Health System in Developed Countries Compared to Developing Countries

Despite recent outbreaks of measles and other preventable illnesses in some parts of the country, the United States continues to have low infection and mortality rates. Meanwhile, those in Third World and developing countries have never quite had the success with preventing those same diseases, even when vaccines are administered.

Vaccines in the US
In the US and other Western, “Global North,” or “First World” countries like the United Kingdom, vaccines and immunisations are used to prevent and treat common viruses like influenza (also known as the seasonal flu), rabies, and hepatitis A and B, along with many that are associated with centuries long past, like:

• Tuberculosis (TB),
• Smallpox,
• Polio,
• Yellow Fever, and
• Diphtheria

– just to name a few.

These vaccines have an efficacy rate of 90% in countries with larger economies – those with the highest GDP and median incomes – where the vast majority of the population receives the requisite vaccines. World Health Organization (WHO) data is not so encouraging elsewhere.

Vaccines in the Developing World
If you compare the effectiveness of vaccines in the US to that of those same vaccines in Third World countries, the names of those ‘long past’ diseases are still very present.

The rotavirus for example, kills around 200,000 children under the age of five per year, almost exclusively in notoriously poor countries located in Africa and Southeast Asia. Sierra Leone, Nigeria, the Democratic Republic of the Congo, India, and Pakistan are among those with the highest mortality rates.

Measles vaccine coverage is also nowhere near the desired level; as low as 61% in some African countries (Ethiopia, for one) in 2018, coverage is actually declining. Several factors contribute to poorer health in poor countries, many of them common sense, like obstacles to preventative care or air and water pollution. Inadequate nutrition, sanitation, and even air conditioning are also problematic.

Herd Protection
Herd immunity refers to an indirect benefit of vaccinating. When an optimal percentage of a given population is immune, it reduces the chances that even unvaccinated people will become infected. It also makes outbreaks less damaging, limiting how far they can spread as long as they’re caught and quarantined early.

Lack of coverage in target populations is only one reason vaccines have lower efficacy rates in poorer countries, however. In India, where both the country’s official estimates and WHO/UNICEF estimates put measles vaccine coverage at over 90%, yet the country reported over 19,000 cases in 2018.

Other diseases notorious for resisting vaccines in Third World countries include rotavirus, noted above but also prevalent in South America, cholera, TB, and polio, which persists in places like eastern Asia and the Tropics despite many remedial interventions.

Ugandan Study
A medical study comparing subjects from the US and Uganda, published last year, might finally explain why vaccines in third world countries are more likely to fail. The test subjects from Uganda, who were more likely for all the reasons above to already be sick, had inflammation or fibrosis in their lymph nodes, which in turn lowered antibody production when those participants were given a vaccine for Yellow Fever.

Researchers had already observed the relationship between lymph node malfunction and an impaired vaccine response in regards to HIV; now they’re sure other illnesses common to developing countries could damage lymph nodes in the same way, explaining the low efficacy rates of widely-administered vaccines in the Third World.

Overall, this is good news. Armed with this new information, medical scientists can focus their efforts on overcoming the problem, by creating new public health protocols to boost immune health before vaccine administration, as well as possibly optimizing or adapting vaccines to work in the world’s immuno-diverse populations.

Other Promising Trends
In many ways, things are looking up. According to the WHO, most infants born today do receive needed vaccines. Plus, despite the albeit-serious cases worldwide in the last two years, measles vaccine coverage is over 85% globally. Historically unused or underused vaccines are coming into more widespread use, and new vaccines are accepted more readily than in the past.

Worldwide, vaccines save up to 3 million lives annually.