To achieve the Sustainable Development Goal of ensuring that no child dies from preventable deaths, stakeholders must collectively work to strengthen immunisation, ODIRI UCHENUNU-IBEH (Lagos) and PATIENCE IHEJIRIKA (Abuja) write.
Several studies have shown that vaccination against childhood diseases, is one of the most cost-effective public health interventions available.
Yet, millions of children still missed out on routine immunisation every year. For instance, according to the United Nations Children’s Fund (UNICEF), over 20 million children worldwide missed out on measles vaccine annually in past eight years, creating a pathway to current global outbreaks.
UNICEF disclosed that an estimated 169 million children missed out on the first dose of the measles vaccine between 2010 and 2017, or 21.1 million children a year on average.
The agency added that widening pockets of unvaccinated children have created a pathway to the measles outbreaks hitting several countries around the world today.
The report further stated that in the first three months of 2019, more than 110,000 measles cases were reported worldwide, up nearly 300 per cent from the same period last year.
An estimated 110,000 people, most of them children, died from measles in 2017, a 22 per cent increase from the year before.
Indeed, two doses of the measles vaccine are essential to protect children from the disease.
However, due to lack of access, poor health systems, complacency, and in some cases fear or skepticism about vaccines, the global coverage of the first dose of the measles vaccine was reported at 85 per cent in 2017, a figure that has remained relatively constant over the last decade despite population growth.
Global coverage for the second dose is much lower, at 67 per cent.
The World Health Organization (WHO) recommends a threshold of 95 per cent immunisation coverage to achieve so-called ‘herd immunity’.
UNICEF’s latest data shows that in high income countries, while coverage with the first dose is 94 per cent, coverage for the second dose drops to 91 per cent. The United States tops the list of high-income countries with the most children not receiving the first dose of the vaccine between 2010 and 2017, at more than 2.5 million. It is followed by France and the United Kingdom, with over 600,000 and 500,000 unvaccinated infants, respectively, during the same period.
In low and middle-income countries, the situation is critical. In 2017, for example, Nigeria had the highest number of children under one year of age who missed out on the first dose, at nearly 4 million. It was followed by India (2.9 million), Pakistan and Indonesia (1.2 million each), and Ethiopia (1.1 million).
Worldwide coverage levels of the second dose of the measles vaccines are even more alarming. Of the top 20 countries with the largest number of unvaccinated children in 2017, nine have not introduced the second dose. 20 countries in sub-Saharan Africa have not introduced the necessary second dose in the national vaccination schedule, putting over 17 million infants a year at higher risk of measles during their childhood.
UNICEF Executive Director, Henrietta Fore, said the ground for the global measles outbreaks witnessed today was laid years ago.
“The measles virus will always find unvaccinated children. If we are serious about averting the spread of this dangerous but preventable disease, we need to vaccinate every child, in rich and poor countries alike.”
Measles is far too contagious, says Fore, adding that it is critical not only to increase coverage but also to sustain vaccination rates at the right doses to create an umbrella of immunity for everyone.
Regional Director for Africa, WHO, Dr Matshidiso Moeti, said the global measles crisis is an urgent wake-up call to the need for countries to ensure that all children, no matter where they live, receive life-saving vaccines.
Countries in the African Region have also experienced a resurgence of measles, including outbreaks reported in countries like Chad, Cameroon, DR Congo, Liberia, Guinea, Madagascar, Mali, Nigeria and Uganda in the last 12 months.
Madagascar, in particular, has had a large measles outbreak affecting more than 122,000 cases in the months between October 2018 and April 2019.
WHO said every year, more than 30 million children younger than five years in Africa fall sick due to vaccine-preventable diseases and of them, more than half a million die, representing 56 per cent of the global deaths related to vaccine-preventable diseases.
“In Africa, vaccine-preventable diseases also impose an economic burden of $13 billion every year, funding that could be used to fuel economies and drive development. A highly contagious disease that accounts for 13 per cent of all vaccine-preventable deaths in children younger than 5 years in Africa, measles infects nine in ten people who are not vaccinated.
“As of 2017, only 16 countries in the African Region had achieved 90 per cent or more immunization coverage of the first dose of measles vaccine (MCV1), according to the WHO and United Nations Children’s Fund (UNICEF) coverage estimates. Across the region, MCV1 coverage has stagnated, at 70 – 73 per cent since 2009,” Dr Matshidiso Moeti, added.
She said “We need to work together to improve immunization delivery so that all children are protected from preventable diseases. Recent disease outbreaks on the continent remind us of the urgency of this goal.
“Everyone has a role to play in ensuring that children and communities get the immunization services they need, from politicians and community advocates to health practitioners and parents themselves.
“I hope African Vaccination Week will encourage each of us to do our part and that these collective efforts will drive progress across the region,” said His Excellency Mr Evaristo do Espirito Santo Carvalho, President of São Tomé and Príncipe.
The Executive Director of National Primary Healthcare Development Agency (NPHCDA), Dr. Faisal Shuaib said Immunisation is critical for building a resilient health system under the visionary leadership of Buhari, and the strategic and policy direction of the federal government.
Shuaib said, “For the first time in Nigeria, we are seeing a consistent and compelling improvement in the number of kids we are reaching with lifesaving vaccines. We have surpassed all historic expectations in immunizations.”
For instance, he disclosed that in six months’ time, Nigeria will be declared polio-free. “Because we have been innovative and creative with routine immunizations, we are now at a point where we are just some six months away from being declared polio-free in Nigeria.
“Working together with partners, traditional, religious, political, and opinion leaders, we have achieved improvements in routine immunisation coverage rates from 48 per cent in 2015 to 57 per cent in 2018 as revealed by the recent SMART survey conducted by the National Bureau of Statistics,” he said.
Dr. Shuaib also commended the efforts of President Muhammadu Buhari and the Federal Ministry of Health, saying that their commitment have resulted in un-precedented improvement of immunisation coverage in the country.
In the celebration of this year African Vaccination week with the theme “Protected Together: Vaccines Work” stakeholders emphasizes the need for collective responsibility and inclusive participation of all in mobilising human, material, financial, technical and logistics resources needed for implementation of vaccination activities, in order to promote the health of children in Africa.
Indeed, parents and caregivers of children must make the kids available for vaccination to prevent disease epidemics and early death.
Why Nigeria Must Scale Up Immunisation - Leadership Newspaper
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