By Michael Gwarisa
Despite immunisation being one of the most impactful and cost-effective public health interventions, responsible for preventing over 4 million deaths every year, the African continent is currently lagging behind other world regions in terms of access to vaccines.
According to World Health Organisation (WHO) data, every year, more than 30 million African children under the age of five suffer from Vaccine Preventable Diseases (VPDs); and over half a million die due to limited access to immunisation services. This translates to 58 percent of global deaths from VPDs. Recurrent VPD outbreaks also persist in many countries in the African Region, especially in areas where immunisation coverage is low.
Data also shows that 11 countries in the African region account for an estimated 82 percent of the zero-dose burden, largely due to weak health systems, and challenges in reaching diverse populations coupled with vaccine hesitancy due to misinformation and mistrust. This has upset Africa’s gains to attain the 2030 global immunisation goals that include reducing morbidity and mortality from vaccine-preventable diseases.
The COVID-19 disruptions to the healthcare sector also negatively affected immunisation programs on the African continent and the African Region has not yet fully recovered from the disruptions caused by the COVID-19 pandemic based on WEUNIC2022 estimates.
Dr Jean Kaseya, the Africa Centres for Diseases Control Director (Africa CDC) Director General said there is a need to innovate and reach the zero-dose children with immunisation services.
This is a time to act and form strong partnerships to deliver services for our children. It is time to act because we still have a huge number of children on zero-dose and we need to act with speed. We saw that COVID-19 was a major challenge to our health systems and highlighted our health systems’ weaknesses,” said Dr Kaseya.
He added that the continent recorded 158 public health emergencies from January to November 2023 and almost 50 percent of them were due to Vaccine Preventable Diseases (VPDs). Over 30 million children missed lifesaving vaccines in Africa between 2019 and 2022 largely due to the covid-19 pandemic disruptions to healthcare.
The World Health Organisation Africa Region (WHO Africa) director, Dr Matsidiso Moeti said it was time to leverage lessons learnt during COVID-19 to strengthen health systems and enhance access to immunisation services on the continent.
“We know what needs to be done. We have a good idea of where these children are and where to find them. We need to find new ways of targeting and reaching the unvaccinated children,” said Dr Moeti.
“We have the tools at our hands and I think what needs improvement is accelerating the innovations and development of additional tools to try and follow-up, learning how to innovate in the face of disruptions and lack of access to people.”
2024 will mark 50 years since the Expanded Programme on Immunization (EPI) was established in 1974 to develop and expand national immunisation programmes in countries. To date, routine immunisation services provided through National EPI programmes in the Africa region have played a pivotal role in reducing deaths and illnesses from vaccine-preventable diseases broadening the scope and breadth of protection through introducing new, underutilized vaccines and new technologies.
Dr Lieke van de Wiel, UNECEF ESARO Deputy Regional Director said it can’t be business as usual and Africa needs to unite to attain the 2030 Immunisation Agenda targets.
“Reaching the Zero dose is very close to our hearts and we have as UNCEF, been working for decades and as long as we exist on making sure that all children are vaccinated and for decades, we have seen very steady progress. We now need to have all hands on deck to reach all the children that we missed and the newborns that we are receiving. We need to keep using the old agenda of straightening systems, working through the systems to accelerate reach and access,” she said.
She also urged stakeholders to come up with smart and innovative ways of reaching the Zero dose children.
“Unfortunately in the last decade here in Africa, we saw sort of a plateauing and we were probably not sufficiently prepared and when the COVID-19 pandemic hit, we witnessed children getting immunised. We saw the impact in terms of Zero-dose children growing and children who are being born not being reached. We also saw the socio-economic impact affect how we reach families and we also saw our health centres and system we had put place suffering from COVID-19 and not being able to reach all children.”
Gavi the Vaccine Alliance Interim Chief Executive Officer, David Marlow said the rising disease outbreaks on the continent were a reason to act to prevent children from VPDs.
“With regards to the zero-dose children in Africa, we are seeing the largest backsliding in three decades. We currently have 8.3 million children on the African continent who might not have had any vaccination based on the 2022 data. That is a 2 percent increase versus 2019,” said Marlow.
He also noted that the African continent was currently the epicentre of most diseases outbreaks. However, despite the challenges facing immunisation on the African continent, Gavi says thay have immunised 438 Million children on the African continent since the year 2000, the same year Gavi was born.
Meanwhile, giving data on the status of immunisation on Africa, Ms Sarah Wanyoike, the Team Lead, Vaccine Preventable Diseases at World Health Organisation African Region said, “The number of zero-dose children (7.7 million) reported in 2022 brought us to a cumulative total of 28.7 million from 2019 to 2022, accounting for 19 percent of the cohorts of surviving children. The top 10 countries with the highest number of zero-dose children account for 80.3 percent of the cumulative number of zero-dose children from 2019 to 2022.”
