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Gavi Support Package: Ending Measles in Developing Countries

measles in developing countries
The measles vaccine has saved approximately 17.1 million lives since 2000, however, global targets to eradicate the disease are still off track according to Gavi, the Vaccine Alliance.

Notably, the World Health Organization (WHO) recently reported that while global measles vaccination coverage increased from 72 percent to 85 percent between 2000 and 2010, it has remained unchanged for the past 4 years.

Founded by the Bill and Melinda Gates Foundation, Gavi recently approved a new support package that aims to end measles in developing countries.

The organization’s new support package will help install a strong immunization routine with high coverage. The new Gavin Vaccine will also take advantage of children’s visits to health care facilities to increase the coverage rates of the vaccine.

Gavi will also support data-driven campaigns on measles and rubella to reach children not protected by immunization. These campaigns will be synchronized with other immunization activities to better reach children in isolated communities.

In developing countries measles vaccination involves a series of strategies and large-scale campaigns which rely on the support of the Measles & Rubella Initiative (M&RI).

In 2014, campaigns and immunization activities reached 221 million children. In the African Region, cases of measles dropped from over 171,000 in 2013 to under 74,000 in 2014.

This new support package also requires developing countries to have a five-year rolling measles and rubella plan, together with their long-term routine immunization plans, all of which will be updated annually.

“Countries cannot begin to hope to eliminate measles until they get epidemics under control,” said Dagfinn Høybråten, Chair of the Gavi Board, “The package of support we have agreed on today will save lives and give developing countries a golden opportunity to reform how they protect their children against measles.”

– Marie Helene Ngom

Sources: Gavi, WHO
Photo: Flickr

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Countries Exceed Global Immunization Target

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Great news from the world of life-saving vaccinations! According to UNICEF and the World Health Organization (WHO), the number of countries with 90 percent coverage of children receiving routine life-saving vaccinations has doubled between 2000 and 2014.

In 2012, 194 WHO Member States endorsed the Global Vaccine Action Plan (GVAP) and committed to delivering vital vaccinations, with the goal of 90 percent diphtheria-tetanus-pertussis (DTP3) vaccination coverage in all countries by 2015. GVAP sought to prevent millions of deaths by 2020 by expanding the access of vaccines. The plan resulted from DoV collaboration, which brought together development, health and immunization experts and stakeholders. It was also made possible with the leadership of organizations such as the Bill & Melinda Gates Foundation and with partnerships in all levels of government, across various segments of society.

The global immunization target has seen an incredible push forward, with 90 percent of children receiving the required three doses of DTP3 vaccines, in 129 countries as of 2014. Currently, DTP3 immunization coverage stands at 86 percent for all 3 doses, and at 91 percent for infants receiving at least one dose. This is a great improvement from 2000, when 21 million children did not receive the first dose of DTP3, which is now up to 12 million.

Another great improvement is India’s current immunization rate. India has the largest number of unvaccinated children and is now at 80 percent of DTP3 coverage. According to the WHO, India is one of the three countries where almost half of the world’s unvaccinated children live. The other two countries are Indonesia and Nigeria.

Improvements in meeting other immunization targets have been made. Hepatitis B, which is common in East Asia and sub-Saharan Africa, has seen an increase in vaccinations from 2000 to 2014, from 30 percent receiving 3 doses to 82 percent. The number of children protected from Hepatitis B is high and increasing.

Another improvement in meeting immunizations targets have occurred with the rotavirus, which is the most common cause of severe diarrhea in children and infants and is widespread in developing and under-developed countries in East Asia and sub-Saharan Africa. More countries are using vaccines against the rotavirus and pneumococcal conjugate vaccine.

Despite these incredible improvements, there is still more room for improvement. According to the WHO, 65 countries need to improve their strategies for meeting the GVAP goal. These include six countries with less than 50 percent coverage with DTP3: Central African Republic, Chad, Equatorial Guinea, Somalia, South Sudan and the Syrian Arab Republic.

We’re on the right path to meeting the global immunization targets considering it has doubled, we just need to develop better strategies to speed up the process to make sure we can get to 100 percent of all children receiving routine life-saving vaccinations.

