Polio Program in SomaliaSomalia is one of the few countries remaining with a risk of poliovirus transmission. The polio program in Somalia was established as a way to eradicate the virus completely as part of the global immunization effort. However, with the arrival of SARS-CoV-2, the polio program in Somalia has been stifled. Somalia ranks 194 out of 195 on the Global Health Security Index. The international recommendation for healthcare workers is 25 per 100,000 people; however, Somalia only has two per 100,000 people. The country also has only 15 intensive care beds for a population of 15 million. It is considered to be among the least prepared countries in the world to detect and execute a quick response to COVID-19.

Effects of the Pandemic on the Polio Program in Somalia

Many of the workers that are part of the polio program in Somalia have suspended all door-to-door immunization due to the ongoing coronavirus pandemic. With travel kept to a minimum, polio samples cannot be flown abroad to external medical labs for testing. In addition to this, millions of polio vaccines will expire in a matter of months.

The global polio immunization program paused at the end of March 2020, leaving more than 20 million workers and medical practitioners without work. The World Health Organization (WHO) estimates that the number of unvaccinated children could reach 60 million by June in the Mediterranean region.

The Polio Program Fights COVID-19

Polio surveillance systems are developed disease surveillance systems. This network of disease surveillance has been able to track the poliovirus and deploy medical teams throughout the world. Now, the polio program in Somalia has shifted its efforts to combat the COVID-19 pandemic. The system’s infrastructure, its capacity and the experience of its medical staff make it prepared to deal with the novel coronavirus. As of July 2020, Somalia had approximately 3,000 confirmed cases of COVID-19 with 930 recovered cases and 90 deaths. The number of actual cases is likely significantly larger, but many cases go undetected due to a lack of testing.

Thousands of frontline workers for the polio program in Somalia started curbing the spread of the coronavirus. These workers form rapid response teams trained to detect COVID-19 cases as well as to educate and raise awareness about the ongoing pandemic in Somalia. WHO’s national staff and local community healthcare workers have joined theses polio response teams, utilizing their resources and skills to tackle the virus.

WHO Support

These teams have traveled to remote areas in Somalia, providing critical information regarding physical distancing, hand-washing, detection of symptoms and prevention. With WHO’s aid, the program has acquired testing kits and equipment to evaluate potential cases of the virus. The surveillance teams have adopted the same procedures that they used for the polio program in Somalia for COVID-19. After collecting potential COVID-19 samples from suspected cases, the rapid response teams transport the samples to external laboratories for testing. Outside humanitarian agencies use the same protocols and operations that they used for the poliovirus.

Furthermore, the response teams continue polio immunization simultaneously with the COVID-19 response. It is essential for the polio program to continue immunization, as Somalia experienced a polio outbreak earlier this year.

How Other Countries Have Adapted

Other countries in the same region have realized the practicality of the polio network. They have accordingly redeployed their own immunization programs to fight COVID-19. For example, South Sudan has converted approximately 80% of its polio workforce to track coronavirus cases in the country. It has trained polio contact tracers to evaluate people for symptoms of COVID-19. Mali has also been engaging its own polio program in response to the ongoing pandemic.

Even though polio and COVID-19 do not have much in common, the polio program is an important tool to fight the pandemic. The Bill and Melinda Gates Foundation, in partnership with the WHO, has been working to equip these polio networks to help countries deal with the pandemic. The suddenness of the pandemic has left no time for countries such as Somalia to prepare. As such, the global polio immunization campaign is a valuable resource for this unprecedented emergency.

Abbas Raza
Photo: Flickr

immunization in pakistanDuring the COVID-19 pandemic, 63 polio cases were reported in Pakistan. Four months after the COVID-19 outbreak occurred in Pakistan, more than 50 million children did not receive a polio vaccination, as immunization in Pakistan was delayed. At the end of July 2020, Pakistan was able to complete a round of vaccinations to cover 780,000 children.

Vaccinations and COVID-19

On April 1, 2020, Pakistan went into a nationwide lockdown for a month due to COVID-19. During the lockdown, immunization in Pakistan reduced by more than 50%. This reduction occurred mainly in impoverished regions and areas that were far from service delivery.

Healthcare workers’ contracting COVID-19 led to a halt in immunization services in some areas. More than 150 Expanded Programme on Immunization healthcare workers contracted COVID-19. Additionally, shortages of personal protective equipment (PPE) further reduced immunization, as healthcare workers were concerned about the risk of transmission while providing immunizations without proper PPE.

