The unfinished business of immunisation

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Expanding new and under-utilised vaccines can save millions of lives, says IFRC/GAVI Alliance report 

IFRC advocacy report 2010 cover

Source: Tom Van Cakenberghe/IFRC

Geneva, 14 September 2010 - New vaccines against the pneumococcal bacteria and rotavirus could save more than one million children's lives each year, but a USD 4 billion gap in funding threatens these and other immunisation programmes, a report published jointly today by the International Federation of Red Cross and Red Crescent Societies (IFRC) and the GAVI Alliance, said.

Immunisation has shown excellent results against diseases such as polio and measles, but continued success requires sustained political and financial commitment. Too many children are still dying of vaccine preventable diseases, the report called "Immunization: unfinished business" said.

Pneumonia and diarrhoea

GAVI's immunisation support is critical to achieving the Millennium Development Goals and the G8 Muskoka Initiative on maternal and child health.

Nina Schwalbe, Managing Director, Policy and Performance, GAVI 

Just two diseases - pneumonia and diarrhoea - account for 36 per cent of all under-five deaths worldwide. Most of these lives could be saved with cost-effective and relatively cheap immunisation measures.

The GAVI Alliance accelerates and finances vaccines in the world's poorest countries. In a forecast detailed in the report, it says that by 2015, more than 40 nations plan to introduce pneumococcal vaccine against the bacteria associated with pneumonia and meningitis. More than 110 million children could be immunised and approximately 840,000 lives saved.

With GAVI support, just over 40 countries are also planning to introduce the vaccine against rotavirus - the most common cause of severe diarrhoea in young children. Nearly 60 million children could be immunised and some 200,000 lives saved.

Cost-effective cornerstone

"GAVI's immunisation support is critical to achieving the Millennium Development Goals and the G8 Muskoka Initiative on maternal and child health," said Nina Schwalbe, GAVI's managing director of policy and performance. "We must remain focused on immunisation as a proven and cost-effective cornerstone to improving global health for children in the world's poorest countries."

Together with an expansion in routine vaccines such as diphtheria, pertussis, tetanus, and other vaccines, GAVI estimates more than four million lives could be saved in total. But to make all the progress that's technically possible, it will have to fill a funding gap of approximately USD 4 billion.

Difficult 20 percent

"Immunisation to date has been a triumph," says Bekele Geleta, secretary general of the IFRC - the world body of the Red Cross Red Crescent whose work includes the promotion of humanitarian values, disaster management and community health action. "But broadly speaking, the world has done the 'easy' 80 per cent; the 'difficult' 20 per cent remains."

"That 20 per cent includes the most inaccessible communities, the poorest of the poor, the marginalised, and those already suffering from complex or neglected disasters, like the long-term drought in the Horn of Africa."

Measles Initiative

A broad decline in funding for the inter-agency Measles Initiative, founded in 2001, and an erosion of political will have enabled the disease to make a comeback. There is growing concern that the gains of the past decade could be reversed, leading to more than 500,000 measles deaths annually by 2012. Recent outbreaks in Africa, where measles deaths had been reduced by 92 per cent (between 2000 and 2008), provide a sobering reminder that the gains are fragile.

Since the start of the Global Polio Eradication Initiative (GPEI) in 1988, meanwhile, the incidence of polio has been reduced by 99 per cent worldwide and only in four countries is it still endemic: Afghanistan, India, Nigeria and Pakistan.

Never has the world been closer to eradicating polio, but the surviving one per cent is lethal, as the recent outbreak in Tajikistan confirms. GPEI says the historic achievement is also now threatened by a US$ 1.3 billion funding shortfall for implementing activities in 2010-2012, and disease surveillance and immunisation campaigns are already being curtailed.

Public health 'best buy'

The joint IFRC and GAVI Alliance report also argues that a key point about immunisation - a public-health 'best buy', especially for low-income countries without the health-care infrastructure to treat large numbers of sick people - is its cost-effectiveness.

Communicable disease is the enemy of development, it adds. US research has shown that every dollar invested in a vaccine dose saves an average of $14.50 in health-care costs. Vaccines enable people to be productive, including those, often women, who care for the sick. Vaccination is easy to do, it reinforces primary health-care, and its impact can be amplified through the "herd-immunity" effect.

About the IFRC

The International Federation of Red Cross and Red Crescent Societies (IFRC) is the world's largest humanitarian organisation, providing assistance without discrimination as to nationality, race, religious beliefs, class or political opinions. Founded in 1919, the International Federation comprises 186 member Red Cross and Red Crescent societies across the world. IFRC is a committed partner in eradicating polio. Civil society plays a key role in the essential 'last mile' of polio eradication - mobilising community volunteers, going door-to-door and organizing community focus group discussions to sensitise people on the importance of being vaccinated against polio and other vaccine-preventable diseases. The IFRC's annual polio appeals provide funds enabling more than 100,000 national society volunteers to work with their Ministries of Health, and other polio partners, to directly reach beneficiaries. Since 2000, more than four million Swiss francs have supported social mobilization activities in more than 70 national immunisation campaigns in order to:

  • Reach the most remote communities,
  • Communicate the truth about the polio vaccine,
  • Encourage caretakers to bring their children to vaccination,
  • Provide valued assistance to health workers.


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