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Pharmaceutical company Merck & Co. Inc. has decided to cut back on its supply of rotavirus vaccines for children in four countries in West Africa, NPR reported Thursday.

Merck, which said this decision was due to “supply constraints,” partnered with Gavi, the Vaccine Alliance, in 2011 to sell its rotavirus vaccine to low-income countries for about USD $3.50 per dose.

By subsidizing the cost and working with Gavi and UNICEF, the life-saving vaccines were made more accessible to the four affected countries (Burkina Faso, Mali, Ivory Coast, and Sao Tome).

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Merck has since told UNICEF and Gavi that it will provide only two-thirds of the doses needed for 2018 and 2019, and will not supply any in 2020, according to NPR.

Merck told NPR that the scarcity of the vaccines is caused by “country-specific requirements, unanticipated manufacturing issues, and packaging challenges that put greater stress on our already strained packaging capacity.”

Critics have pointed out, however, that this news comes after Merck has started sending the vaccine to China, where it is expected to be sold for about $40 per dose.

Merck Chief Executive Ken Frazier said the company did not “pull out” of its agreement to supply West Africa with vaccines, and argued that China is also in need of the vaccine, STAT reported.

“So the challenge here is, again, incredible rise in demand, challenges around supply, with long lead times in vaccines … We have a temporary imbalance that we have to deal with. And, yes, the Chinese … Their children should be vaccinated. So we have to think about how to apportion it across many markets. The headline [in the NPR story] makes the assertion that we just decided that children in Africa are not worth saving, and that could not be further from the truth,” Frazier said.

Still, this supply shortage could have devastating effects on the global health of children in West Africa.

More than 500,000 children in Burkina Faso, Mali, Ivory Coast, and Sao Tome may not get the vaccine in 2018 and 2019, according to STAT.

Rotavirus causes inflammation in the stomach and intestines and is one of the leading cause of diarrhea in the world.

Diarrheal disease is the second leading cause of death for children under 5, and about 213,000 deaths among children were caused by rotavirus in 2013, according to the World Health Organization.

GlaxoSmithKline, another vaccine supplier, provides vaccines for more than 40 other countries, but cannot fill the gap caused by this decision. Talks have started with Bharat Biotech and Serum Institute, suppliers in India — but no matter what, a delay in vaccine delivery can be expected, a Gavi spokesperson told NPR.

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Pharma Giant Merck Cutting Its Supply of Life-Saving Vaccines for Children in West Africa

By Jackie Marchildon