– Paula Acevedo

Sources: International Business Times, World Health Organization
Photo: International Business Times

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Sudan’s Measles Crisis

Measles
The Nuba Mountains in Sudan were once seen as a sanctuary but because of their remoteness and ongoing military struggle in the area, the largest measles crisis in years is currently sweeping across Sudan. Due to the power struggle between the government and rebels, children have been denied access to immunization.

The measles virus is spread by respiratory transmission and is highly contagious. Up to 90 percent of people without immunity who are sharing a house with an infected person will catch it.

According to UNICEF, Sudan has already seen 2,700 cases of measles this year. “Of these, roughly one in 10 will die. The fear now is that, with around 150,000 children under 5 in the Nuba Mountains who have had no reliable access to immunization since 2011, the situation could explode.”

Without immunization, there is a real potential that more lives will be lost to measles than to the recent Ebola outbreak in West Africa. However, in this case, the majority of lives lost will be children.

Sudan’s recent outbreak of measles is not caused by a lack of immunization efforts. In April 2015, UNICEF launched an immunization campaign to first vaccinate children in the highest risk states and then expanding into other areas identified to be at risk.

Geert Cappelaere, UNICEF Representative in Sudan said, “Measles is a life-threatening disease but on that can easily be prevented with timely immunization. Every girl and boy must be reached no matter where they live. There are no excuses and no child can be left out.”

Children are the most at risk for contracting measles; children who are malnourished are even more vulnerable. For malnourished children, measles can cause serious health complications including blindness, ear infections, pneumonia, and severe diarrhea.

“In Sudan, some 36 percent of children are stunted and the country has one of the highest levels of malnutrition in Africa. Of the total number of reported measles cases in Sudan, 69 percent are below 15 years of age, including 52 percent under the age of five.” A large portion of the children in Sudan is at risk to contract measles.
With the dispute over border territory around the South Kordofan region, the region has struggled to see vital humanitarian aid that is a crucial lifeline. Since 2011, the region has not seen food and medical supplies.

For the partners of Gavi, the Vaccine Alliance, there are few options left to deliver the much-needed vaccines. UNICEF and the World Health Organization have put their support behind the efforts of the Ministry of Health.

Another option is to try to get vaccines delivered by partner organizations that are still working in the area. These organizations include Doctors Without Borders and faith-based organizations such as Caritas. However, these organizations are not given immunity and vaccines cannot be promised to be delivered.

In light of this situation, it is also a learning opportunity. Governments must be more proactive about not just responding to humanitarian disasters but by also preventing them. The warning signs need to be recognized. “After all, for any country to have a future it must protect its children.”

– Kerri Szulak

Sources: CNN, UNICEF
Photo: Flickr

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Alwaleed Philanthropies to Support Childhood Immunization

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On July 13, 2015, Alwaleed Philanthropies announced their commitment to protecting the lives of children through immunization programs. They have signed an agreement with Gavi, the Vaccine Alliance, worth $1 million.

According to its website, “Alwaleed Philanthropies supports and initiates projects around the world, regardless of gender, race, or religion. [They] collaborate with a range of philanthropic, governmental and educational organizations to combat poverty, empower women and the youth, develop communities, provide disaster relief and create cultural understanding through education.”

Alwaleed Philanthropies has supported thousands of projects in over 90 countries and served millions of people across the globe for over 35 years.

The agreement with Gavi, the Vaccine Alliance was negotiated in January at the Gavi Pledging Conference. This is the first time Alwaleed Philanthropies has provided support to Gavi.

The contribution from Alwaleed Philanthropies is multiple projects to support the vaccine needs in Timor Leste, Kiribati, Armenia, Azerbaijan, Moldova and Guyana for the 2016 to 2020 period.

Gavi’s Resource Mobilization and Private Sector Partnerships Managing Director Marie-Ange Sarakao-Yao say, “We are very pleased that His Royal Highness Prince Alwaleed Bin Talal has decided to support Gavi through Alwaleed Philanthropies. Immunization is one of the most effective ways of reducing preventable deaths in the poorest countries and thanks to this contribution, Gavi will be able to support developing countries with vaccines that protect children against preventable diseases.”

