[e-drug] layperson administered tetanus vaccination

[e-drug@usa.healthnet.org]

E-DRUG: layperson administered tetanus vaccination
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[From UNICEF, http://www.unicef.org/newsline/02pr46mali.htm
This may be a useful user-friendly technology, and may be safe in
laypersons. However, what about the costs? The new technology is donated
for 3 years.
Will it be available for USD 1.20 per case after that (as the current
vaccines cost)?
WB]

UNICEF Press Centre

New effort to reach women with tetanus vaccine could save thousands of
lives

Pre-Filled Injection Device Is Helping Reach Remotest Communities

Bamako / Geneva / New York, 26 July 2002 -

UNICEF today announced concentrated efforts to reach women in poor,
hard-to-reach communities with vaccine against maternal and neonatal
tetanus, an effort it said could potentially save the lives of thousands of
women and their new-born children.
UNICEF said the campaign, which starts today in Mali, is being enhanced by
the introduction of a pre-filled injection device that will make it easier
to immunize women in remote areas. The new device, BD UnijectT with tetanus
toxoid is a single dose, pre-filled syringe and needle that can be
administered by lay people.

Maternal and neonatal tetanus can be eliminated globally through
immunization and hygienic birth practices. But it has often been difficult
to reach women and children in remote communities since the traditional
vaccination can only be administed by trained health workers. As a result,
last year alone, tetanus claimed the lives of 200,000 newborns and 30,000
women in 57 developing countries.

"The introduction of a pre-filled injection device has the potential to
greatly simplify the way this vaccination is given, making it possible to
train non-medical personnel such as social workers and teachers to
vaccinate women against tetanus," said Carol Bellamy, Executive Director of
UNICEF. "Our goal is the elimination of maternal and neonatal tetanus by
2005, and reaching women in remote areas is essential to succeeding." She
noted that women at risk must receive at least three doses of the vaccine
over a one-year period to be fully protected.

Since lay people can use the new device, traditional birth attendants,
teachers and community workers are being trained to support health workers
in immunizing women in communities without access to clinics or health
centers.

The pre-filled device has additional advantages:

It is a single-use needle and syringe, reducing the possibility of
transmission of blood-borne diseases such as HIV/AIDS and Hepatitis.

It has a very small needle, about an inch long, making it easier to dispel
fears of needles and vaccinations.

UnijectT is manufactured by BD (Becton, Dickinson and Company) and another
company, Bio Farma, produces the vaccine and fills the syringe. The two
companies have jointly donated 9 million units to UNICEF over the next
three years for use in the collaborative effort to eliminate maternal and
neonatal tetanus.

"This is an excellent example of a partnership between the public and
private sectors," Bellamy said. "We are grateful for the donation these
companies have made and hope their commitment to this campaign will be a
lasting one. There is no reason why women and children should die from a
disease we can effectively prevent."

The first major use of UnijectT for tetanus immunizations will be in two
remote districts in Mali - Bla and Bougoni - from July 25 to July 31. The
Ministry of Health is carrying out the campaign with support from UNICEF,
BASICS and Save the Children (U.S.). A total of 118,000 women of
childbearing age (14-45) will be vaccinated during this period. The use of
UnijectT will be extended later in the year to other districts in Mali and
to other developing countries where maternal and neonatal tetanus is still
claiming the lives of thousands of children and their mothers.

The global campaign to eliminate maternal and neonatal tetanus is being
spearheaded by Ministries of Health, UNICEF, WHO, UNFPA, PATH, BASICS, Save
the Children (US) and other partners. The Maternal and Neonatal Tetanus
Elimination Initiative has received major donations from the Government of
Japan, the US Fund for UNICEF, the UK National Committee for UNICEF, Ronald
McDonald House Charities, The Bill and Melinda Gates Foundation, and Becton
Dickinson.

About Maternal and Neonatal Tetanus

Neonatal tetanus is a deadly disease, common in poor countries, mostly
affecting populations with little or no access to basic health care
services and education. The disease, which was eliminated in the
industrialized world as far back as the 1950s, is still a major killer of
infants in the developing world, responsible for no less than 200,000
infant deaths every year and accounting for 14 per cent of all neonatal
deaths.
Up to 70 per cent of all babies that develop the disease die in their first
month of life. It occurs as a result of unhygienic birth practices, leading
to contamination of the umbilical cord with tetanus spores when it is being
cut or dressed after delivery. The disease usually presents itself on the
third day after birth, causing the baby to stop feeding due to stiffness of
the jaw muscles. The baby then goes into painful convulsions, coma and
eventually dies.

Maternal tetanus is also caused by contamination from tetanus spores
through puncture wounds, and is linked to unsafe and unclean deliveries.
Maternal tetanus is responsible for at least five per cent of all maternal
deaths, and accounts for up to 30,000 deaths each year.

Unlike smallpox and polio, complete eradication of tetanus is not possible
as the tetanus spores can survive outside the human body, in dirt and in
the stools of infected people and animals. The disease can be transmitted
without any human contact.
In the past it has cost $1.20 per woman to provide three doses of tetanus
toxoid and promote clean delivery practices. Over the 2-year period since
the Initiative began (in 1999/2000) the partnership has been able to
prevent 15,000 additional newborn deaths.




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