintain stocks of fully stored emergency vaccines.

“If we do not want some of these diseases, such as Ebola, to come on our banks (we), we really have to contain them at the source,” explains Karron.