In a model of public and private partnership, the medical technology company BD (Becton, Dickinson and Company) has teamed up with the United Nations Children's Fund (UNICEF) to eliminate maternal and neonatal tetanus by giving vaccinations to millions of women and children in poor countries around the world.
The program centers around a device called UnijectTM which BD manufactures. BD developed the device specifically for public service projects in the developing world. UnijectTM is an easy-to-use syringe that comes filled with the proper dosage of vaccine. It remains viable without refrigeration for three months, which allows it to be transported to remote corners of the globe. It can easily be administrated by non-medical personnel with very little training. And to top it all off, the needle does not hurt any more than a mosquito bite.
Where vaccination is rare, tetanus stalks childbearing women and their newborns because of bacteria spread during childbirth. Tetanus kills at least 200,000 newborns and 30,000 mothers every year. If mothers are vaccinated, infants are protected from contracting the disease at birth, though they should still be immunized later in life.
BD has pledged to donate half of the 270 million injection devices that will be used in this worldwide campaign. Initially, the company planned to donate nine million Uniject devices and 126 million SoloShot™ auto-disable syringes, another device BD manufactures. But according to Gary Cohen, president of BD Medical Systems, more UnijectTM devices may be necessary. “Uniject has turned out to be so instrumental in reaching remote areas,” he said.
He should know. In late July, he flew to Mali with representatives from UNICEF to help in a one-week marathon effort to vaccinate 118,000 women.
“Mali is a very poor country,” he said. “I would consider many places to be undeveloped, as opposed to underdeveloped.” The group started in the capital, Bamako, then moved on to small cities and large towns with health clinics. From there, the visitors drove for hours on dirt roads to remote villages with no running water or electricity.
Cohen said that he and the other foreign visitors, including reporters, tried the device and found it extremely easy to use. But more important was a testimonial he received from a midwife in one of the towns he visited.
“She told me that it made a huge difference for her to be able to use Uniject,” Cohen said. “She was able to vaccinate three times as many women in the same time period. And the most significant thing she said, which hit all of us in the heart, was that using it increased the valor of her job. That was a direct translation. ... That was a testimonial that was much stronger than I had anticipated hearing and it redoubled my personal resolve to make sure that we make this device as accessible as possible to the areas that need it.”
BD has taken part in similar public health initiatives in the past. In the 1950s, when polio was eradicated in the U.S., BD initiated the first large scale effort to use disposable injection devices, providing them at no cost. In June, the company joined UNICEF, the Red Cross and the World Health Organization in a measles vaccination effort in Kenya. BD has also donated money towards the development of an AIDS vaccine. The tetanus effort, however, is BD's largest effort to date; the company's donations are worth about $18 million.
The Uniject™ concept was born at the Program for Appropriate Technology in Health (PATH), a non-profit. BD obtained the design in the 1990s, and was the first company to manufacture it. Bio Farma, an Indonesian pharmaceutical manufacturer, is donating the vaccine and filling the syringes. At least $100 million is needed to supplement the BD and Bio Farma donations, and $70 million has already been raised, much of it through a donation from the Bill and Melinda Gates Foundation.