Every year, nearly 22 million children do not receive a full course of even the most basic vaccines. These children are mainly in poor countries. More than one in five of all children who die before the age of five lose their lives to vaccine-preventable diseases.

Since 2000, Gavi has invested more than $3.8 billion to introduce vaccines to the members of the Organization of Islamic Cooperation (OIC). For the 2016 to 2020 period, Gavi predicts that 60% of its funding will support immunization programs in OIC who are eligible for Gavi support.

Since its introduction in 2000, Gavi has helped developing countries immunize over a billion children, saving seven million lives. World leaders joined German Chancellor Angela Merkel in January to raise $7.5 billion to ensure Gavi supported programs anticipated for the 2016 to 2020 time period

With this contribution, Gavi will be able to support an additional 300 million children with vaccines. Because of the funding it is receiving, Gavi is taking the steps to ensure all children will survive vaccine-preventable diseases. Because not all families can afford vaccines, Gavi is the bridge between healthy children and the future of vaccinated children.

– Kerri Szulak

Sources: Alwaleed Bin Talal Bin Abdulazaz Al Saud, Gavi, the Vaccine Alliance
Photo: Alwaleed Philanthropies

World Health Assembly Passes Resolutions

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Among the resolutions passed at the gathering of delegates for the World Health Assembly on May 25, the most critical to the development of sustainable health for nations involved were resolutions that focused on the growing problem of antimicrobial resistance and low immunization rates.

The World Health Assembly (WHA) marked its sixty-eighth year last month, May 2015, with an annual meeting, lasting nine days in Geneva, Switzerland. Whilst a number of important pieces on global health were shared, WHA attendees from 194 member states also determined what should be done to advance the global health agenda.

WHA attendees agreed on resolutions that focused on microorganisms’ growing resistance to antimicrobial drugs as well as antibiotic resistance around the world, which jeopardize healthcare providers’ ability to effectively treat infectious diseases. As a result, a part of the resolutions drafted included a plan of action for member states, which they could utilize to combat this growing threat.

The World Health Organization outlined the five objectives of this plan:

  1. Improve awareness and understanding of antimicrobial resistance;
  2. Strengthen surveillance and research;
  3. Reduce the incidence of infection;
  4. Optimize the use of antimicrobial medicines;
  5. Ensure sustainable investment in countering antimicrobial resistance.

WHA delegates encouraged the adopting member states to customize and enact this global plan by May 2017.

Additionally, there were also resolutions passed in regards to scaling up immunizations in low and middle income countries, which tend to suffer some of the highest immunization costs.

Though the WHA enacted the Global Vaccine Action Plan in 2012, due to extremely slow and irregular progress, the World Health Organization states that the “resolution calls on WHO to coordinate efforts to address gaps in progress. It urges Member States to increase transparency around vaccine pricing and explore pooling the procurement of vaccines.”

Not only will decreasing the costs of vaccines potentially shape the way nations deal with health crises, it will also save thousands, if not millions, of lives. This effort will drastically reduce the number of deaths among children and greatly improve their ability to fight infections, both minor and life threatening.
In an effort to bring better vaccination programs to low and middle income countries, the WHA secretariat, met with representatives of participating countries to discuss what could be done to improve vaccination accessibility.

Both antimicrobial resistance and suitable access to vaccinations are issues that every nation must contend with, as they represent a threat to the health and safety of citizens everywhere. Combating a problem begins with awareness, and hopefully, we will see more development in awareness campaigns regarding these important global health issues in the coming months.

– Candice Hughes

Sources: International Business Times, The New York Times World Health Organization World Health Organization
Photo: Flickr

The Fight for Vaccination

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In some of the most rural areas of the world, people suffer from preventable diseases due to exposer to unsanitary drinking water and poor living conditions. While organizations continue the fight to bring clean water and food to these areas, it is also important that rural populations have access to vaccinations to help them combat these diseases. According to UNICEF, immunizations have the potential to save up to three million children yearly. However, there has been a decline in the progress of maintaining the spread of vaccinations.

