Maternal and Neonatal Tetanus
The silent killer, otherwise known as maternal and neonatal tetanus, is a life-threatening bacterial infection in newborns and their mothers that is associated with nonsterile delivery and cord-care practices. Although it is vaccine-preventable, when tetanus develops, mortality rates are extremely high. This is especially true when the appropriate medical care is not available, which is often the case in low-income counties. In 1999, there were 57 countries where tetanus posed a considerable risk for women giving birth. Today, that number has dropped significantly, but maternal and neonatal tetanus remains a public health threat in 13 countries: Afghanistan, Angola, Central African Republic, the Democratic Republic of the Congo, Guinea, Mali, Nigeria, Pakistan, Papua New Guinea, Somalia, South Sudan, Sudan and Yemen.

Kenya has put in great effort to eliminate maternal and neonatal tetanus where it once was a common problem. The commitment the country made has drawn global attention and is inspiring other countries to do the same.

Kenya’s Initiative

As of 2018, Kenya has been removed from the list of countries that sees maternal and neonatal tetanus as a public health threat by attaining elimination status. Elimination is only attained when there is a reduction of neonatal tetanus incidences to below one case per 1,000 live births per year. Kenya’s progress towards achieving this important public health milestone began in 2001, proving that this process takes time. A pre-validation assessment took place in Kenya in September 201 by the Ministry of Health with the support of the World Health Organization (WHO) and UNICEF. A WHO-led validation process took place in 2018 to confirm the elimination of the disease.

Eliminating maternal and neonatal tetanus takes a lot of planning, and Kenya has set a great example. In 2002, Kenya introduced a five-dose tetanus toxoid vaccination schedule and in 2003, the country began to implement immunization campaigns in high-risk areas. Kenya also focused on providing free maternity services to increase skilled birth attendants. Over time, they began including tetanus toxoid vaccines into the routine antenatal care packages. Today, Kenya is still working on strengthening health facilities and resources and plans to provide free medical care to children under five years of age.

The involvement of schools is another factor that helped Kenya eliminate maternal and neonatal tetanus. Aliaphonse’s Katuit primary school is a prime example of the success seen from the campaign. Ann Talam, one of Katuit primary school’s teachers, explained in an interview with UNICEF that the campaign not only reaches members of the student body but also their sisters or relatives who may not attend school. Education ensures that all girls, even those from poverty-filled communities, are immunized.

Kenya’s Impact

Reducing deaths from neonatal tetanus is one of the simplest and most cost-effective ways to reduce the neonatal mortality rate. As of 2012, Kenya’s immunization coverage for newborns protected against tetanus reached 73 percent — and it continues to rise. WHO estimates a 94 percent reduction in neonatal deaths from 1988, when an estimated 787,000 newborn babies died of tetanus within their first month of life.

As Kenya eliminates maternal and neonatal tetanus, it has inspired the country to combat other diseases as well. They plan to identify the unreached and design an innovative approach to reach these populations with immunizations. On February 22, 2019, WHO representative, Dr. Rudi Eggers, addressed the recent measles outbreak in the country, attributing it to lapses in the routine immunization system since the previous measles and rubella outbreak in 2016.

“There is an urgent need for all stakeholders to come together and work to increase immunization coverage and address inequities,” Eggers said.

The Kenya campaign also aims to vaccinate nearly 14 million children between the ages of nine months and 14 years — nearly 40 percent of the population — for other common viruses.

Since Kenya’s elimination of maternal and neonatal tetanus, more than 153 million women around the world have been immunized with two or more doses of vaccines fighting against tetanus. The Eliminate Project, funded by the Kiwanis Children’s Fund, plans to learn from Kenya’s success and use it to inspire other countries to follow their lead. In 2018, The Eliminate Project raised a total of $502.282.72 to save and protect mothers and their babies worldwide.

Along with planning and taking initiative, Kenya recommends planning outreach activities for remote places, promoting delivery in health facilities and strengthening knowledge of health workers on the immunization schedule. Kenya sets an example of how small changes can overcome the silent killer of maternal and neonatal tetanus.

