Gavi should waive co-financing requirements for countries with fragile health systems or in humanitarian crises
Geneva, 18 July 2023 — Today, Médecins Sans Frontières/Doctors Without Borders (MSF) again called on Gavi, the Vaccine Alliance to broaden “catch-up” vaccine coverage for unprotected children by temporarily waiving co-financing requirements for all countries and areas with fragile health systems and/or in humanitarian crises. In addition, countries must urgently update their national vaccination policies to ensure that catch-up vaccinations for children up to at least the age of five are prioritised. These calls follow today’s published World Health Organization (WHO) and UNICEF estimates of national immunization coverage (WUENIC) which show some recovery since historic backsliding during the COVID pandemic. However, childhood vaccination coverage is still lagging too far behind, especially in lower-income countries – many of which are supported by Gavi.
The immediate adoption of national catch-up vaccination policies is crucial to ensure that countries can provide vaccines to ‘zero-dose’* and under-immunised children up to at least the age of five who have missed out on their routine vaccinations. However, many countries are seeing over-stretched budgets as they struggle to keep fragile health systems functional after the COVID pandemic and other crises, meaning that Gavi’s current co-financing obligations may further impede reaching children who have missed routine vaccinations.
Dr Sharmila Shetty, Vaccines Medical Adviser, MSF Access Campaign:
“The disruption of health systems during the COVID pandemic had a disastrous effect on childhood vaccinations, so the cautious improvement in today’s WHO and UNICEF data is good news, but there are still significant immunisation gaps, especially in lower-income, Gavi-eligible countries. At this point, all hands need to be on deck to ensure that every child who missed their routine vaccinations has the chance to catch up, and this means that Gavi – and governments – must prioritise reaching all ‘zero-dose’ and under-protected children by all available means.
“If childhood vaccination coverage doesn’t increase, we will see more children fall ill and die from vaccine-preventable diseases around the world, which is unacceptable. So, although sustainable vaccine programmes are the goal, what is currently needed is for Gavi to waive co-financing requirements for countries with fragile health systems, or those in humanitarian crises, to ensure those countries can access enough doses to reach ‘zero-dose’ and under-immunised children who have missed out on their routine vaccines.”
Dr Louis Massing, MSF Medical Referent, Democratic Republic of Congo (DRC)
“It is worrying to see that in some of the countries where we work, immunisation gaps are leading to outbreaks, like in DRC where measles wreaks havoc. Our teams have been working relentlessly along with the national health authorities to keep responding to measles outbreaks in DRC: in 2022, MSF teams in DRC supported the Ministry of Health in vaccinating more than 2 million children in 14 provinces and treated over 37,000 people with measles. Given how contagious measles is though, as soon as we put out a fire in one place, it flares up elsewhere. It’s therefore vital that every eligible child receives their routine vaccines, including two doses for measles. That’s where catch-up vaccinations are crucial, as they aim to ensure that no child slips through the cracks and is left unprotected. This is why we are asking Gavi to make more financial resources available to extend child immunisation coverage in the DRC, and in all other countries facing worrying gaps in child immunisation.”
*‘Zero-dose’ children is defined as children who have not received the first dose of diphtheria, tetanus, and pertussis-containing vaccine.
Editor’s Note: While we have learned from various sources that Gavi has taken the positive step to support providing 5 specific vaccines for children up to age five, countries will still need to co-finance these additional vaccines – a significant barrier that many countries may struggle to overcome.