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Africa: Despite Pandemic Setbacks, WHO Vows Continued Fight for Global Immunization

The new World Health Organization (WHO) report highlights the remarkable impact of vaccines in Africa. Over the past 50 years, an estimated 51.2 million lives have been saved thanks to immunization programs.

World Immunization Week celebrates a remarkable milestone – 50 years of the Expanded Programme on Immunization (EPI). This global initiative has been instrumental in saving countless lives and protecting children from devastating vaccine-preventable diseases.

“Thanks to vaccines, smallpox has been eradicated, and polio is on the brink of elimination. Many once-feared diseases, including measles, cervical cancer, yellow fever, pneumonia, and diarrhea, are now easily preventable,” said World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus, kicking off a virtual press conference to celebrate the momentous occasion.

“Today, 84% of the world’s children are now protected against diphtheria, tetanus, and pertussis with three vaccine doses, a powerful testament to global vaccination efforts.”

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The new World Health Organization (WHO) report highlights the remarkable impact of vaccines in Africa. Over the past 50 years, an estimated 51.2 million lives have been saved thanks to immunization programs. This translates to an additional 60 years of life for each child saved. This success is attributed to the WHO’s Expanded Programme on Immunization (EPI), launched in 1974. This global initiative ensures all children have access to life-saving vaccines, regardless of where they live or their family’s background.

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“Just 50 years ago, fewer than 5% of infants worldwide were vaccinated. This led WHO to launch EPI in 1974, inspired by smallpox eradication. Today, all countries have set up vaccination programs for diphtheria, measles, and other serious diseases, saving millions,” said Dr Tedros.

The Expanded Programme on Immunization (EPI) saved about 154 million lives since its launch in 1974. That’s more than 8,000 lives saved a day.

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“Children born today are 40% more likely to survive their fifth birthday thanks to immunization,” Dr. Tedros said. “The future looks even brighter with new vaccines in development for diseases like COVID-19, malaria, and Ebola. Beyond saving lives directly, EPI programs act as a cornerstone for healthcare delivery in remote areas, offering essential services like nutrition support alongside vaccinations. Despite this progress, the fight for global immunization continues.”

“Immunization programs are also the bedrock of primary health care in some of the most remote locations. A child brought to a clinic for vaccination often receives other life-saving services, such as nutritional support, illness screenings, or bed nets. Over the past 50 years, EPI has achieved so much, but we cannot take these gains for granted.”

Dr. Tedros acknowledged that the COVID-19 pandemic “disrupted routine immunization programs globally”, and ongoing crises leave millions without access to vaccines.

“The fight isn’t over,” said Dr. Tedros.

“WHO remains dedicated to the cause,” he added. “Together with partners like UNICEF, Gavi, and the Bill & Melinda Gates Foundation … “we’re supporting countries to respond to outbreaks, catch up on missed vaccinations, and deliver life-saving vaccines even in the most difficult situations.”

Gavi’s Vaccine Impact – Saving Lives, One Shot at a Time

Jose Manuel Barroso, the Board Chair of Gavi, the Vaccine Alliance, and former President of the European Commission, emphasized the significance of vaccines in saving lives, citing the new report indicates the remarkable impact: “at least six lives saved every minute over half a century.” He stressed that vaccines represent one of the most cost-effective investments in health and development throughout history, highlighting the findings from the study which examined 14 vaccines. These vaccines are a vital component of healthcare systems worldwide, reaching populations through various channels.

Barroso underscored Gavi’s role in supporting immunization efforts, particularly in low-income and some middle-income countries. He expressed pride in serving as the chair of the board for Gavi, the Vaccine Alliance, which was established in 2000 to bolster the progress initiated by the Expanded Programme on Immunization (EPI).  Gavi brings together a coalition of key stakeholders in immunization, including the World Health Organization (WHO), UNICEF, and the Bill & Melinda Gates Foundation, among others.

Why was Gavi established? asked Barroso. “Simply put, to expedite the delivery of new products to low-income countries. However, despite initial progress, vaccination coverage rates stagnated, necessitating improvement. These countries relied on partners to bolster their efforts and invest in sustainable immunization systems,” he said.

“An entire generation of children, more than one billion, have been protected against a range of diseases. Coverage rates in the regions we focus on, such as Africa and South Asia, have dramatically improved and childhood mortality has fallen. Through Gavi, lower-income countries can access affordable vaccines suited to their settings and protect their populations against 20 infectious diseases, including those delivered through EPI programs in each country.”

