Polio survivor, Richard Elaka, age 60, has made it his mission for the last 20 years to educate his community in Kinshasa, Democratic Republic of the Congo (DRC) on the benefits of vaccinating. At 7 years old, Elaka suddenly lost the use of his legs. His family initially believed this was the result of a curse that his uncle put on him. It was not until later that Elaka understood that the poliomyelitis virus had infected him, a case that could have been prevented if he had received the polio vaccine. Unable to walk without the use of crutches from the age of 7, Elaka does not take his survival for granted. He spends his free time engaging in community outreach, roaming the streets in an attempt to teach his neighbors about the dangers of non-vaccination.

The Under-Vaccination Problem in the DRC

Only 35% of children in the DRC between the ages of 12-23 months have complete vaccination records by the time they turn 1 year old. The COVID-19 pandemic exacerbates this issue; the DRC has steadily watched vaccination numbers decline since the start of the pandemic. The primary reasons for the declining numbers are:

1. Vaccinators lack the personal protective equipment required for dispensing injections.
2. Parental concerns of exposure to COVID-19 when traveling to vaccination facilities.
3. Insufficient funds to purchase the vaccines.
4. Conflict and insecurity in the area.

Number three on this list is one of the biggest barriers the DRC faces.

The Plan

The DRC’s government is working to remedy the issue of under-vaccination. The dangers of non-vaccination, particularly within the population of a developing country like the DRC, can have lifelong consequences. In June 2020, the DRC  doubled the immunization funding budget it had in 2019. In fact, about $16.4 million went toward the purchase of vaccines.

Along with the financing from UNICEF, the money that the DRC government provided has made it possible for the Emergency Plan for Revitalization of Routine Immunizations’ work in the DRC to continue. Some formally know the Emergency Plan for Revitalization of Routine Immunizations as the Mashako Plan, named after the late DRC Minister of Health Professor Leonard Mashako Mamba. Its creation in 2018 was a direct response to the issue of incomplete immunizations. Initiated with the hope of targeting several under-vaccinated areas of the DRC, the Mashako Plan established five key components in creating a sustainable immunization practice:

1. Dispensing Immunizations. The 2018 goal was to increase the number of completed vaccination sessions by 20%.
2. Stockout Reduction. Reduce incidents of local health care centers experiencing stockout by 80%.
3. Observation and Assessment. Closely monitoring data results of vital factors.
4. Supervision. Routine inspections of immunization storehouse and vaccine dispensing facilities.
5. Funding and Strategy. Monthly meetings to discuss finance and implementation.

The Good News

From its inception to 2019, the Mashako Plan has contributed to a 50% increase in completed vaccination sessions. The impacts of COVID-19 on the DRC’s mission to vaccinate is challenging. In 2020, the DRC contended not only with COVID-19 but also with Ebola and measles outbreaks as well. Despite these arduous circumstances, volunteer vaccinators, DRC public health officials and community members, like Richard Elaka, remain undeterred in the commitment to protecting the citizens of the DRC from the dangers of non-vaccination.

– Rachel Proctor
Photo: Flickr