1. Cholera Outbreak: Experts consider Yemen’s cholera outbreak, which started in 2016, to be the largest epidemic to ever occur in recorded epidemic history. As of 2018, Yemen reported 1.2 million cases of cholera, and 58 percent of the resulting deaths were of children. The ongoing civil war and the fact that only half the country’s population has access to clean water and sanitation has made it increasingly challenging to tackle the spread of the disease effectively. Organizations like WHO and UNICEF have made severe efforts in distributing Oral Cholera Vaccines (OCV), funding to supply clean water to the citizens and establishing health centers to combat the outbreak. Several randomized trials showed the efficacy of the distributed OCVs to be nearly 76 percent.
2. Vaccination Rate: Even though vaccines have a proven rate of efficacy, the immense pressure that health care in Yemen experienced suddenly due to large outbreaks decreased the effectiveness with which it could mobilize its immunization efforts. According to the official country estimates of 2018, 80 percent of Yemen’s population received DTP3 vaccination coverage. However, Yemen did not distribute Oral Cholera Vaccines widely until 16 months after the cholera outbreak. This led to a rapid spread of cholera in the nation.
3. Vaccine Storage Facilities: Many often overlook a country’s vaccine storage capacity. Yemen’s lack of proper facilities and shortage of electricity made it difficult to safely store the vaccines. UNICEF and the Kingdom of Saudi Arabia worked together to provide solar refrigerators to several health care centers to facilitate safer and more reliable vaccinations in Yemen. Health care workers say that solar refrigerators enable them to store the vaccines for one month. This reduces material waste and optimizes vaccine distribution.
4. Impact of War: The ongoing civil war has put Yemen in a vulnerable position when it comes to the re-emergence of preventable disease outbreaks. Research has shown that countries with conflicts are more susceptible to disease outbreaks. However, these are easily preventable with vaccines. In Yemen, airstrikes destroyed many hospital centers, which made health care more inaccessible to its citizens. The civil war disrupted the stable vaccination rate in Yemen, which was at 70 to 80 percent, falling to 54 percent in 2015 at the time that the war broke out.
5. Humanitarian Efforts of International Organizations:  In war-torn countries with feeble financial stability, humanitarian efforts play a significant role in disease control. The World Health Organization (WHO) contributed 414 health facilities and 406 mobile health teams to combat the cholera outbreak and facilitate vaccination in Yemen. Meanwhile, UNICEF made substantial efforts to provide safe drinking water to 1 million residents of Yemen. It also contributed medical equipment to remote parts of the country with the help of local leaders.

Yemen has clearly faced challenges in vaccinating its citizens in recent years due to civil war and conflict. Hopefully, with continued aid from UNICEF, the WHO and other countries like Saudi Arabia, vaccination in Yemen will improve.

– Reshma Beesetty
Photo: Flickr