By funding stockpiles of vaccines for deadly diseases like Ebola and cholera, Gavi prepares countries for potential outbreaks. This, along with their 23-year investment in strengthening health systems, has made a significant economic impact. Gavi’s programs are estimated to have generated over $220 billion in benefits for developing countries, demonstrating the far-reaching value of immunization efforts.

“This is important to every person in the world, not just to those in low-income countries,” added Barroso. “Yes, some countries are donors and we are very grateful for their efforts. But the reality is that all countries, including donors, are beneficiaries because all have to gain from global health security.”

Barroso emphasizes the urgency, saying, “COVID-19 and climate change are teaching us that infectious diseases threaten us all. And vaccines are certainly among the best tools we have to fight back against their impact on our lives and our economies.”

“Today, we embark on a campaign to remind the world of vaccines’ pivotal role in human achievement and collective health security. We call upon governments worldwide to invest in immunization and implore individuals across partisan lines to join us in this vital endeavor,” said Barroso.

Hurdles Remain, But Hope Lives On

Millions more children today celebrate their fifth birthday compared to any other point in history. This remarkable achievement is due, in large part, to the success of global immunization programs.

Dr. Efrem Lemango, UNICEF’s Associate Director for Health and Global Chief of Immunization, calls it a “miracle.” He highlights immunization as a cornerstone of this success, a “simple yet bold goal” of ensuring every child has access to life-saving vaccines.

The launch of the expanded immunization program in 1974 marked a turning point, expanding vaccine reach beyond common areas. Further progress came with the Universal Childhood Immunization Initiative spearheaded by UNICEF in the 1990s. This initiative propelled global vaccination coverage from under 20% to nearly 80%. The establishment of Gavi, the Vaccine Alliance, was another critical step.

UNICEF, along with WHO, played a crucial role by mobilizing world leaders, training healthcare workers, building vaccine confidence within communities, procuring and distributing vaccines, and developing innovative cold storage solutions to reach remote areas.  In 1980, UNICEF distributed just 100 million vaccine doses annually. Today, that number has soared to 2.5 billion doses, reaching over 100 countries.

“This is a testament to the power of global collaboration,” said Dr. Lemango. “Our celebration won’t be complete without recognizing the remaining tasks ahead of us.”

The COVID-19 pandemic disrupted vaccination efforts, leaving over 80 million children without critical immunizations. But there’s hope. UNICEF, WHO, and Gavi are collaborating to address this gap. The future vision extends beyond children, aiming to make vaccines accessible to everyone,” he said.

Humanly Possible – A Vision for a Healthier Future

“From eradicating smallpox to protecting communities from deadly outbreaks and moving closer to a polio-free future,” said Violaine Mitchell, Director of the Immunization Program Strategy Team. “It’s truly amazing to see proof of what’s possible when we work to make vaccines accessible around the world. And I’m proud that the Foundation has contributed to that success.”

Since its inception in 2000, the Gates Foundation has become a major force in global health, dedicating over $23 billion to bringing life-saving vaccines to those who need them most. This commitment extends to both vaccine discovery and delivery. “This has included 87 million to the meningitis vaccine project, a public-private partnership to develop a low-cost shot against meningitis A, reducing meningitis by 99% in Africa,” she said.

The Gates Foundation’s impact extends even further. They have also contributed more than $6 billion to Gavi, the Vaccine Alliance. This partnership has empowered 78 low-income countries to develop their own vaccination programs, reaching over a billion children with life-saving immunizations.

“But despite these achievements, global progress is in jeopardy,” she said.  ” Immunization coverage may be rebounding from pandemic-related disruptions, but in today’s global health environment, these gains are in jeopardy.   In many countries, debt crises are forcing governments to cut funding for essential health programs.”

Climate change and conflict are throwing a wrench in efforts to deliver essential health services like vaccinations and primary care, particularly in the world’s most impoverished regions. This disruption creates a breeding ground for outbreaks of vaccine-preventable diseases like measles, cholera, diphtheria, and polio. These outbreaks threaten to stall, halt, or even rewind the significant progress we’ve made toward global health security.

“As of 2023, an estimated 14 million children around the world have not received a single vaccine, and tragically, infectious diseases are starting to flourish in these environments,” she said.

Mitchell added “We must protect the immense progress made in the past 50 years of global health while forging ahead towards even greater achievements. By steadfastly investing in immunization programs, we have the power to create a future where everyone is shielded from vaccine-preventable diseases and can live long and healthy lives.”

“As you’re aware, we’re currently celebrating the 50th anniversary of the Expanded Programme on Immunization (EPI) with a year-long campaign called “Humanly Possible.” This initiative, led by WHO, UNICEF, Gavi, the Gates Foundation, and numerous partners, reflects on the remarkable impact of vaccines highlighted today.”

