Lee and Harmer’s editorial marking 10 years of Global Alliance for Vaccines and Immunisation (GAVI)1 was published before discussion of a controversial press release issued by the World Health Organization jointly with GAVI and others in 2007 after the Bangladesh study on Haemophilus influenzae type B (Hib) vaccination.2 3 4 The press release suggested that the vaccine was useful whereas the study showed no benefit. No statistical difference was seen in the vaccination state of those with pneumonia or meningitis compared with controls. A post-hoc analysis presented without proper multiple testing was used to bolster the erroneous claim. Contrary to the implication in the press release, analysis of data from an earlier Indonesian probe study also found no benefit.5
This misleading press release looks like a smoking gun. GAVI (which includes representatives of vaccine manufacturers on its board) “encouraged” developing countries in Asia to avail themselves of the vaccine at subsidised rates. The subsidy came from money given by donor countries and the Bill and Melinda Gates Foundation for achieving millennium development goals. Given that the probe studies in Asia had failed to confirm benefit from the vaccine, millions of dollars from the Millennium Development Goals Fund seem to have been wasted.
Those responsible need to be called to account. If that is not seen to happen, the credibility of WHO and GAVI and other global organisations will be eroded. Widespread reporting of these events may also change how decisions are taken for developing countries.
Cite this as: BMJ 2010;341:c4081
Jacob M Puliyel, head1
1 Department of Paediatrics, St Stephen’s Hospital, Delhi 110054, India