The World Health Organization (WHO) is working to improve the distribution of immunizations in developing countries. According to the WHO, all of the 194 member states belonging to the WHO endorsed the Global Vaccine Action Plan (GVAP) in 2012. Moreover, member states have set goals to eliminate six diseases by the end of 2015. Although there continues to be a gap with one in five children missing vaccines, WHO hopes to see a world free of preventable diseases by 2020.

The goal to spread vaccination around the world by 2020 is also known as the Decade of Vaccines– implemented in 2011 and already eliciting substantial progress. The Gates Foundation has invested in vaccines and immunizations to help achieve the goals of the Decade of Vaccines. The Foundation understands the restrictions that keep vaccinations from people in rural areas, especially since some vaccines need refrigeration which is lacking in these places.  The Gates Foundation  continues to “support the innovation needed to develop new vaccines and new delivery technologies and approaches.”

The Center of Disease Control (CDC) also continues to take action against vaccine-preventable diseases, disability and death. It is important “to protect the health of Americans and global citizens by preventing disease, disability, and death through immunization,” says the CDC, as stated in their Global Immunization Strategic Framework for 2011-2015. Organizations like these provide hope that the world will some day be free of preventable diseases. Although there are many places that continue to be hard to reach, the fight to vaccinate the world by 2020 continues in full force.

– Kimberly Quitzon

Sources: UNICEF, WHO, The Gates Foundation, CDC
Photo: Flickr

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Polio Revisited

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The date is August 24. The year is 1960. A vaccine for polio is licensed for use in the United States for the first time. Nineteen years later, after a widespread campaign for immunization, the disease is completely eliminated from the U.S.

The year is 1988. The United Nation’s World Health Assembly has launched a campaign to eradicate polio globally. During that year there were 350,000 cases of polio. By 2012, that number dropped to 223. It was a disease that scourged millions. For the first time since the eradication of small pox, we had the power to eradicate a disease from the entire planet that has affected human beings, sometimes leading to paralysis and death, for thousands of years.

Despite a few sporadic cases elsewhere, the disease was mostly contained to Afghanistan, Pakistan and Nigeria. However, in 2013, two years into the Syrian Civil War, polio reappeared in Syria for the first time in 15 years. And now, for the first time since before mass vaccination efforts began, the disease is now gaining ground.

Recording an exact number of cases is tricky, particularly in a war zone, but several sources on the ground in Syria place the number above 100. The World Health Organization has taken a more conservative stance at around 25, but any number of cases could have devastating global consequences.

Polio spreads rapidly, but most who contract it never show any symptoms. Instead, they remain carriers for the duration that the disease incubates in their body. Therefore, doctors suggest that for every one symptomatic case, there could be 200 people infected.

Some estimates are much higher. With that in mind, we don’t need exact numbers to know that any number of new documented polio cases is a threat.

According to the U.N., during the course of the Syrian Civil War approximately 2.5 million refugees have fled Syria to neighboring countries. These countries are mainly Syria’s immediate neighbors; Turkey, Iraq, Jordon and Lebanon. With so many people fleeing Syria, polio could spread with them, and what was once a national crisis could become a regional one in much the same way the war itself has spread to other countries.

And in a world as globalized as ours, the potential impact of this resurgence could reverberate to the U.S.

This scenario is an immediate and physical example of how what happens outside our borders and across oceans has a direct impact on American lives. In times of war, formerly robust food and medical facilities often shut down, sometimes as collateral damage, at other times as a means to intentionally damage an enemy. But under any circumstances, when disease spreads, nobody wins. The year is 2014, and we are now in danger of revisiting a disease that we came within the final steps of eradicating a few short years ago.

– Julian Mostachetti

Sources: ABC News(1), ABC News(2), BBC, The History of Vaccines, Migration Policy Centre, New York Books
Photo: Tribune

Duflo Talks Social Experiments to Fight Poverty

Esther Duflo is the founder and director of the Jameel Poverty Action Lab (J-PAL), a research network that evaluates social experiments to fight poverty. It’s concerned less with wide-ranging policy than with specific questions. Esther Duflo takes economics out of the lab and into the field to discover the causes of poverty and means to eradicate it.

