Monday, October 18

Covid is an opportunity to build a world where everyone has access to basic vaccines | Global health

TMassive public, private and foundation investments in a coronavirus vaccine are producing results at a record rate. And countries are reacting accordingly. A recent global assessment of the Covid-19 vaccine purchase agreements reveals that high-income countries, as well as some middle-income countries with high manufacturing capacity, have already purchased sufficient doses for their populations.

But the administration of the vaccine needs a new level of care. This is especially the case for populations in poor and war-torn countries, where the health system is weak or non-existent. Even before the pandemicApproximately 20 million infants a year, often some of the most vulnerable in the world, were missing basic vaccines. For example, it is estimated that there are more than 10.6 million children in the world’s poorest countries that in 2019 did not receive even a first dose of the diphtheria, pertussis and tetanus (DPT) vaccine.

The geography of this population is not random: approximately half of unvaccinated children live in fragile or conflict-affected countries, reflecting the new concentration of poverty in these states (such as Yemen, the world’s largest humanitarian emergency).

Solving this problem requires new ways of working, and the Covid-19 crisis provides the perfect opportunity. Our organizations are determined to work together to learn from each other’s experiences.

An urgent priority is internally displaced persons (IDPs), who lack international refugee protection and generally have very limited access to health systems. With 79.5 million people displaced in 2019 – more than half of them internally displaced and twice as many as 10 years ago – the gap between need and provision is growing.

In 2017 we saw a diphtheria outbreak, the worst in decades, among Rohingya living in refugee camps in Cox’s Bazar, Bangladesh. The Rohingya, who have been denied citizenship in Myanmar since 1982, were largely unable to access vaccines there. The diphtheria outbreak triggered a massive vaccination campaign in and around the camps, quickly ending the crisis, but the fact that an outbreak of such a highly preventable disease could occur in the first place was an indication of how far. point IDPs miss vaccines.

Even before the arrival of Covid, stagnating immunization rates weakened our global health security. Data was found from the World Health Organization and the US Centers for Disease Control and Prevention (CDC). measles deaths in 2019 rose to more than 200,00050% higher than in 2016. Immunization plays a critical role in preventing outbreaks, but it can only work if everyone has access. The fact that we cannot reach all people today with widely available vaccines, such as measles, polio and diphtheria, not only means that we have failed to collectively protect these people, it is an indictment of our preparedness for a global pandemic. .

Health systems must be strengthened by strengthening supply chains, ensuring adequate and sustainable financing, and empowering community health workers. In many conflict and crisis-affected contexts, the formal health system cannot reach the entire population that needs access to immunizations. Health facilities are sometimes destroyed (and attacked) and fleeing the conflict can lead people to other, safer areas, which may not be close to health facilities. This is where community health workers have a vital role to play. A study The impact of community health workers on immunization in Kenya found that their intervention raised coverage rates to 99%, an increase of 10 percentage points.

Many vaccines, including Covid-19, require cold storage, and this means we need a supply chain that can reach places affected by conflict or in areas that lack electricity and specialized equipment. Strengthening the supply and availability of vaccines must take place in conjunction with efforts to increase the demand for vaccines. This will happen only when communities rely on vaccines and local health services. To do this, we need to involve communities in the planning processes and keep them engaged throughout the vaccination journey, with access to information and services, as well as motivation to participate.

To address this problem, the International Rescue Committee and Gavi, the vaccine alliance, are launching a new partnership aimed at reaching the most vulnerable within the Horn of Africa and the Sahel with high-quality care. This moment may be a valuable opportunity, when the world’s attention will focus more than ever on preventing the spread of infectious diseases and closing the immunization gaps.

The time has come for a new effort to ensure that all children receive the life-saving benefits of the vaccine. Whether it’s measles, diphtheria, or Covid-19, global pandemics and their aftermath won’t end until everyone is accounted for and can access the vaccines they need.

• David Miliband is Executive Director of the International Rescue Committee and Anuradha Gupta is Deputy Executive Director of Gavi, the vaccine alliance.

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