– Grace Arnold
Photo: Flickr

 

Vaccines in Egypt
For the past 20 years, the Centers for Disease Control and Prevention (CDC) of the United States has assisted the Egyptian government by providing aid to fight vaccine-preventable diseases. Efforts such as strengthening immunization services, responding to public health emergencies and conducting surveillance studies and surveys have contributed to the reduction of these fatal diseases. The CDC has provided financial support for diseases that can be prevented by vaccines in Egypt through the World Health Organization (WHO), which focuses on polio, measles and rubella elimination.

Impeding Access to Vaccines

In 2006, vaccinations in Egypt eradicated wild poliovirus transmissions. The government continues to monitor the environment for wild polioviruses in a program involving the CDC and other organizations. However, despite the efforts of these organizations, many of those living in poverty in Egypt still do not have access to the vaccination. This presents a problem in the eradication of vaccine-preventable diseases since disease such as the wild poliovirus could return.

According to WHO, full immunization coverage for the poorest to the wealthiest populations showed national levels in Egypt to be under 20 percent. Studies show that the high rates of unemployment and low literacy rates contribute to the increase in the population living in poverty. This results in many individuals being unaware of the healthcare and medical aid they are entitled to and leads to the low proportions of immunization within the population.

Many children are also part of the child labor industry. Working interferes with their school attendance and education, resulting in low literacy rates, which perpetuate the ongoing poverty cycle. Without awareness of health and safety maintenance, those who live under the poverty line may not have the necessary knowledge to access vaccinations in Egypt.

Improvements Made in Vaccinations

The Expanded Program of Immunization (EPI) in Egypt focuses on saving lives by controlling vaccine-preventable diseases such as measles, diphtheria, tetanus, polio and whooping cough through constant surveillance and an increase in vaccine coverage. Despite the extreme decline of cases of vaccine-preventable diseases in the past decades, outbreaks of measles in 2013 and 2014 suggests that full immunization coverage is not yet supported for all populations of Egypt.

However, despite 60 percent of the population living under the poverty line and a large number of people not receiving immunizations, resources and efforts towards improving access to vaccinations in Egypt have increased. WHO claims that only 24 cases of measles, 5.9 cases of mumps and 34 cases of rubella were reported in 2017. A drastic decrease compared to decades of consistent outbreaks in the thousands. Part of the progress could be a result of the fact that 94 percent of children aged 12-23 had received measles vaccinations in 2017. Furthermore, in 2008-2009, there was a significant increase in vaccines in Egypt for measles, mumps and rubella, with 95 percent of children having been vaccinated, an increase of 53 percent from 2007.

The Future of Disease Control

The Ministry of Health and Population (MoHP) works to promote the funding of the Haemophilus influenza vaccine as a part of the PENTA vaccine, a type of vaccine designed to protect the receiver from multiple diseases. The PENTA vaccine will help fight bacterial pneumonia, a communicable disease that contributes to high mortality rates. With WHO supporting the MoHP, the push for programs that fight viral hepatitis is stronger as more resources are being devoted to procuring equipment, allocating funding and the constant surveillance of vaccine-preventable disease outbreaks.

Efforts to control vaccine-preventable diseases are allocating funding to provide coverage for those who may not be able to afford it. Now, increased focus on spreading awareness to the population about the importance and availability of vaccines in Egypt is needed in order to increase coverage and finally eradicate some of the vaccine-preventable diseases in the country.

– Aria Ma
Photo: Flickr

immunizations africa
Globally, more than 2 million children are saved every year by immunizations. In Africa, the success of programs for immunization plays a significant role in world health. Immunization programs bring benefits to Africa and other countries around the world by reducing, containing and eliminating life-threatening diseases.

Successful Immunization Program

The Expanded Programme on Immunization (EPI) is responsible for most of the vaccinations in Africa. EPI focuses its attention on immunizing children against six life-threatening diseases: diphtheria, pertussis, tetanus, tuberculosis, polio and measles.

EPI has been acknowledged for maintaining control over many infectious diseases, showing significant progress since its initiation in 1974. For instance, EPI is credited for being on the forefront of eradicating smallpox. The eradication of the polio-virus is currently underway. This disease was responsible for infecting and killing millions of children previous to EPI. After the launch of EPI, enormous reductions of paralysis caused by polio was observed due to polio immunization.