Transportation Interruptions Delay Immunization

Many immunizations in Pakistan were not delivered due to flight disruptions from COVID-19. Reduced immunization in Pakistan can lead to new outbreaks of other preventable diseases, like measles. The Khyber Pakhtunkhwa Province, an area with a large refugee population and limited healthcare access, has already seen an increase in measles cases.

The lack of public transportation available during the pandemic also made it difficult for many to travel to receive immunizations. People who are at high risk of contracting COVID-19 were often afraid to go out in public and get immunized.

New mothers in particular were not willing to risk the travel to hospitals to get their children vaccinated. One new mother expressed her concern that the absence of vaccinations could lead to contracting preventable diseases, but she was also worried about the coronavirus. Furthermore, multiple private and public hospitals were overwhelmed with COVID-19 and did not allow babies and mothers to receive their immunizations.

WHO’s Restrictions Led to Vaccination Difficulties

After the World Health Organization advised countries to postpone their immunization campaigns, Pakistan halted its door-to-door polio immunization program. The postponement of mass vaccination programs may lead to 117 million children worldwide not receiving a measles vaccine. Countries that have low immunization rates are at the highest risk. Pakistan’s routine vaccination campaign for tuberculosis, for example, reached only 66% of its slated coverage this year, compared to 88% in 2019.

In Karachi, the Health Education and Literacy Programme (HELP) works to support maternal and child health and maximize vaccination coverage. Founder of HELP, Dr. D. S. Akram, said that the delay in immunization could lead to hundreds of thousands of young Pakistanis missing their tuberculosis and polio vaccines. On average, 12,000 to 15,000 children are born in Pakistan every day. Since polio is still endemic in Pakistan, the suspension of the door-to-door polio immunization program may lead to more outbreaks in the future.

Once Pakistan started to come out of its lockdown in May 2020, clinics began to reopen in an effort to continue vaccination campaigns. Pakistan faced two obstacles in attempting to increase routine vaccinations: both opening hospitals and ensuring that parents felt safe to bring their children there. Hospitals had to ensure not only that there were enough vaccinations in supply but also that parents would be willing to get their children immunized.

In Pakistan, children who belong to poor households are affected by vaccination coverage the most. The reduction of immunization in Pakistan has occurred mainly in slum areas, where it is difficult to deliver healthcare products. Despite the delay in immunization caused by COVID-19, Pakistan continues to adapt in its efforts to return to routine vaccination.

– Ann Ciancia
Photo: Flickr

Measles in the Central African Republic
Measles is a viral infection spread through airborne respiratory droplets from an infected individual. Measles can cause typical flu-like symptoms and a skin rash, and, under certain circumstances, it can lead to death. While the illness is virtually obsolete in more developed countries, other countries, such as the Central African Republic, struggle with keeping it at bay. Here are four important facts you should know about measles in the Central African Republic.

4 Facts About Measles in the Central African Republic

  1. Measles primarily affects children. The viral infection is especially taxing on those with weakened immune systems. Thus, children, especially those who are malnourished or HIV-positive, are more likely to become infected and die from the measles. In 2017, only 49% of Central African children under five years of age received vaccinations against measles. In the resurgence of measles in 2019, 90% of cases in the Central African Republic affected children aged 10 or younger. Although a safe vaccine is available, many Central African families have been displaced, live in rural areas or do not have access to a nearby healthcare center. With the help of foreign aid, the government can initiate more vaccinations and widespread awareness – two critical components in combating measles.
  2. The fight against measles in the Central African Republic is ongoing. For more than 40 years, Central African citizens have struggled with measles. The epidemic is a health crisis and is at the top of the country’s political priorities. In 2014, with the help of the Red Cross and the United Nations, the government of the Central African Republic rolled out a vaccination campaign. It aimed to provide free measles vaccines for more than 115,000 children. However, in January 2019, a resurgence of the measles appeared in the Central African Republic. Since then, the citizens have been fighting widespread outbreaks of the disease. From January 2019 to February 2020, there were more than 7,000 new cases of the measles and 83 deaths.
  3. Vaccines are hard to distribute in the Central African Republic’s war-torn political climate. As of 2017, nearly 900,000 Central Africans had fled violence and unrest. More than half of these displaced people were children. Children and adults are more likely to contract measles and die if they are subjected to overcrowding, malnutrition, immunosuppression or poor healthcare systems. The political turmoil throughout the country can cause these factors to become more prevalent and inhibit effective immunizations. Furthermore, the looting and closing of healthcare facilities across the country has stifled the progress made by previous vaccination campaigns.
  4. The government is working with other international organizations to eradicate measles in the Central African Republic. As a response to the recent outbreaks, the Ministry of Health partnered with the World Health Organization to develop specialized courses of action and vaccination campaigns. They have increased epidemiological tracing, communication about the disease’s risks and vaccination and medicine availability. Additionally, the Center for Emergency Operations in Public Health has aided government officials in devising plans for dealing with outbreaks. Another important international program is Gavi, an alliance that promotes free access to vaccinations all over the globe. Gavi has helped the Central African Republic fund measles treatment and follow-up vaccines by donating more than $1 million to the cause. Similarly, USAID has helped in the fight against measles by making financial donations that fund testing and vaccinations.

