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Source: Save The Children

This week, World Immunisation Week 2020, we’ve been celebrating the development, progress and success of vaccines in protecting children against preventable infectious diseases.

At this critical time of a global pandemic, COVID-19 provides a stark reminder of the devastation that occurs to health, communities and economies where no available vaccine exists. As coronavirus spreads with no known vaccination or treatment, claiming lives across the globe, it poses a major risk of secondary outbreaks from other vaccine-preventable diseases, such as measles, pneumonia, cholera, polio and meningitis.

Now, more than ever, we need to protect essential services like immunisation so we do not lose the gains we have made in health over the past 30 years.

As of 2018, roughly 13 million children – one in ten – have never received any vaccines, putting them and their communities at risk of disease and death. The majority of these children live in contexts with fragile health systems – poverty, conflict-settings, urban slums and refugee camps – further limiting their access to essential health services to prevent and treat disease.

At Save the Children, we believe that every child has the right to immunisation as part of their right to health, and our teams across the world are supporting efforts to provide access to life-saving vaccines. Here are three examples of how our programmes are making a difference to child survival through immunisation:

1.  Integrating good water and hygiene practices and routine immunisation in Nigeria

Nigeria is among the countries with the highest child mortality rates. In 2014, diarrhoea was the third leading cause of under-five mortality accounting for 96,000 (12%) of deaths annually. Since 2014, Save the Children in Nigeria has been leading on the Stop Diarrhoea Initiative, a multi-sectoral approach that combines treatment and immunisation – rotavirus and measles vaccinations -– with water, sanitation and hygiene services to reduce illness and death from diarrhoea.

In 2017, after years of hard work and close cooperation with development partners, the Lagos State Ministry of Health and the National Primary Healthcare Development Agency, the first free rotavirus vaccine was introduced to the Shomolu area of Nigeria. Until then, the vaccine had only been available at private clinics. Just nine months after the introduction of the rotavirus vaccine, coverage had increased to an impressive 90% – well over the 80% target recommended by UNICEF and World Health Organization and a big jump up from the previous rate of just 5% coverage, meaning many more children are protected from disease.

Oumar, one, is being treated at Aguie hospital, Niger. Oumar has just turned 1 year old. He and his mother Mariam live in Nigeria, but the Aguie hospital in Niger is the closest hospital to their home.

2. Leaving no child behind with immunisation in Madagascar

In Madagascar, which has one of the highest proportions in the African region of malnutrition among children under five (47%), malnutrition increases the risk of serious complications and death from measles infections. In 2019, Madagascar experienced one of the worst measle outbreaks in modern history with 118,000 infections and 1,700 deaths (at the time of reporting).

More than half of the cases reported during the outbreak had not been vaccinated or had unknown immunisation status. Save the Children’s Emergency Health Unit supported the Ministry of Health and WHO with a national mass vaccination campaign to stop the outbreak from spreading further. We successfully vaccinated more than 180,000 children across two districts. The Ministry of Health has already reported a drop in the number of measles cases in the vaccinated areas, demonstrating the immediate impact of the campaign on the epidemic and child health in Madagascar, even in the hardest-to-reach areas.

EHU nurse Nancy preparing a vaccine at the EHU ‘s mobile clinic.

3. Safeguarding immunisation in fragile settings such as Syria

In Syria, with funding from the Bill and Melinda Gates Foundation, we have been partnering with Syria Relief and Idlib Health Directorate to resume routine immunisation services in some of the world’s most challenging conditions, an active warzone.

Operating in Idlib, north-western Syria, the programme is led by the World Health Organization and the International Red Cross and involves the work of 41 partner organisations. Bombings and fighting have damaged many health facilities and Save the Children, Syria Relief and Idlib Health Directorate have been working in partnership to reduce illness and deaths from vaccine-preventable diseases by renovating facilities including immunisation services and restarting the routine vaccination programme.

We set out to reach 40,000 children with routine immunisation (including vaccines against tuberculosis, polio, measles, mumps & rubella, diptheria, pertussis, tetanus and more) by rebuilding six vaccination centres and ensuring they were equipped and staffed to provide quality vaccination services. We also provided support to communities to ensure that they were aware of the vaccination services running in the local area.

Through these strong partnerships, we were able to work together to deliver services and equitable access to immunisation for vulnerable children and families affected by the conflict.

Save the Children staff working inside Syria carry out a polio vaccination campaign in North West Syria for children aged 1 day to 5 years.

What now?

Despite immunisation having been proved to be one of the most successful, cost-effective, and far-reaching public health interventions, the percentage of children who received their full course of routine immunisation has stalled at 86%. This rate falls short of the 2020 global immunisation coverage target of 90% and leaves 19.4 million children vulnerable to vaccine preventable diseases.

The number of children missing out on life-saving vaccinations is only expected to increase due to COVID-19, with the most vulnerable and marginalised children likely to be worst affected. Gavi, the Vaccine Alliance, reported that within their country programmes, at least 13.5 million people will miss out on vaccinations due to postponement of vaccination campaigns and interruptions in routine vaccinations, with millions more likely to follow.

As part of the global pandemic response, routine immunisation systems and essential healthcare must be maintained to protect against preventable disease outbreaks and relieve the strain on already weak or overwhelmed health systems. National governments, donors, development partners – Gavi, WHO and UNICEF – civil society organisations, vaccine manufacturers and the private sector all have a responsibility to continue to accelerate action to ensure that all children are reached through access to affordable vaccines with a strong primary health care (PHC) system, as a first step towards universal health coverage.