Eradication and Vaccination

In 2017, the required three doses of the polio vaccine were successfully distributed to 85 percent of newborns around the world. With the exception of Afghanistan, Nigeria and Pakistan, polio has been eradicated in almost every country, according to The World Health Organization.

Measles vaccinations have been a huge success as well. In 2015, about 85 percent of children around the world, including Africa, have been immunized with the measles vaccine. In 2017, 167 countries had received two doses of the measles vaccine. Since 2000, more than 20 million lives worldwide have been saved through measles immunization.

MenAfriVac, the first vaccine created specifically for Africa, is a vaccine for adults and children (9 months to 29 years old) that protects them from group A Meningitis. More than 270 million people have been immunized, and cases due to the type A bacterium have declined 99 percent in areas that obtained full vaccinations. It is predicted that more than 400 million people will be vaccinated with MenAfriVac in fewer than two years. This can prevent over 150,000 deaths.

Immunization programs are making huge changes for better healthcare. Immunization coverage in Africa has advanced since the start of EPI, which has helped increase the needed dosages of DPT3 (a vaccine that shields diphtheria, pertussis and tetanus) for children. In 2017, DPT3 had reached as high as 90 percent in 123 countries.

The Economic Impact of Vaccinations

Vaccines also have a strong economic impact on people. “A healthy child is more likely to go to school and become a more productive member of society in later life while their families can avoid the often crippling healthcare costs that diseases can bring” explained Dr. Seth Berkley, CEO of a vaccine alliance (GAVI). “[…] this is enough to save millions of people from the misery of extreme poverty. [..] we now need to redouble our efforts to ensure every child, no matter where they’re born has access to lifesaving vaccines.”

Not only are families saved undo economic hardship thanks to vaccines but also governments save money through ensuring a healthier population. On average, $16 is saved for every $1 that is spent on vaccinations. This can be due to the money that would be lost from missing work, healthcare costs and lower productivity due to illness.

Other Immunization Programs

There are many other programs like EPI that are aiming to make a difference such as The Global Immunization Vision and Strategy (GIVS), The Sustainable Development Goals (SDGs), and The Global Vaccine Action Plan (GVAP). Programs such as these are continuing to help Africa in powerful ways.

Although these developments have been successful, 1 in 5 children still will not get the vaccines needed to prevent life-threatening diseases. Immunization coverage in Africa is still below the goal of 90 percent, leaving many people without vaccines.

The need for extending immunization to everyone is extremely high, and a plan is currently in place through The Global Vaccine Action Plan (GVAP) to continue to achieve the goal. GVAP has set six principles to elaborate on the plan in order for it to be achieved by 2020, saving millions of lives. These principles include partnership, country ownership, equity, integration, sustainability and innovation.

Hope

To help GVAP achieve their goals, each region has developed their own plan in order to ensure that every child will be immunized and protected from deadly viruses. If this plan works out, all communities will have access to life-saving vaccines.

Vaccinations meet the needs to care for weaker societies by enabling good public health, which helps in reducing poverty. Immunization programs bring benefits to Africa as well as saving millions of people in need of vaccines. Challenges are still faced but hope continues.

– Kathleen Smith

Photo: Flickr

Immunization in Sudan
For the past few years, Sudan has been in the middle of one of the worst measles outbreaks in their country’s history. With 1,730 confirmed cases and over 3,000 suspected cases, measles is spreading like wildfire. This has brought to light the desperate need for a proper system for immunization in Sudan, especially for diseases like measles.

Measles Prevention

Measles is a highly infectious disease that spreads very quickly, but can be easily prevented by vaccine.

After the introduction of the measles vaccine, there was an 84 percent drop in measles deaths between 2000 and 2016 worldwide. It is estimated that the vaccine prevented 20.4 million measles-related deaths during this time period. This statistic delineates the power of the vaccination and the positive effects it can bring to a country like Sudan.

With support from UNICEF, the Ministry of Health launched a country-wide campaign to vaccinate almost 8 million children for measles.

Combatting Poverty and Measles

Children living in poverty are particularly susceptible to catching measles as they are often malnourished. Additionally, children living in conflict zones are difficult to reach in order to immunize. As a result of such conditions, UNICEF has been tirelessly fighting to get humanitarian access to these areas.

