How Global Agencies Conspired to Keep Mercury in Vaccines

A Winning Example of Advocating for Health

Posted: 03/05/2013 9:36 am
Steve Davis
This past January in Geneva, a large conference center buzzed with the energy of negotiation and refinement. Inside each meeting room, a few hundred people from around the world sat or stood or huddled in clusters, reasoning and deliberating their way toward an international agreement on mercury use convened by the United Nations Environment Program (UNEP). Overhead, a projector cast onto a big screen the text of the draft treaty, and as delegates in the audience offered their changes, someone at a computer typed red-lined revisions in real time. Translators spoke into their headsets to broadcast the proceedings in multiple languages. Delegates flowed in and out of the doors, holding side meetings in the hallway, gathering their peers for quick consultations.
Members of PATH's advocacy team were in the thick of things. They spoke in hushed sideline discussions with delegates, monitored conversations, introduced country representatives to doctors and researchers and policy experts, and kept a careful handle on how this roomful of people might preserve millions of children's chances for access to critical vaccines.
This exciting, bustling scene was policy advocacy at its core and, I think, a prime winning example. Just a few days later, capping almost three years of negotiations marked by deep involvement from PATH and our partners, delegates from 140 countries approved the global treaty with language that protects the use of the vaccine preservative thimerosal and preserves global access to vaccines.
While the treaty's focus is on curbing mercury in the environment, it had the potential to ban thimerosal-containing vaccines despite medical and scientific evidence showing the small amount of ethylmercury in the preservative is safe. Thimerosal is required in multidose vials of vaccine to keep the vaccine free of contaminating microorganisms as the vials are opened and used over a period of time. The United States, European nations, and other developed countries have moved toward single-dose quantities for convenience, but most countries can't afford to switch to more costly single doses. Thimerosal keeps vaccines both safe and affordable for developing countries.
PATH joined with some of our top peers in the field -- the World Health Organization, the GAVI Alliance, UNICEF -- as well as civil society organizations and animal health experts (animals need thimerosal-containing vaccines, too) to lead a months-long advocacy effort that highlighted the evidence behind the use of thimerosal. We wanted to be sure policymakers all over the world had the facts so they could make informed decisions for their countries. So we gathered experts in pediatrics and policy, veterinary medicine and vaccine safety, and linked them up with dozens of country representatives who were the voices for their populations.
When activists opposed to thimerosal tried to plant seeds of fear among the delegates, our team shared scientific evidence and persuasive examples of the safety and power of vaccines. When, during the formal UNEP negotiations, the intense 19-hour meetings meant wealthier counties (that could afford to send more delegates) were in the room at all hours while poorer countries' sole representatives slipped out for breaks or side conversations, our team monitored the situation to ensure these delegates could take part in key vaccine discussions.
I personally am fascinated by what this process looks like -- by the way true on-the-ground, get-your-feet-wet advocacy in conference rooms in Switzerland and in government halls around the globe elevates voices and drives actions and decisions that affect and protect the lives of millions. Because, while preserving the use of thimerosal in vaccines is vital unto itself, keeping the evidence and urgency about vaccines at the forefront of policymakers' minds is crucial for taking our work to the next steps and beyond.
By ensuring that global health policies are driven by evidence, we can continue to develop and facilitate new ideas and technologies that improve the lives of people who need them most. It's a growing tool that PATH and others in the field are using to bolster our technical work to find solutions for the future.
At PATH, we like to think big. We're looking at new ways to package and deliver vaccines that could revolutionize how we protect people from preventable diseases. We will keep pursuing these disruptive innovations and bringing them to scale so that more children can live healthier, more productive lives. We're committed to using all of our tools to make it happen.