Although the prevalence of measles in the Central African Republic is serious, the government and other organizations are committed to fighting it. Moving forward, continued efforts are needed to reduce the prevalence of measles in the nation.

– Danielle Kuzel
Photo: Flickr

10 Facts About Life Expectancy in Togo
Although global aid has decreased, Togo has managed to increase its health expenditure as a share of GDP to 6.6 percent in 2016, a jump of about 8 percent from the previous year where this amount was actually negative. Due to the scarcity of hospitals and health centers, Togo’s 2018 population of approximately 8.2 million faces numerous obstacles from birth onwards in the battle to survive. Of every 1,000 Togolese infants, 49 will die before they are 1 year old and approximately 69.8 before they reach the age of 5. In addition to infant deaths, the maternal mortality ratio is 396 per 100,000 live births as of 2017. Overall life expectancy in Togo is 69 for females and 63 for males, the 178th worst globally. These 10 facts about life expectancy in Togo demonstrate the changes over time. 

10 Facts About Life Expectancy in Togo

  1. Crime: In Togo, the homicide rate was nine cases per 100,000 people in 2015. Compared to the United States, it has 4.1 more cases per 100,000 people. Violent crimes, theft and pick-pocketing are common in marketplaces or along the beach of Lome. There is an abundance of scam artists that fake online friendships to steal or stage accidents to jack cars and there has even been a threat of kidnapping recently. The ECOWAS Regional Action Plan renewed for 2016-2020 to address crime and drug trafficking in West Africa.

  2. Sanitation: Most drinking water sources in the urban parts of Togo have improved with only 8.6 percent of urban populations not having access to reliably safe drinking water. In rural areas, however, 55.8 percent of the water sources have remained unimproved. Sanitation facility access has not improved much, either, with 75.3 percent of urban Togo and 97.1 percent of rural Togo having unimproved sanitation facilities. Public toilets are often unavailable as well, and when they are available, they generally range from sit-down and squat toilets to holes in the ground.

  3. Disease: As of 2017, Togo’s most prevalent diseases are malaria, neonatal disorders, HIV/AIDS, lower respiratory infection, ischemic heart disease, diarrheal diseases and tuberculosis. HIV/AIDS afflicted approximately 110,000 Togolese or 2.3 percent as of 2017, ranking the country 22nd worst globally. An estimated 4,700 deaths were from HIV/AIDS in 2017, the 43rd worst ranking in the world. It is also common for infants to suffer from diarrhea, one of the main contributors to the infant mortality rate in Togo.

  4. Malnutrition: Malnutrition rates exceed 10 percent in three out of five regions in Togo, with 16 percent of children under 5 underweight. Many parents have been relying on feeding their children a simple paste that is filled with vitamins and minerals, called Plumpy’Nut, and has improved the situation of many Togolese children. An agricultural improvement is the development of a drought-resistant, high-yield rice, Nerica, specifically for Africa. For Western Africa, rice is a staple, but to meet nutritional demand, the region needs to import 3.5 million tons of rice per year, which costs nearly $1 billion.

  5. Overcrowding: The best example of Togo’s overcrowding problem is its 12 prisons. Though there is a set capacity for these prisons, they end up holding more than twice their capacity. As a result of these cramped conditions, hygiene, food and medical care are poor, and disease and death run rampant. Prisoners reportedly sleep like “sardines in a tin,” and even sleep in shifts, with some waiting for their turn against a wall.

  6. Immunization: Immunization coverage among Togolese children is severely incomplete. A study found that 36.2 percent of children did not receive all vaccines that the Expanded Program on Immunization (EPI) recommends. Togo has a multi-year plan (2016-2020), a national system to monitor adverse events following immunization, and a standing technical advisory group on immunization.

  7. Maternal/Neonatal/Child Health: Only 61.4 percent of Togolese births have skilled health personnel in attendance, and as a result, the maternal mortality rate in Togo is 396 deaths/100,000 live births as of 2017. Mothers already have to travel long distances to reach health facilities, and when said places do not have the necessary expertise or medication, they become discouraged from attending any appointments before birth. When these women do not attend regular checkups, health professionals cannot detect problems early on or provide mothers with rudimentary health care.