The “Humanly Possible” campaign goes beyond celebrating past achievements. It’s a powerful call to action, urging us to envision what the next 50 years hold with sustained commitment to immunization. We’re on the cusp of eradicating polio, eliminating cervical cancer, and making health systems more resilient against climate-sensitive diseases like typhoid and cholera.  However, securing a healthier future for generations to come hinges on continued investment in immunization and a renewed focus on strengthening global vaccination programs.

“We’re on the brink of eradicating polio, eliminating cervical cancer, and future-proofing health systems against diseases that are climate-sensitive like typhoid and cholera,” she continued. “But to secure the next chapter for future generations, we must continue investing in immunization and recommit to strengthening vaccine programs around the world.”

“As I reflect on the “Humanly Possible” initiative, I’m deeply grateful for the tireless efforts of health workers around the globe who dedicate themselves to vaccinating every child, everywhere. Last year, I met Aisha, a young woman in northern Nigeria, who went above and beyond to ensure all village children received the polio vaccine. Her dedication is truly inspiring. On that same visit, I also encountered a farmer who left his fields to bring his four children for measles vaccinations. He understood the importance of protecting his family’s health. These are just two examples of the countless healthcare heroes who make life-saving vaccines a reality.”

Mitchell highlighted the importance of celebrating past successes, future potential, and the frontline health workers who make it all possible.  “By working together, we can save millions more lives, advance equity, and create a much healthier and more prosperous world,” said Mitchell.

Hope on the Horizon –  New Vaccines Fight Meningitis, Malaria, and Dengue

Significant strides are being made in the fight against meningitis and malaria, thanks to new vaccines. In Africa, the MEN5CV vaccine, which protects against the five major strains of meningitis, has been a game-changer. Nigeria became the first country to roll it out, offering a glimmer of hope for eliminating meningitis as a public health threat by 2030.

“Just last month, Nigeria became the first country to roll out the new MEN5CV vaccine, which protects against the five major strains of bacterial meningitis in Africa,”  Dr. Tedros said. “I thank the government of Nigeria and partners, including Gavi, UNICEF, PATH, and the United Kingdom, who have been critical to the development and rollout of this vaccine.”  He emphasized the importance of leveraging this success, saying, “Building on this success, WHO is working with governments and partners on future rollout plans, including in Niger.”

“For the first time, the MEN5CV vaccine gives us real hope of being able to eliminate meningitis as a public health problem,” he added. He outlines that defeating meningitis by 2030 roadmap requires an initial investment of $130 million. This would not only save countless lives but also generate significant financial benefits through reduced healthcare costs and increased productivity.

“The ‘Defeating Meningitis by 2030’ roadmap requires an initial investment of 130 million US dollars, which is frankly loose change compared to the return that investment will deliver,” he said.

Malaria is another disease where recent vaccine advancements offer significant promise. The first two malaria vaccines recommended by WHO are now being used in African countries. With the potential to save tens of thousands of young lives each year, these vaccines are a crucial step forward.  However, the fight against malaria isn’t over. In 2022, the disease claimed an estimated 608,000 lives globally, with the heaviest burden falling on children under five in sub-Saharan Africa.

“In the past two years, WHO has recommended the world’s first two malaria vaccines, which are now being rolled out in Africa and could save tens of thousands of young lives every year.   Burkina Faso, Cameroon, Ghana, Kenya, Malawi, and Sierra Leone are already delivering malaria vaccines through national immunization programs.  And many more countries are planning to introduce them in the coming weeks and throughout the year.”

He emphasized the importance of partnerships like the Roll Back Malaria initiative, which advocates for health equity and addresses underlying issues like gender equality and human rights.

While new vaccines offer hope for some diseases, Dengue remains a growing threat, particularly in the Americas. Warmer weather and climate change are contributing to a rise in cases, exceeding last year’s record highs. To combat this, WHO recommends a new vaccine for children aged 6-16 in affected areas.

“Last year, WHO recommended the use of a new dengue vaccine for children aged 6 to 16 in areas where dengue is present.” He acknowledged challenges such as limited supply and high costs, noting, “Countries including Brazil are now using the vaccine, although the supply is constrained and the costs are still relatively high. In February, WHO released $5 million from our Contingency Fund for Emergencies to support priority countries to implement essential interventions against dengue,” he added.

“But the needs are immense and more support is needed from donors,” he said.

“From the world’s oldest vaccine against smallpox to the newest vaccines against meningitis, malaria, and dengue, WHO remains committed to doing everything humanly possible to realize the life-saving power of vaccines for everyone, everywhere,” said Dr. Tedros.

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