Health equity

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Over 22 million of the world's poorest children do not receive basic life-saving vaccines

Good health is a building block for socio-economic development

WHO Children in front of UN car, Ibanda, Uganda

A child's right to health

If immunisation coverage is an index of how a child's right to basic health is respected, then the UN Convention on the Rights of the Child (CRC) is currently failing children in developing countries.

With an average 12-15 year delay between a vaccine's discovery and its introduction in low-income countries, over 22 million of the world's poorest children have yet to receive the basic life-saving vaccines that are taken for granted on vaccination cards in most industrialised countries.

As a result, one in five of all children who die before the age of five lose their lives to vaccine-preventable diseases.

Life, survival, maximum development, access to health and access to health services are not just basic needs of children and adolescents, but fundamental human rights.

The United Nations Convention on the Rights of the Child (CRC)

A child born in a low-income country is 17 times more likely to die before reaching the age of five compared to a child in a high-income country.1 

In recent years, Gavi support has allowed low-income countries to fill some of the critical gaps in their immunisation schedule, but millions of children still lack access to newer vaccines. Of the 2010 global birth cohort of 136 million (surviving) newborn children:

  • 44 million (30%) were not immunised with hepatitis B vaccines;
  • 81 million (60%) were not immunised with Haemophilus influenzae type b (Hib) vaccines;
  • 121 million (89%) were not immunised with pneumococcal conjugate vaccines;
  • 119 million (91%) were not immunised with rotavirus vaccines.2, 3, 4 

Equal access to vaccinations

Investing in equal access to vaccinations represents a tried and tested way of accelerating progress toward the three health-related Millennium Development Goals (MDG) 4, 5 and 6 - and universal good health is a pre-requisite for socio-economic growth.

MDGs targeting faster access to vaccines

MDG4, reduce child mortality: vaccines have helped reduce child deaths by 30% since 1990
MDG5, improve maternal health: vaccines such as maternal and neonatal tetanus protect newborns and their mothers against death
MDG6, combat HIV/AIDS, malaria and other diseases: vaccinating HIV-positive adults and children can help to protect them from pneumonia, diarrhoea and other diseases

It is no coincidence that health inequities correspond to economic disparities around the world (see table). Good health leads to social and economic development enabling people to reach their full potential as active and productive members of society. It also encourages investment in human capital as investors shun environments in which the labour force suffers a heavy disease burden.4 

In 2008, some of the world's leading experts on development economics identified six health-related issues in their list of the top 10 most cost-effective ways to improve global welfare.5 

"Improving the health of the poor is an end in itself, a fundamental goal of economic development; but it is also a means to achieving the other development goals relating to poverty reduction," said Dr Gro Harlem Brundtland, former WHO Director-General and the first Chair of the Gavi Board.

   Disease Average death rate per 100,000LIC/ HIC ratio
 Low-income countriesHigh-income countries 
1. Hib disease
   (in children under 5)6 
14246237
2. Rotavirus diarrhoea
   (in children under 5)7 
177015118
3. Pneumococcal disease
(in children under 5)8 
32883789
4. HIV/AIDS9 11972157
5. Tuberculosis10 4601629

1 United Nations Department of Economic and Social Affairs, Population Division. World Population Prospects: the 2998 Revision [CD-ROM edition]. May 2009.

2Johns Hopkins School of Public Health, Accelerated Vaccine Initiative (AVI) Report [cited March 2011].

3 United Nations, Department of of Economic and Social Affairs, Population Division. World Population Prospects: the 2008 Revision [CD-ROM edition]. 2009 May.

4 World Health Organization. Vaccine-preventable diseases: monitoring system. 2010 Global Summary.

5 Lawson S, Douglas DB. Health buys wealth. Goldman Sachs, Global Markets Institute. 2009 Dec 3 [cited 2010 Feb 1]

6 Copenhagen Consensue [Internet]. Frederiksberg, Denmark; 2008 [cited 2010 Feb 1]; The outcome of Copenhagen Consensus 2008. Available from: http://www.copenhagenconsensus.com 

7 World Health Organization. Estimated Hib and pneumococcal deaths for children under 5 years of age. 2009 Sep [cited 2010 Feb]. Available from: http://www.who.int/ immunization_monitoring/burden/Pneumo_hib_estimates/en/index.html 

8 World Health Organization, Estimated rotavirus deaths for children under 5: 2004, 527000. 2006 Mar 31 [cited 2010 Jan]. Available from : http://www.who.int/ immunization_monitoring/burden/rotavirus_estimates/en/index.html 

9 World Health Organization. Estimated Hib and pneumococcal deaths for children under 5 years of age. 2009 Sep [cited 2010 Feb]. Available from: http://www.who.int/ immunization_monitoring/burden/Pneumo_hib_estimates/en/index.html 

10 World Health Organization. Global burden of disease: disease and injury country estimates. [cited 2009 Feb]. Available from: http://www.who.int/healthinfo/global_ burden_disease/estimates_country/en/index.html 

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