Non-governmental organizations (NGOs) have also come to the forefront in the fight against measles. GOAL Global, a nonprofit that focuses on international aid for those in poverty, launched its own campaign for immunization in Sudan. Within the first 7 days, they vaccinated over 20,000 children.

GOAL Global worked in partnership with other major groups like the International Organization for Migration (IOM) to get this campaign off the ground. Thanks to groups such as these, children that would otherwise lack access to healthcare are able to stay safe in the face of the measles epidemic.

Campaigns for immunization in Sudan are not as simple as just bringing the vaccine out to children. They require extensive planning and mapping out of areas, in addition to training healthcare workers to administer the vaccine.

Meningitis and Aid Organizations

Meningitis is another disease that Sudan struggles with. Meningitis affects the spinal cord and brain and in some cases can be life-threatening. Sudan accounts for 15 percent of meningitis cases in the “meningitis belt,” which is a stretch of countries heavily affected by the meningitis infection.

In recent years, WHO in partnership with the Ministry of Health and UNICEF have launched an immunization campaign for meningitis with the goal to vaccinate 720,000 children in Sudan. Campaigns such as these require upkeep in order to keep the outbreak at bay and prevent the return of the disease.

Fostering Impactful Change

Vaccines are also an inexpensive, high-impact solution to disease. The introduction of immunization campaigns to Sudan has the potential to stop the measles epidemic and the meningitis problem dead in their tracks.

Vaccinations are a big step towards evening the playing field for children living in poverty compared to children from more affluent communities. Immunization in Sudan for diseases like the measles and meningitis give all children across the board a better chance at life.

– Amelia Merchant
Photo: Flickr

Bill and Melinda Gates Foundation
At the turn of the nineteenth century, German mathematician David Hilbert attended the International Congress of Mathematicians in Paris, and asked his colleagues a simple question: “Who of us would not be glad to lift the veil behind which the future lies hidden?”

In a call to action, Hilbert presented a set of ten unresolved problems, which if solved, would signal major breakthroughs in the fields of mathematics and science. Over a century later, Tthe Bill and Melinda Gates Foundation launched Grand Challenges in Global Health, an open innovation program inspired by Hilbert’s bold question.

Grand Challenges

Originally focused on 14 scientific challenges that could lead to breakthroughs in combating disease in the developing world, the initiative was relaunched in 2014 as Grand Challenges to reflect its broadened scope. Grand Challenges co-opts Hilbert’s approach and applies it to the world of philanthropy, inspiring innovators to come up with solutions to essential development problems and funding the best ideas.

Just as Hilbert expanded his original ten problems to a later published 23 this month, the Bill and Melinda Gates Foundation is adding to the list. Sponsored by its Explorations program, Grand Challenges has outlined three new problems designed for early-stage ideas.

After submitting a two-page application, recipients receive $100,000 over 18 months to implement their visions. Here are three new calls to action from the Bill and Melinda Gates Foundation.

1. Reducing Malnutrition

One in three people worldwide suffer from malnutrition, which can have devastating ripple effects on health, cognitive development and productivity. This new challenge seeks to address three essential problems in the fight against malnutrition — making food accessible, affordable and appealing.

People suffering from malnutrition often live in places where nutritious food is hard to find, or is so expensive that they are priced out of a healthy diet. In other cases, people simply don’t know the vital benefits of eating nutritious food.

This challenge seeks solutions that work with existing food systems in low-income countries to improve people’s diets through food product development, processing, packaging, distribution, consumer education and marketing.

2. Combating Crop Disease

Pests and crop disease threaten the livelihoods of not only farmers, but the millions of people who rely on their harvests. Grand Challenges has identified the dearth of information on diseases and pests as an essential problem in responding to protect farmers’ fields.

This call to action seeks to harness the emerging research in data science, engineering, biology, chemistry, computer science and telecommunications to improve pest and disease surveillance in low-income countries so that smallholder farmers can mitigate their risks.

3. Improving Immunization

Each year, about 21.8 million children do not receive vaccines necessary to protect against serious infectious diseases. This year, at least 1.5 million of these children will die from diseases vaccines could have prevented. In a two-pronged approach, this challenge encourages innovators to find new ways to collect and use data, and develop efficiencies that improve existing immunization systems to work better for both health workers and patients.