In Esther Duflo’s TED Talk, she brought up three specific questions people care about:

  1. The “last mile problem” of immunization.
  2. Should we donate lots of bed nets to solve malaria?
  3. What do we do about education?

When you ask the general question of whether millions dollars of aid are good or bad for Africa’s development, no one seems to be able to produce an exact answer. No one knows and no one can do the control experiment to prove his or her point, because Africa is a singularly unique continent whose development cannot be so easily compared to other regions of the world. But when you specify that big idea into small questions, social experiments, in some areas, may answer these questions. This may not answer people’s big questions like whether or not donating to African charities is a good or bad thing, but they definitely can tell us what we should do to help make Africa a more stable and prosperous continent.

– Caiqing Jin (Kelly)

Source: TED Talk

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Polio Immunization Still Matters


The widespread strategic implementation of polio immunization has reduced the number of reported cases by 99% since 1988. However, as long as there are countries where polio immunization is not widespread, there is a significant risk of this highly contagious virus exploding. The World Health Organization reports, “[failure] to eradicate polio from these last remaining strongholds could result in as many as 200 000 new cases every year, within 10 years, all over the world.” The strongholds referred to are some of the poorest and most dangerous countries in the world: Afghanistan, Nigeria and Pakistan.

Polio is a viral infection that attacks the nervous system of non-immunized children. Children under 5 have the highest risk of contracting the virus. Polio sometimes results in partial or full paralysis, but there is no indication of who or why paralysis occurs. Paralysis can occur within a few hours of contracting the virus. Between 5 to 10% of the paralysis cases result in lung muscle paralysis and death.

Anyone can be a symptomless carrier. The infection can be spread without notice through person-to-person contact to thousands before the first case of polio paralysis emerges. The disease enters through the mouth and multiplies in the intestines. The virus is then excreted into the environment and spread through contaminated food and water. Flies are also suspected to transmit the virus.

A global action plan to eradicate polio calls on donors to make a down payment of 5.5 billion dollars which would take us to the 2018 end game. Another 1.1 billion dollars will keep the world polio-free for the foreseeable future. Compared to the 527.5 billion dollar US Department of Defense budget for 2013, this is a drop in the bucket that quantifiably improves human security. Defend our children from polio. Make total polio immunization a reality.

– Katherine Zobre
Sources: WHO, Polio Global Eradication Initiative

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UNICEF Immunization Week

Immunization-Week
UNICEF, among other majors organizations, is known for their heavy work in immunization. Their efforts extend beyond acquiring funding for the actual products but actually probe into issues such as geographical obstacles, social stigmas against vaccinations, and political issues such as the killings in Pakistan. With its first ever World Immunization Week, UNICEF, the World Health Organization (WHO), and European health agencies are not only raising awareness of the life-saving capabilities of vaccines but increasing their efforts to reach children in even the most remote areas.

In Bosnia and Herzegovina, many Roma communities lack access to clinics and thus vaccines. This week, with the help of funding from the German National Committee, 5,000 children vulnerable to diseases were given vaccines that protected them against diphtheria, tetanus, pertussis, polio, mumps, measles, and rubella. Dr. Mitar Tesanovic, a coordinator for the program, stated that “it was unrealistic to expect those children to approach the medical institution. Therefore we decided that the system should approach them; we know now the decision was a good one.”

Jos Vandelaer, UNICEF’s Global Immunization Program director, also touched on the issue of anti-vaccination in his reddit AMA on Monday. Many parents, regardless of socio-economic background, have certain fears of constantly injecting their children with different medicines and vaccines. For example, there was the fear that vaccinations lead to autism, a link that Vandelaer discredits and said has been scientifically disproven. By partnering with local clinics and volunteers, UNICEF is able to go beyond education but really help them realize the benefits of not only having their children immunized but trying to keep records of that as well.

With 22.4 million unimmunized children in 2011, UNICEF hopes that they can jump off the plateau they have been resting on for a couple of years and start to fully eradicate diseases such as polio by next year.

– Deena Dulgerian

Source: UNICEF, The-Star