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(Bloomberg Business) -- The U.S. measles outbreak has shone a light on the growing number of parents opting not to vaccinate their children, despite overwhelming medical reasons to do so. Amid the often-vicious debate between anti-vaxxers and their critics, it's gone largely unnoticed that when it comes to vaccination rates, the U.S. is out of step with the rest of the world.

Last week, a group of donors that included the U.S., the U.K., and the Gates Foundation met in Germany to pledge $7.5 billion to Gavi, the vaccine alliance, to pay for its operations to 2020. Gavi is a global organization that buys vaccines to immunize children in low-income countries. The alliance has provided billions of dollars’ worth of new vaccines over the past decade for such conditions as haemophilus influenza and pneumococcal disease, both of which can cause pneumonia and meningitis, as well as rotavirus—the leading global cause of death due to diarrhea under age 5. Gavi support has translated into more kids being protected against catching and spreading these killer illnesses.  

Some Gavi resources have gone toward buying vaccines that even the poorest countries were already providing before they got donor support—including immunizations against diphtheria, whooping cough, and tetanus.  The very fact that many of the world’s poorest countries are already immunizing against a number of diseases, including measles, and that "middle income" countries are providing a growing spectrum of vaccines without any donor support at all, is a demonstration of the level of global commitment against infectious disease that should shame America. Average health expenditures per person per year—public and private combined—are as low as $20 in some of the poorest countries that receive Gavi support and remain below $100 in such countries as Nigeria and India. Despite tight resource constraints, those countries are providing the staff and equipment to run national vaccination programs at a cost of $20 a child or more—mostly with minimal donor assistance (which is focused on providing the vaccines themselves). 

Thanks to this global commitment, alongside U.S. domestic backsliding, America is now a laggard in world league tables of basic vaccination. Nine percent of U.S. kids aren’t immunized against measles—that’s a higher proportion than in Tajikistan, Zimbabwe, Bhutan, Libya, and 106 other countries. In some U.S. communities, vaccination rates are low enough that the risk of a local epidemic is considerable. In 2014, a large measles outbreak occurred among unvaccinated Amish communities in Ohio, for example, traced back to a victim who had visited the Philippines during a measles outbreak there.  Sadly, the Philippines is one of the minority of countries worldwide with an even lower measles immunization rate than the U.S.—10 percent of children aren’t vaccinated on schedule.

It isn’t just with measles that the U.S. is a world-lagger. America is 115th worldwide in terms of Hepatitis B vaccination, according to World Health Organization data, with one-10th of one-year-olds not immunized. Six percent of U.S. kids aren’t vaccinated against whooping cough–that’s higher than Serbia, Burundi, Mongolia, and 89 other countries. And that's why U.S. whooping cough cases in 2012 were at their highest level since 1955—48,277 infected and 20 related deaths, some of which were among infants too young to be vaccinated. 

In the developing world, the spread of immunization coverage has been a central part of declining illness and child deaths—the number of measles deaths globally has fallen from half a million to 100,000 in the 12 years from 2000, for example. And by considerably reducing the chance that an American travelling abroad will come back with hepatitis B, measles, or whooping cough, developing countries are also making lives safer for the vaccine deniers, immune-suppressed infants, and the allergic in the U.S. 

Given its atrocious standing in the vaccination league tables, America should be grateful for the better efforts of much poorer countries to roll out immunizations—and should redouble its support for their fight against infectious disease through vehicles like Gavi. If we want the luxury of denying science and allowing people the choice to expose others to risk, it's even more important we ensure that other countries are building global immunity and reducing that risk for us all.

To contact the author on this story: Charles Kenny at ckenny@cgdev.org To contact the editor on this story: Romesh Ratnesar at rratnesar@bloomberg.net

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