Much like Hilbert’s problems, two of which remain unresolved to this day, identifying and implementing solutions to the problems facing developing countries remains immensely complex. These new calls to action from the Bill and Melinda Gates Foundation represent an important continuation of Hilbert’s legacy.

By offering competitive, accessible grant opportunities aimed at pre-targeted problems, the Grand Challenges program is spurring innovation to lift the veil over a better future.

– Whiting Tennis

Photo: Flickr

Vaccination Acts As a Solution to Poverty
Over the past few years, the health status of many developing countries has improved significantly as the goal of increased accessibility and affordability of basic healthcare services became attainable across different regions of the world. Recently, researchers at Harvard University have debated the fact that vaccination is the key solution for not only lowering the number of deaths in developing countries, but also for alleviating the burden of medical expenses inflicted by poverty on the population and government.

The study was carried out by the Harvard T.H. Chan School of Public Health faculty, and was published in the journal of Health Affairs. Results highlighted that investments in preventive healthcare, particularly immunization which allow individuals to have access to 10 types of vaccines (measles, hepatitis B, human papillomavirus, yellow fever, rotavirus, rubella, Hib, pneumococcus, Neisseria menpngitidis and Japanese encephalitis) in 41 low-and-middle-income countries, could prevent a total of 36 million deaths over a period of 15 years.

It was also seen that 24 million cases of medical impoverishment could be prevented since most out-of-pocket medical expenses are usually associated with vaccination services in third world countries.

How Vaccination Acts As a Solution to Poverty

The following are five ways of how vaccination acts as a solution to poverty:

  1. Positive Economic Impact

    According to Dr. Seth Berkley, CEO of the Vaccine Alliance-GAVI, vaccines not only save lives, but also generate huge economic impacts for families, communities and society at large. He further explained his point of view by stating that a healthy child who has received all of his/her vaccination will become a productive member of society and can then contribute positively to the prosperity of the country. The family of vaccinated children can also avoid any strenuous costs associated with vaccine-preventable diseases.

  2. Increased Health Equity

    By legislating new policies allowing people to afford the necessary vaccinations, poverty will eventually decrease, leading to improved equity on the global development agenda. New vaccination policies could be considered as a milestone contributing to the process of achieving the Sustainable Development Goals and universal health coverage.

  3. Reduced Mortality Rates

    Poverty-related statistics reveal that people living in extreme poverty tend to benefit the most from increased access to vaccines since they are more susceptible to preventable infectious diseases. Increasing their access to complete vaccine doses can lower their risk of contracting deadly communicable diseases, and thus lower their overall healthcare costs.

  4. Increased Life-Expectancy

    A study conducted by John Hopkins University in 2016 found that every $1 spent on immunization efforts is equivalent to $16 saved on healthcare costs. Therefore, the more the population saves money by avoiding additional healthcare costs, the higher its productivity and income due to improved health. As a result, people are offered the opportunity to lead longer, healthier lives, and the return on investment rises to $44 per $1 spent on vaccines.

  5. Reduced Burden of Preventable Infectious Diseases

    Hepatitis B was estimated to cause 14 million cases of medical impoverishment per year, while measles and meningitis A generated 5 million and 3 million cases of poverty per year, respectively; Rotavirus was also set to cause 242,000 poverty cases per year. By providing people with the necessary vaccines, morbidity and mortality rates will decline significantly and thus lead to overall reduced poverty rates. Currently, measles vaccine is projected to prevent around 22 million deaths each year.

The assumption that vaccination acts as a solution to poverty is a highly supported public health issue that has caught the attention of medical professionals and public health workers all over the world. Such a powerful primary prevention method should be widely dispersed among the public in order to initiate the start of a bright, equitable future and a world where poverty is defeated.

– Lea Sacca
Photo: Flickr

Increase Child Immunization
Orange, GAVI and Côte d’Ivoire Ministry of Health are coming together for a mobile phone project, “M-Vaccin Côte d’Ivoire,” which will increase child immunization by focusing on regions with the lowest immunization rates in the Côte d’Ivoire.

