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As hard as it may be to believe, diarrhea causes the deaths of 500,000 children under the age of five every year. Striking during the winter in countries where the poor do not have enough clean water for washing hands.

This Time the Vaccine Is Not for Profit

Striking during the winter in countries where the poor do not have enough clean water for washing hands and washing clothes, the diarrhea-causing rotavirus causes fever, abdominal pain, vomiting, diarrhea, and then death from dehydration, sometimes in just a few hours. Young lives usually could be saved with intravenous infusions of water and electrolytes, but even the $2 actual cost of bag of saline solution is out of reach for some families. And if they could afford the $10 to $50 that treatment costs, there are no doctors or nurses to insert the IV properly.

Hilleman Laboratories, a non-profit enterprise funded by pharmaceutical giant Merck and the Wellcome Trust in 2009, has announced that it will attempt to stop childhood diarrhea by developing an oral vaccine. Consisting of sugar-coated granules that dissolve on the tongue, this vaccine is intended to be easy to store, easy to transport, and easy to deliver to the children who might otherwise sicken and die from viral diarrhea. The vaccine to be given away, the US $0.50 cost of transporting the vaccine will also be paid by charities.

What's not to like about a vaccine for a deadly childhood disease? Vaccines have their detractors. Undoubtedly some headline somewhere will scream "Merck plans to poison poor." While it is true that vaccines "rob" the immune system of opportunities to develop natural defenses, if you happen to live in a country where people cannot wash their hands after going to the toilet, a lack of opportunities to develop your immune system is not going to be a problem. However, there is a more comprehensive, vaccine-free approach that might also be better for the poor.

If You Don't Like the Idea of Vaccines for Childhood Diarrhea

Children don't need vaccines for diarrhea when they live in homes with plentiful supplies of clean water. Children don't need vaccines for diarrhea if there is even enough water for everyone in the family to wash their hands and their clothes.

A study in a village in Bangladesh found that simply making hand soap and hand washing facilities available for the whole village reduced cases of childhood diarrhea by over 60 per cent. A study in Brazil found that making clean water available for washing dishes reduced cases of childhood diarrhea by 80 per cent. These achievements are comparable to what could be expected from a vaccine campaign—but they cost more than US $0.50 per child.

Providing clean water costs about $20 per child, and there are fewer total dollars available for water projects than for drug projects. Some organizations, however, are making a dent in water awareness and water projects. The American charity What About Blue, for instance, has sent a novice kayaker down the Mississippi River from Minnesota past New Orleans to raise funds for village wells. Simple, sensible, vaccine-free therapies for saving children's lives are already a reality, but they have much farther to go.

  • Shahid NS, Greenough WB 3rd, Samadi AR, Huq MI, Rahman N. Hand washing with soap reduces diarrhoea and spread of bacterial pathogens in a Bangladesh village. J Diarrhoeal Dis Res. 1996 Jun,14(2):85-9
  • Sobel J, Gomes TA, Ramos RT, Hoekstra M, Rodrigue D, Rassi V, Griffin PM. Pathogen-specific risk factors and protective factors for acute diarrheal illness in children aged 12-59 months in São Paulo, Brazil. Clin Infect Dis. 2004 Jun 1, 38(11):1545-51. Epub 2004 May 11
  • Photo courtesy of Gates Foundation on Flickr: www.flickr.com/photos/gatesfoundation/5391348510/