New vaccination figures show millions more children being immunised in world’s poorest countries.

Geneva, 26 July 2018 - Children in fragile states are being left behind in the global effort to improve immunisation rates in the world’s poorest countries, an analysis by Gavi, the Vaccine Alliance of the latest global immunisation statistics has shown.

For the 68 developing countries in which Gavi works, the latest WHO/UNICEF Estimates of National Immunisation Coverage (WUENIC) show that coverage for the basic Diphtheria, Tetanus and Pertussis vaccine (DTP3) rose to 86% in 2017 from 80% in 2010, when fragile states are excluded.

However coverage has stagnated at 62% in fragile states. Five of the six Gavi-supported countries with less than 50% DTP3 coverage in 2017 were classed as fragile. The number of under-immunised children has also increased by 170,000 in Gavi-supported countries to 16.2 million children. Just under half of these children were in fragile countries.

In July 2017, Gavi introduced a new fragility, emergencies and refugee policy to boost the number of children receiving vaccines in fragile settings, especially among vulnerable populations. Bangladesh became the first country to take advantage of the policy in late 2017, carrying out Gavi-funded vaccination campaigns for Rohingya refugees in Cox’s Bazar.

“Over the last two decades we have made enormous progress in boosting vaccination coverage in many of the world’s poorest countries,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “Gavi is helping more children receive lifesaving vaccines than at any point in our history but millions of children are still being left behind, with half of these under-immunised children living in fragile countries. As an alliance we need to redouble our efforts and maintain our focus on routine immunisation as the most sustainable way to improve child health, strengthen health systems and boost economies.”

The WUENIC figures for 2017 show that Gavi supported the vaccination of 65 million children in 2017 – three million more than 2016 and so keeping pace with increasing birth rates. Both DTP3 and measles routine immunisation coverage rates remained static in Gavi-supported countries. DTP3 coverage has remained at 80% for the past two years, while measles vaccine coverage has remained at 78% since 2015.

The analysis also showed that:

  • Coverage for newer vaccines continues to increase steadily. In Gavi-supported countries over 1.5 million more children were vaccinated against the leading cause of pneumonia than 2016 and 3.9 million more were vaccinated against rotavirus, the leading cause of severe diarrhoea.
  • Vaccine coverage increased markedly in Liberia and Sierra Leone, indicating their health systems are showing signs of strong recovery since the Ebola outbreak three years ago. In Liberia DTP3 coverage jumped from 79% to 86%, while in Sierra Leone coverage increased from 84% to 90%.
  • Revisions to historical data have shown that Uganda has significantly higher DTP3 coverage rates than previously thought, jumping from 78% to 85% for the past few years. In Pakistan revisions to the data show an impressive increase in DTP3 coverage from 52% in 2010 to 75% in 2017.
  • Of the 17 countries to have transitioned out of Gavi financial support, seven countries have achieved at least 90% DTP3 coverage, however six have shown signs of downward trends in 2017.

Gavi, the Vaccine Alliance brings together UN agencies, governments, NGOs and the private sector to increase access to vaccines in 68 of the world’s poorest countries, representing 59% of all surviving infants worldwide.

Fragile countries

Once per year, Gavi reviews the following officially published lists to identify a sub-set of the countries it supports that meet the criteria for facing ‘fragility’.

  • Fund for Peace Fragile States Index: top two categories (‘very high alert’ and ‘high alert’)
  • OECD States of Fragility: top category (‘extremely fragile’)
  • World Bank harmonised list of fragile situations

The following countries classify as facing ‘fragility’ for Gavi’s purposes: a) Low-Income Countries and countries in the first phase of transition from Gavi support that feature on at least two of the three lists within the categories indicated; b) countries in the second phase of transition that feature on at least one of the three lists within the categories indicated. The figures shown in this analysis relate to countries classed as fragile in 2017.

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