 

GAVI, the Vaccine Alliance

GAVI, the Vaccine Alliance, is dedicated to protecting children’s lives and health by providing immunizations in developing countries. Orange works towards providing technology to use as tools in both healthcare and also education and finances and believes that their digital outreach supports those aspects of underdeveloped countries.

The project will use Orange mobile technology to both inform parents about the importance of vaccinations through text and voice messages and to also make sure parents don’t forget about immunization appointments by sending reminders of the date and time of their child’s session.

 

Orange Technology

Orange will also be providing health care workers with the M-Vaccin mobile application that allows them to view data, create vaccination schedules for individual families they are caring for and monitor the results, which in turn should increase child immunization.

The partnership between these organizations will continue for five years; during this time, Orange and GAVI will combine to invest a collective $5.47 million in the project. Half of the investment will be from the GAVI Matching Fund, and the other half from the Bill and Melinda Gates Foundation.

This funding will go to support the outreach program and provide both mobile devices to those in need and healthcare workers, and also inform citizens about the importance of immunizations, and keeping up with vaccination appointments and learning sessions.

 

Project Implementation

The Project will be implemented in the 29 districts of Côte d’Ivoire where immunization is lower than the national average. Many of the parents living in these districts aren’t fully informed about immunizations, and often aren’t living close enough to healthcare centers in the first place. Côte d’Ivoire’s infant mortality rates are some of the highest in the world, and only continue to increase; about half of children under age one are immunized.

 

The M-Vaccin Program

The M-Vaccin Program expects to reach more than 800,000 children and could possibly be expanded into other countries in West Africa upon evaluation. Dr. Seth Berkley, the CEO if GAVI, said the partnership is really important for the children of Côte d’Ivoire, and that their parents do not receive enough information about vaccinations because of where they live.

Solving or working around these situational obstacles will significantly improve the rates of child immunization in the Côte d’Ivoire, and also hopefully serve as a catalyst for further increases in child immunization across the continent.

– Chloe Turner

Photo: Flickr

Maternal ImmunizationMaternal immunization is a necessary solution to reduce mortality rates for newborns as well as pregnant women. These vaccines must be monitored for safety and effectiveness. Systems must also be enforced to make the change, especially in low and middle-income countries, as the neonatal (first 28 days of life) period mortality rates are significantly higher in developing countries. 99 percent of all neonatal deaths occur in low and middle-income countries. Vaccinations in a pregnant woman protect herself, the fetus, and the newborn by transferring maternal antibodies across the placenta, guarding them both from life-threatening infections.

A system that identifies, evaluates, and responds to the potential events after immunization is called Pharmacovigilance system. This system is vital for pregnancies but unfortunately, it is still uncommon in developing countries. Fortunately, however, GAPPS (Global Alliance to Prevent Prematurity and Still Birth) and the Bill and Melinda Gates Foundation have created a report that discusses the monitoring of existing systems for safety,  identifies the gaps, and outlines a plan to implement this program in low and middle-income countries.

The analysis brings in a range of organizations including the WHO (World Health Organization), UNICEF, and MNCH (Maternal, Newborn and Child Health) to develop the strategy further. The report also discusses key necessities such as the need for regulations, response to events including the health of pregnant women and their offspring, training in the Pharmacovigilance system, model creation of dates, and linkages between the systems and collaborators.

If a pregnant woman is at a high risk of being exposed to any diseases that would be a high risk to both her and the fetus, the benefits of maternal immunization would typically outweigh the risks. The two vaccinations for pregnant women that are most encouraged are the whooping cough (Pertussis), and the flu (Influenza) vaccines. The whopping cough can be life-threatening for newborns, but with the vaccine, the body will produce protective antibodies for the mother and the baby which protects against the whooping cough. The flu vaccination is a necessity for pregnant women because they are more susceptible to the virus with the changes in their immune system, heart and lungs. If a pregnant woman catches the flu it can potentially cause serious problems for the fetus including premature birth.

With these systems and an increase in maternal immunization, pregnant women can have confidence in their pregnancy and labor as well as lower the global maternal and newborn mortality rate.

