Intervention by Kate Elder, Médecins Sans Frontières International
Médecins Sans Frontières welcomes the renewed focus on immunisation brought by the Decade of Vaccines and the draft Global Vaccine Action Plan. All children should have access to life-saving vaccines.
MSF’s experience shows us that significant challenges remain in reaching infants with even the basic package of vaccines. Last year, we vaccinated over four million children against measles in the Democratic Republic of Congo alone, and responded to numerous other outbreaks of basic vaccine-preventable diseases such as measles, diphtheria and pertussis. These outbreaks testify to the weakness of routine immunisation systems in a number of developing countries. And it is the children in these countries who are disproportionately affected by preventable diseases. Their deaths contribute significantly to the total number of under-five mortality.
To optimise the potential of vaccines, MSF calls for a renewed focus on boosting routine vaccination and EPI programmes in the implementation of the Global Vaccine Action Plan. To do this, we make three urgent requests to member states and immunisation stakeholders as the GVAP moves into regional and country plans:
First, put the 20% of children who go unvaccinated each year at the centre of our next steps. In our direct experience, vaccination coverage rates are low in many countries where we work. It is unacceptable that 1 in every 5 children is still not being reached and it is not enough to say that we will build EPI systems through the introduction of new vaccines. Countries need to address the shortcomings of their immunisation programmes immediately.
Second, we need better data to inform planning and prioritisation. We know that administrative coverage figures are woefully inaccurate and yet they are still one of the primary tools used for decision-making. Before we can design strategies to raise coverage where it is low, we need to acknowledge where we are failing. We urge donors and developing countries to invest in building capacity for data collection and improved evaluation methods to make more informed decisions.
Last, we need products that are easier-to-use in places with few clinics and health care workers. Adapted products that are more thermostable, easier to administer – that is without injection – and require fewer doses are an essential tool to improving immunisation. Developing countries are too often given products that are neither designed for local epidemiology nor for the reality of their resource-poor settings. Products that would enable task-shifting so that community health workers could deliver routine and new vaccines, much as they deliver oral polio vaccines today, will help to reduce the 19 million children missed.
As the Decade of Vaccines moves forward, we should all urge a balanced approach whereby we acknowledge the real challenges faced in communities and implement concrete solutions.