  8. Health Systems: Togo only has 746 health centers, which is approximately 11 health centers per 100,000 people, and only six regional hospitals, which is 0.09 per 100,000 people. There are only 0.05 physicians per 1,000 people as of 2015. This scarcity of health facilities results in overcrowding of existing ones and it stretches health professionals thin. With so few people operating each facility, Togo cannot meet average health standards and thus cannot help people efficiently. Life expectancy could improve in this respect by creating more health centers.

  9. Substance Abuse: Togo is a transit point of Nigerian heroin and cocaine traffickers. There were 2,000 drug users in 2001 (12 deaths), 3,000 in 2006 (68 deaths) and 3,575 in 2007 (100 deaths). Togolese drug use has only increased over time, stretching to 5.5 percent of students. The students consider drugs to be fortifying and have developed a dependency on drugs just for studying.

  10. Road Safety: People do not stress road safety in Togo. Many Togolese drivers do not obey traffic laws mostly due to traffic signals not functioning properly, and a lack of reinforcement. Sometimes they run red lights and stop signs or drive in the wrong direction on one-way streets. Not only do these driving standards threaten pedestrians and drivers alike, but they also set the stage for fake accidents.

These 10 facts about life expectancy in Togo show that even the smallest of changes could evolve into much more for the Togolese. The ECOWAS is working diligently to improve the lives of those in West Africa by limiting crime and drug trafficking and abuse. Togolese life expectancy has even increased because of other countries’ efforts.

– Nyssa Jordan
Photo: Flickr

Madagascar Measles Outbreak

Between September 2018 and April 2019, Madagascar‘s measles outbreak has killed over 1,200 people. According to the World Health Organization, measles is a highly contagious viral disease that remains a significant cause of death among young children globally, despite the availability of vaccines.  Organizations are currently coming together to aid Madagascar against the outbreak and educate the public about the importance of vaccinations in protecting children from harm.

Recent Outbreak

Madagascar is facing the largest measles outbreak in its history, and only 58 percent of people on the island have been vaccinated against the disease. Dr. Dossou Vincent Sodjinou, a WHO epidemiologist in Madagascar, expressed concern about the expansion of the outbreak and the lack of vaccination.

“The epidemic unfortunately continues to expand in size, though at a slower pace than a month ago,” said Dr. Sodjinou. “Some cases of resistance to vaccinations exist because of the influence of religion or of traditional health practitioners but they are isolated ones.”

Measles is one of the leading causes of death for children, and WHO reports that 450 die each day worldwide due to the illness.

According to the Centers for Disease Control and Prevention, the symptoms of measles generally appear seven to 14 days after a person is infected. Measles begins with a fever, a cough, runny nose, a sore throat and red eyes. After a few days of symptoms, tiny white spots, medically known as Koplik’s spots, begin to appear inside the mouth.

The outbreak is complicated by the fact that nearly 50 percent of children in Madagascar are malnourished, which increases the likelihood of severe cases. Those whose immune systems have been weakened by HIV/AIDS or other diseases are also at risk.

Weak Healthcare and Shortage of Vaccines

According to United Nations Children’s Fund, once a child is infected, there is no specific treatment for measles, so vaccination is a life-saving tool for children.

“The Madagascar measles outbreak is a particularly precarious situation because many of the districts have weak health infrastructure and systems to begin with, which is now exacerbated with a shortage of vaccines,” said Michael L. Rich, a Harvard Medical School assistant professor and the chief clinical advisor at PIVOT, an organization partnering with the Madagascar Ministry of Health. “Without a reliable supply of vaccines, strong supply chains or facilities adequately staffed with trained personnel, an end to Madagascar’s ongoing measles crisis is difficult to foresee.”

Doing More to contain the outbreak

The United Nations Children’s Fund is issuing an urgent appeal to governments, health care providers, and parents to do more to contain Madagascar’s measles outbreak. Efforts against the outbreak include educating the public about the safety of vaccines, vaccinating all children between the ages of 6 months and 5 years, training and equipping health workers, and strengthening immunization programs.

PIVOT, an organization dedicated to providing healthcare to impoverished communities, aims to help Madagascar become a symbol of healthcare transformation. In the wake of the outbreak, PIVOT is aiding public systems and pushing for an era of medicine guided by the needs of the poor.

While organizations successfully fight measles in Madagascar, there is also hope around the world. Under the Global Vaccine Action Plan, the elimination of measles is a target in five WHO regions by 2020. WHO, as the lead agency responsible for achieving this goal, is giving children around the world hope for a healthier future.

– Carolina Chaves
Photo: Flickr

 

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