Chloe Turner

Photo: Flickr

UNDP Supports Universal Immunization Program in IndiaWith high risks of communicable diseases like bacterial diarrhea, malaria, hepatitis A and E and typhoid, there’s a rising necessity for a proper immunization program in India. The United Nations Development Programme (UNDP) has partnered with the Indian government and Ministry of Health and Family Welfare to design and put into effect an Electronic Vaccine Intelligence Network (eVIN). This project, known as Improving Efficiency of Vaccination Systems in Multiple States, has already run since 2014 and is to run until 2021 to strengthen the evidence base for policy-making related to vaccine delivery, procurement and planning, and ensure equity in availability.

As the world’s largest immunization program, eVIN technology has already shown results in enabling real time information on cold chain temperatures and vaccine stocks and flows in all 371 implementing districts in India. It has managed to achieve over a 98 percent reporting rate from vaccine storage areas, with over 2 million transactions logged each month, and developed the skills of over 17,000 government staff in store keeping, data operating or cold chain handling in over 550 batches of training programs.

The eVIN is setup on a mobile application that easily allows cold chain handlers to log stock positions at the end of each routine immunization day, which is then relayed immediately onto a web interface for assessment by health officials. In India, this can come to play an important role as geography and communications can pose an issue, like in the small hill-state of Manipur, where vaccine vials are carried over extensive distances to session sites by auxiliary nurses and midwives. Instances of stock-outs have decreased by more than six times here, and eVIN has enabled staff to learn how to use a smartphone and other technology, improving quality of work and management in the process.

This immunization program in India has also significantly empowered women health workers, giving them the opportunity to work with technology after attending regional and district eVIN training sessions. This allows them to manage stocks and temperatures themselves, bridges the digital divide in rural parts of India and ensures transparency alongside accuracy. Over 50 percent of cold chain handlers are women, and many are from older age groups.

EVin has taken India out of the unproductive days of delayed decision making, shortages and expirations, and has created an efficient health system that allows for valuable state-wide geographic, stock-out or excess stock and temperature overviews on each district’s centers. It also allows for large savings by reducing vaccine wastage and allowing for timely and quality injections, as in Rewa, where around $70,000 was saved after six months of eVIN activation.

Though led by the UNDP and Ministry of Health and Family Welfare in India, the Universal Immunization Program is largely supported by GAVI, a global vaccine alliance established in 2000. With support from GAVI and the Indian government, the Universal Immunization Program in India has immunized at least 65 percent of India‘s children and expects to immunize 27 million more each oncoming year.

Zar-Tashiya Khan

Photo: Flickr

How to Bring Medicine to the PoorThere are many diseases plaguing the developing nations of the world. There is also much that can be done to improve the state of health across the globe. This is especially true with regards to measles. Measles is a serious problem, particularly in African nations, including Nigeria. Nigeria desperately needs people to bring medicine to the poor.

The CDC reported 176,785 confirmed cases of measles in Africa between 2013 and 2016. While the frequency of measles cases has been on the decline since 2013, the disease is still too widespread to be considered a solved problem. This is especially true for children between nine and 59 months old; they are the most vulnerable to this disease.

Starting in 2013, Nigeria had 50,585 known cases of measles. By 2016, this number had dropped to 11,499 known measles cases, leaving it still the most highly infected African nation. This seems like an exceptionally great dilemma to members of the developed world who are accustomed to the high cost of vaccines. In the United States, the CDC’s five recommended childhood shots can cost an average of $937 per person. Considering how much these vaccines cost Americans, how could it be possible to combat an epidemic in a nation as poor as Nigeria?

According to the World Health Organization, it is actually quite cost-effective to immunize nations such as Nigeria from measles. While vaccines are quite expensive in nations such as the United States, they are relatively inexpensive to use when manufactured for mass immunization projects. The World Health Organization has estimated that mass immunizations could be performed in countries such as Nigeria for roughly $1 per child vaccine.

What can be done to bring medicine to Nigeria? A simple solution would be to write and call your Congress representatives to encourage them to support immunization projects. Donating to the Borgen Project is also a great way to put forth efforts to increase U.S. spending on global disease prevention. To make a direct impact, it is also possible to contact the World Health Organization to ask how you can contribute to the fight against measles. From these steps, there will be an improved capacity by many organizations to bring medicine to the poor.

Tim Sherwood

Photo: Flickr