Giving immunisation efforts a booster

  
polio vaccination
Polio vaccination. Credit: Ramesh Lalwan

Since 2000, 440 million children have been immunised against preventable diseases – and an estimated 6 million deaths have been avoided. But 22.6 million children are still not vaccinated and 1.5 million children under-5-years-old die annually from preventable diseases. Changing this picture may require action, not least on vaccine prices.

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Overview

Every year immunisation helps avert an estimated 2.5 million deaths around the world, and millions more debilitating illnesses and disabilities. It is one of the most cost-effective health investments, with proven strategies that can reach the most dispersed and remote populations. 

Vaccinations can prevent some of the world’s biggest killers, including diphtheria, measles, pertussis (whooping cough), pneumonia, rubella and polio. Progress in immunisation efforts is alternatively stagnating or holding steady, with around 83% of the world’s children receiving the benchmark diphtheria-tetanus-pertussis (DTP3) jab in each of the last three years. In 2012, this amounted to some 110.6 million infants.

Progress against some diseases has been stunning. Smallpox has been eliminated and 84% of children around the world have now been given three doses of the polio vaccine, with India recently announcing that the highly infectious and deadly disease had been eradicated. It has, however, made a comeback in Syria and even Gaza, and remains epidemic in Afghanistan, Nigeria and Pakistan.

Access to many other recommended vaccines, especially the newer ones, remains patchy and dependent on levels of wealth. A rotavirus vaccine developed in 2012 against severe diarrhoeal diseases which kill around 760,000 children under 5-years-old each year has a global coverage of just 11%. Similarly, global protection against haemophilus influenze type b (Hib) which causes meningitis and pneumonia is estimated at 45%. In 36 of the 48 countries and territories at risk of yellow fever in Africa and the Americas, just 37% of the population is covered. 

The World Health Organisation (WHO) cites several barriers to extending protection from preventable killer diseases in the Global South, such as limited resources, competing health priorities, poor management of health systems and inadequate monitoring and supervision. More than half of the world’s 22.6 million children who have not received a DTP3 shot live in just three countries: India, Indonesia and Nigeria.

Consequently, one out of five of the world’s children does not get the protection they need and, as Unicef puts it, “the ‘unreached’ fifth child is defenceless against killer diseases”.  Research shows that scaling up the use of existing vaccines in 72 of the world’s poorest countries before 2020 could save 6.4 million lives and avert $6.2 billion in treatment costs and $145 billion in productivity losses.

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