Strengthen immunization programs for better health outcomes

By Dr. Githinji Gitahi, Group CEO Amref Health Africa

Over the past decade Africa has made tremendous gains in increasing access to immunization directly through domestic resources and multi-laterally through the Global Vaccine Alliance (GAVI). This laudable progress has brought the continent closer to ending several diseases such as neonatal tetanus and Meningitis A, goals that seem more achievable following the eradication of wild poliovirus in the World Health Organization (WHO)-classified African Region, a geographical area comprising of 47 countries in Africa, in August 2020.

While such milestones offer a well-deserved cause for celebration, the impact of the COVID-19 pandemic on immunization programs threatens to dampen the achievements we have made as a continent. COVID-19 has devastated health systems and interrupted the delivery of essential health services, especially immunization, around the world. In 2019, 20 million children worldwide — more than 1 in 10 — missed out on basic vaccines. In Africa 1 in 5 children remain unprotected from vaccine-preventable diseases, meaning that the likelihood that a child born today will be fully vaccinated with all the globally recommended vaccines by the time he or she reaches the age of 5 is less than 20%.

This is not just another set of often-repeated health statistics. It represents millions of children around the world — many of them in low- and middle-income countries in Africa — who are at risk of infection, disability and death from vaccine-preventable diseases such as measles, diptheria and yellow fever.

To be fair, the gaps that exist in the delivery of these life-saving vaccines were present before the pandemic. COVID-19 did not create the financial, structural and cultural barriers that lead to disruption of immunization programs: it exacerbated them and then forced us to acknowledge the importance of investing in resilient health systems to ensure uninterrupted administration of vaccines to the last mile. In fact, nothing in recent memory has highlighted the value of vaccines clearer than the COVID-19 pandemic, which has shown us that vaccines can bring us closer to a world where no one suffers or dies from a vaccine-preventable disease.

Last week, countries around the world marked World Immunization Week against the backdrop of a pandemic that has — perhaps for the first time in history — earned vaccines a near-permanent spot in daily news headlines. The frantic search for a reliable and relatively affordable and accessible COVID-19 vaccine has pushed the interest in vaccines from the purview of scientists and health practitioners and thrust it into the mainstream conscience. We need to capitalize on the zeitgeist of this period to push for sustained investment in other life-saving vaccines, both during and beyond the pandemic.

Immunization is widely recognized as one of the world’s most successful health interventions. Investing in national immunization programs can avert 2–3 million deaths every year and bring countries closer to achieving Universal Health Coverage (UHC), whose social and economic impact will be a boon for the African continent.

While nations focus on critically important new vaccines to protect against COVID-19, there remains a need to ensure that routine vaccinations to avert outbreaks of vaccine-preventable diseases are not missed. Despite the complexities of trying to manage the COVID-19 pandemic, while causing minimum harm to populations that cannot — for the sake of putting food on the table — fully adhere to preventive measures such as staying home and social distancing, we must not lose sight of our goal of ensuring that every citizen is protected from vaccine-preventable diseases. This calls for multi-sectoral collaboration toward prevention of future disease outbreaks through strengthening of immunization programs.

COVID-19 may have shaken the core of our health systems but it has also taught us a key lesson: there is no time to waste. Now is the time to increase immunization funding, strengthen vaccine supply chains and delivery systems, and make universal access to immunization a cornerstone of Africa’s health and development efforts. This is what was envisioned when African Heads of State endorsed the Addis Declaration on Immunization (ADI) in January 2017, a historic and timely pledge to ensure that everyone in Africa — regardless of who they are or where they live — receives the full benefits of immunization.

We must push for collective action and greater accountability to strengthen immunization and enhance access to essential health services across the continent if we are to keep populations safe and achieve UHC by 2030. By advocating for increased financial l investments in immunization globally through the Global Vaccine Alliance (GAVI) as well as through increasing domestic resources for primary healthcare which includes comprehensive immunization, leaders across Africa can ensure that every citizen is given an equal shot at a healthy life and is better equipped to withstand the threat of pandemics such as COVID-19, which continues to serve as a poignant reminder of what a world without vaccines would look like.