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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 Uniject™ 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.

Uniject™ 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."

Uniject™ 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 Uniject™ 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 Uniject™ 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.