Closing the immunisation gap

Correspondent Our Children, Our Future
Progress towards global vaccination targets for 2015 is far off track with one in five children still missing out on routine life-saving immunisations that could avert 1,5 million deaths each year from preventable diseases.

In the lead-up to World Immunisation Week 2015 (April 24-30), the World Health Organisation (WHO) is calling for renewed efforts to get progress back on course.

The theme for this year’s immunisation week is “Close the immunisation gap”.

In 2013 nearly 22 million infants missed out on the required three doses of diphtheria-tetanus-pertussis-containing vaccines (DTP3), many of them living in the world’s poorest countries.

WHO is calling for an end to the unnecessary disability and death caused by failure to vaccinate.

“World Immunisation Week creates a focused global platform to reinvigorate our collective efforts to ensure vaccination for every child, whoever they are and wherever they live,” said Dr Flavia Bustreo, WHO Assistant Director-General, Family, Women’s and Children’s Health.

“It is critical that the global community now makes a collective and cohesive effort to put progress towards our six targets back on track.”

In 2012, all 194 WHO member states at the World Health Assembly endorsed the Global Vaccine Action Plan (GVAP), a commitment to ensure that no one misses out on vital immunisation. However, a recent independent assessment report on GVAP progress rings an alarm bell, warning that vaccines are not being delivered equitably or reliably and that only one of the six key vaccination targets for 2015 is currently on track – the introduction of under-utilised vaccines.

Many countries worldwide have experienced large measles outbreaks in the past year, threatening efforts to achieve the GVAP target of eliminating measles in three WHO regions by end-2015.

A global collaborative drive for immunisation, begun in the mid-1970s, with the establishment of the Expanded Program on Immunisation in all countries, achieved dramatic results, raising vaccination levels from as low as 5 percent to more than 80 percent in many countries by 2013.

WHO estimates that today immunizations prevent between two and three million deaths annually and protect many more people from illness and disability.

Although progress has stalled in recent years, this early success demonstrates the potential of vaccines, which are increasingly being extended from children to adolescents and adults, providing protection against diseases such as influenza, meningitis and cervical and liver cancers.

The GVAP recommends three key steps for closing the immunisation gap:

l Integrating immunisation with other health services, such as post-natal care for mothers and babies;

l Strengthening health systems so that vaccines continue to be given even in times of crisis; and

l Ensuring that everyone can access vaccines and afford to pay for them.

Dr Jean-Marie Okwo-Belé, Director of Immunisation, Vaccines and Biologicals at WHO, says the organisation will work to increase its support to all countries that are lagging behind in meeting immunisation targets. In May this year, WHO will bring together high-level representatives of 34 countries with routine vaccination (three doses of DTP3) coverage of less than 80 percent to discuss the challenges faced by countries and to explore solutions to overcome them.

Although many countries are already vaccinating four out of five children with DTP3, a full one-third of countries are still struggling to reach the “fifth child”, meaning millions of children remain at risk of illness, disability or death because they are not getting the immunisations they need.

“There is no one centralised approach that can ensure vaccines are delivered and administered to each child. Vaccination plans on the ground need to be adapted not just to countries, but to districts and communities,” said Dr Okwo-Belé.

“What is required is a truly concerted effort and much stronger accountability so that each one of the key players involved fulfills its mandate and helps close the immunisation gap.”