The 12-15 March measles-rubella vaccine campaign was the latest in a long list of Rwandan vaccine rollouts. Health Minister Agnès Binagwaho explains how political commitment to high immunisation coverage has helped her country more than halve child mortality
Agnès Binagwaho, Rwandan Health Minister, answers GAVI’s questions.
1. Why is this vaccine so important for Rwanda?
This new conjugate measles and rubella vaccine is essential, not only for Rwanda, but for the whole world as well. Rubella is a very serious disease, particularly in pregnant women, because it can cause the death of the foetus or congenital malformations (congenital rubella syndrome). There is no specific treatment. Few people are protected against this disease. In Europe, it was brought under control by immunisation, but the disease is still extremely widespread in Africa.
Moreover, this conjugate vaccine will also provide better protection from measles, a disease that is still causing a significant number of deaths. Rwanda has brought this disease under control, but there is still more work to be done. Immunisation is the only way to avoid and control measles and rubella.
2. How will this campaign be conducted?
We will introduce this vaccine throughout the country over an intensive four-day period. All the stakeholders in public health, in every city and village, will make certain that no child is forgotten. Even nursing school students have been enlisted.
Healthcare workers will be working round the clock to immunise almost five million children between 9 months and 14 years of age. All children under five years old will be immunised in health centres while school-age children will be immunised at school.
This is the first time that immunisation is taking place in our schools. We tested this approach with the human papillomavirus (HPV) vaccine and it worked well.
Ahead of this campaign, we improved and modernised our cold chain to ensure that all Rwandans would receive safe and effective vaccines. We also conducted an awareness campaign to inform people of the importance of measles and rubella vaccine.
We are hopeful that it will be a success, just like other immunisation programmes we have conducted in the past.
3. This is the latest in a long list of Rwandan vaccine introductions. Do you think Rwanda is setting an example in immunisation and, more generally, public health?
With GAVI support, in January 2014, the conjugate measles and rubella vaccine will be incorporated into routine immunisation. We have already introduced vaccines to fight one of the primary causes of pneumonia and rotavirus diarrhoea. We have also launched the HPV vaccine.
Finally, Rwanda has long used the five-in-one pentavalent vaccine to fight diphtheria, tetanus, pertussis (DTP3), hepatitis B and Haemophilus influenzae type b.
Today, the people of Rwanda have access to the 11 vaccines recommended by WHO for routine immunisation. Our performances are remarkable: DTP coverage rate is over 95%, a level seldom seen in Africa. These results are being achieved thanks to political will and the support of the people, not to mention our international partners.
The Government and I are truly involved and engaged in promoting health for all the people. With this cohesion, all of us are able to move forward in the same direction.
In Rwanda, the Millennium Development Goals (MDGs) have long been a part of our public policy as indicators of progress. Our health priorities are therefore primarily to reduce maternal and child mortality. To date, Rwanda has more than halved its child mortality. We are one of the few African countries with such amazing results. Our high routine immunisation coverage is contributing to this result.
4. How are you getting the message across to Rwandans about the importance of these vaccines?
Rwandans have confidence in us. We have never lied to them. However, as in any public health campaign, an immunisation campaign requires preparation.
The parents and communities must be informed to ensure their grassroots support. Therefore, we clearly explain what will happen, and what are the benefits. For example, for this week’s campaign, we conducted campaigns on radio and television as well as in health centres to inform families of the benefits of the measles-rubella vaccine. Everyone is enlisted, including myself, because Rwandans must be convinced if immunisation is to work. The people are always part of the solution.
5. What is your greatest satisfaction as Rwanda’s Health Minister?
Every night, I go to bed knowing that the health of the children of Rwanda and of the world is better.
Photo credit: © UNICEF Rwanda/2013/Rusanganwa