Lancet: Dozens of nations inflated vaccine numbers
AP foreign,
Saturday December 13 2008
By MARIA CHENG

AP Medical Writer= LONDON (AP)Dozens of developing countries
exaggerated figures on how many children were vaccinated against deadly
diseases, which allowed them to get more money from U.N.-sponsored
programs, a new study said Friday.

Research in the medical journal, The Lancet, said only half as many
children were vaccinated than was claimed by countries taking part in
special programs meant to reach kids in poor nations. The findings
raise serious issues about vaccination programs â’ and whether money
earmarked for children is actually reaching their intended recipients.

"With the unprecedented billions given by the international community,
there is no excuse for these poor coverage rates," said Philip Stevens,
of the International Policy Network, a London-based think-tank. "One
has to wonder where the money has gone hopefully not into Swiss bank
accounts."

American researchers analyzed records of children supposedly vaccinated
by initiatives led by the United Nations and related groups like the
Global Alliance for Vaccines and Immunization, or GAVI.

The scientists examined reports the countries gave to the United
Nations on how many children were immunized. They then compared those
figures to independent surveys on vaccination conducted by
non-governmental groups and other outside researchers.

The report did not20focus on the tens of millions of children immunized
globally each year. Instead, the researchers studied programs meant to
increase the availability of vaccinations in poorer countries
vaccinations designed to reach kids who would not be covered otherwise.

From 1986 to 2006, the United Nations reported that 14 million children
received immunizations in the programs. But the reports from the
independent surveys put that number at just over 7 million.

"The magnitude of the gap is surprising," said Christopher Murray,
director of the Institute for Health Metrics at the University of
Washington and the study’s lead author.

Murray and colleagues found that at least 32 of the 51 countries taking
part in the U.N.-backed programs over-reported by at least 50 percent
how many children were protected against diphtheria, tetanus and
whooping cough.

Experts suggest that inflating the numbers is part of a larger problem
in attracting limited resources.

"That’s how you get money," said Ken Hill, a public health professor at
Harvard University who was not linked to the study. "You exaggerate the
number of people who die or who you save to get visibility. Somehow,
numbers always end up bigger than they would be otherwise."

The global alliance pays developing countries $20 per extra vaccinated
child a payment that relies exclusively on reports from the countries.

Murray and colleagues estimated that the alliance should have paid=2
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countries $150 million. Instead, it paid them $290 million.

The report said the worst countries for over-reporting were Armenia,
Somalia, Zimbabwe and Myanmar, none of which immunized any additional
children at all.

Countries that reported vaccination numbers more than four times higher
than surveys showed included Tajikistan, Pakistan, Togo, Lesotho,
Liberia and Zambia.

Those overestimating immunizations by more than two times were Niger,
Ivory Coast, Congo, Central African Republic, Guinea, Indonesia,
Gambia, North Korea, Chad and the Democratic Republic of Congo.

Nations that claimed at least 50 percent more vaccinations than were
actually done included Afghanistan, Burkina Faso, Mali, Sudan, Uganda,
Tanzania, Ethiopia, Rwanda, Ghana, Azerbaijan, Cameroon and Nepal.

Experts said the study raised questions about the credibility of other
health data from the United Nations and countries.

Julian Lob-Levyt, the chief executive officer of the global vaccines
alliance, said it would hold off on all payments until affected
countries can clarify what is happening in their programs.

He also stressed that there was no evidence of corruption in any of the
countries that had received money from the alliance.

Some experts worry that the Lancet study, which was paid for by the
Bill & Melinda Gates Foundation, overstated the problem and that
immunization programs would be unfairly overhauled.

The United Nations has been criticized for its fluctuating figures in
the past. In 2007, it dramatically slashed its HIV figures, citing new
surveillance methods.

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