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The World Health organisation has chosen the theme “vaccines bring us closer” for this year’s theme marking world immunisation week. This is the crucial message in the middle of a global pandemic of an infectious disease for which we have amazingly now got very good vaccinations.
Infectious diseases are transmitted person to person, either through droplets or through bodily fluids contaminating the environment and then infecting others. We can do many things to reduce the risk of transmission, but many of these measures go against our instincts and our way of life. The way out is to stop the infectious organism circulating in the community.
Vaccines bring us closer - to universal health coverage[/caption]
WHO AFRO points out: “On the eve of the African Vaccination Week – the annual campaign for universal access to life-saving vaccines on the continent – new, early data shows that an estimated 16.6 million children in Africa missed planned supplemental measles vaccine doses between January 2020 and April 2021 and eight African countries reported major measles outbreaks that affected tens of thousands during the period. The outbreaks were largely due to low routine immunization coverage or delayed vaccination drives. In addition, the quality of measles surveillance in Africa fell to the lowest level in seven years in 2020, with just 11 countries meeting their target” There have also been outbreaks of yellow fever, cholera and meningitis because of worrying gaps in immunization coverage.
COVID 19 vaccination and Africa: “With a fast-moving pandemic, no one is safe, unless everyone is safe”.
Vaccination programs roll out globally has been grossly inequitable, with richer countries buying much greater access than poorer countries. Most sub-Saharan African countries have managed low levels of coverage so far. By 22 Apr 2021 - 946 million doses of vaccine had been given worldwide but these were very unfairly distributed.
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Share of people who have received at least one COVID vaccine, 21st April 2021[/caption]
The Director-General of WHO told a recent UN gathering: “Vaccine equity is the challenge of our time. And we are failing”. He said that of the 832 million vaccine doses administered, 82 per cent have gone to high or upper-middle-income countries, while only 0.2 per cent have been sent to their low-income peers. In high-income countries alone, one in four people has received a vaccine, a ratio that drops precipitously to 1 in 500 in poorer countries.
Although some countries in sub–Saharan Africa are manufacturing some vaccine, there are major barriers to access. The big hope is through the COVAX program which is forecasting that it could roll out almost 2.3 billion doses worldwide this year. Even if this optimistic forecast becomes a reality, this will still only be 27% of the population of lower-income countries across the world in 2021. And it is not on track, with reports this week that the programme had delivered about 40.2m or 21.5% of the 187.2m doses it planned to distribute during or by the end of May.
The world is on the brink of a catastrophic moral failure -and the price of this failure will be paid with lives and livelihoods in the world's poorest countries Dr Tedros Adhanom Ghebreyesus, WHO Director-GeneralHowever, if pharmaceutical companies would release their intellectual property rights, vaccines could be manufactured everywhere, especially if richer countries supported the development of manufacturing capacity in poorer countries. Vaccine equity at grassroots Even when a country acquires a supply of vaccines, we see challenges to equity similar to those for any health care service. Vaccination should be distributed according to the greatest benefits to the individual and their community. However, this often does not happen unless proactive strategies are put in place and monitored. For example, people may be less likely to be vaccinated if they belong to a socially excluded group, are living with a disability or are socioeconomically disadvantaged. Wales has recognised this early and is seeing results from applying its vaccine equity strategy. We should try to leave no one behind and apply the principles of Gender Equity and Social Inclusion (GESI) to how vaccination programs are rolled out (THET have a useful GESI toolkit).
