The Journal The Authority on Global Business in Japan



Vaccines: Truths, Myths, and Realities

By David Hulmes

First there was global security, a state of high alert prompted by the war on terror. Then along came global energy security and global food security—protection without protectionism.

Now the world has a new threat to neutralize: global health security.

Where once outbreaks of disease tended to remain localized, particularly in the developing world, now they have the capacity to spread quickly, given the advent of a rising middle class in Asia and Africa that is making full use of its newfound ability to afford international travel.

With that comes the potential to unwittingly transport deadly diseases around the world.

Globetrotting business travelers and aid workers are others who can spread a virus across the planet.

“Global health security is really important. It’s one world now . . . Ebola has shown that,” according to Seth Berkley, chief executive of Gavi, the Vaccine Alliance. Berkley, recognized as one of the world’s 100 greatest influencers by Time magazine in 2009, was speaking in late October at the Tokyo American Club.

He addressed the topic of vaccination policy and preventable diseases at the seminar entitled, “Vaccines: Truths, Myths & Realities,” an event co-hosted by the American Chamber of Commerce in Japan and the European Business Council. 

Appearing alongside him was Nobuhiko Okabe, chair of the Subcommittee on Immunization and Vaccination at the Ministry of Health, Labour and Welfare (MHLW).

Both speakers drew parallels with, and made connections between, the local and the global, with specific reference to a controversy in Japan over the HPV vaccine given to girls and young women to help prevent cervical cancer.

The MHLW withdrew its HPV vaccination recommendation last year after several hundred recipients complained of side effects, largely related to long-term pain and numbness.

Consequently, local health officials were told not to promote the vaccination while investigations took place, although the vaccine is still available on request.

And in the intervening 18 months? Silence.

When the forum was thrown open to questions from the floor, one audience member wanted to know: “Is the mood in Japan changing to allow more serious discussions on the HPV vaccine?”

Okabe replied, “We need some more time. We have to think about the young female generation.”

Berkley, however, had a different take. “The most important thing is transparency,” he said.

“If there are no side effects from the vaccine then we need to make that public. It’s not only one world for vaccines, it’s also one world for information on the Internet. Obviously, if vaccines are not safe then we have to show that. There have been hundreds of millions [globally] who’ve had the [HPV] vaccine, and the side effects seen in Japan have not been seen elsewhere. Confidence is so critical.”

The confidence factor is a key issue for Gavi, which is seeking—with partners such as the Bill & Melinda Gates Foundation, UNICEF, and the World Health Organization—financing for its 2016–20 vaccination program.

Funding supports 11 vaccines, including a five-in-one shot against diphtheria, tetanus, whooping cough, hepatitis B, and Haemophilus influenzae type b.

Co-financing needs are projected at $1.2 billion during this timeframe, up from $470 million in the previous five years. A Gavi funds replenishment conference is on the agenda for the G7 meeting in Germany next June.

The aim of Gavi and its partners is to increase access to immunization in the poorest countries.

About 440 million children were immunized between 2000 and the end of 2013, a program Gavi believes prevented 6 million deaths. Yet, only about 5 percent of children will be fully immunized by 2015. “By 2020, we hope it’s going to be close to 20 percent,” Berkley concluded.



A former Bloomberg and Reuters editor in Japan, David Hulmes recently returned to Tokyo from London.