Global rise in vaccine-preventable diseases highlights urgent actions needed to save lives and alleviate future suffering – Global

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Jillian Watt
Program Associate, Humanitarian Policy and Practice, InterAction

The re-emergence of vaccine-preventable diseases is a global threat that requires international action.

Vaccines have been used to prevent the spread of communicable diseases for over a century. Since humanitarian health interventions are extremely expensive to implement after an outbreak occurs, preventive health programs such as vaccines are internationally recognized as cost-effective public health tools. However, the recent trend of declining immunization coverage threatens decades of progress.

Even before the COVID-19 pandemic, the world was experiencing an increase in vaccine-preventable diseases and associated deaths. According to the World Health Organization (WHO), in 2019 rates of diphtheria, hepatitis B, measles, meningitis, mumps, tetanus, tuberculosis and yellow fever all increased, mainly in due to vaccine hesitancy and lack of resources. The decline in coverage in Latin America and the Caribbean is concerning, as routine vaccinations in Brazil, Bolivia, Haiti and Venezuela have declined by 14% since 2010. Infectious diseases, most often measles and cholera, continue to cause epidemics among displaced populations.

Rise in vaccine-preventable diseases disproportionately affects children and exacerbates health inequalities

At the start of the COVID-19 pandemic, WHO and UNICEF warned of declining vaccination coverage for other infectious diseases such as measles and diphtheria. In 2020 and 2021, the world has seen a further increase in vaccine-preventable diseases, as COVID-19 disrupted immunization schedules for children around the world. Children missed routine vaccinations due to movement restrictions to prevent the spread of COVID-19. School closures have diminished parents’ incentive to keep their children’s immunization records up to date and health resources have been reallocated to COVID-19, straining health systems and deprioritized from other routine vaccination campaigns.

Countries that were improving childhood immunization coverage began to lose progress due to COVID-19-related disruptions. In 2020, 23 million children missed routine immunization coverage. Of these 23 million children, 60% lived in 10 countries: Angola, Brazil, Democratic Republic of Congo, Ethiopia, India, Indonesia, Mexico, Nigeria, Pakistan and the Philippines. Disproportionate levels of immunization coverage represent growing health inequity around the world. In 2020, the chance of a child born being fully immunized based on global recommendations by age 5 was less than 20%. So far in 2022, there have been 17,500 measles cases in Africa, an increase of 400% compared to the same period in 2021.

Conflict is a barrier to immunization coverage

Conflict has also been a constant obstacle to global efforts to vaccinate children. Poliomyelitis, measles and cholera are among the preventable diseases that continue to cause epidemics in areas facing political instability and conflict. In Yemen, it is estimated that a child dies every 10 minutes from a vaccine-preventable disease. The world has made progress in eradicating polio, but the conflict in Afghanistan, including violence against polio teams, has delayed polio vaccination campaigns for children. In Venezuela, the economic collapse weakened the health sector, leading to outbreaks of measles and diphtheria that spread to neighboring countries.

Focus on the context: Ukraine

Ukraine currently has one of the lowest routine vaccination rates in Europe and is experiencing a massive influx of refugees. Vaccination coverage of children in Ukraine is below WHO recommended levels for tuberculosis, poliomyelitis and measles. From 2017 to 2018, measles cases in Europe tripled to more than 82,000, including 53,000 in Ukraine. Moreover, only 35% of the population received two doses of a COVID-19 vaccine before the conflict. The war in Ukraine is expected to further disrupt routine immunization programs for children, as health facilities are destroyed and forced migration prevents scheduled immunization appointments. This dangerous combination of low vaccination rates and a high-risk environment for the spread of disease is a pattern we often see in conflict zones.

In Poland, Ukrainian refugees are encouraged to participate in the country’s routine immunization programme. The EU also plans to purchase measles and polio vaccines for Ukrainian refugees. This strategy should be used in every global refugee response to protect both the health of refugees and the host community.

Immediate investments and international action are needed to save lives and mitigate future public health emergencies

The COVID-19 pandemic has highlighted the power of vaccines while simultaneously illustrating the health inequities that exist in vaccine deployment as well as the potential deadly consequences of not being vaccinated. Vaccines are a life-saving tool when accessible to all and deployed in a culturally sensitive manner.

As the world continues to grapple with COVID-19, it is important to continue investing in vaccines to prevent diseases such as polio and measles that the international community has fought for decades to eradicate. The GAVI Vaccine Alliance emphasizes the importance of collaboration as part of its mission to “save lives and protect people’s health by increasing the equitable and sustainable use of vaccines”. Donors, the UN system and NGO partners should work together to improve access and availability of routine immunizations through dedicated funding. This investment is crucial to avoid wasting years of public health development. These efforts should prioritize children who missed routine vaccinations during the pandemic and those living in countries with the lowest vaccination coverage. Diseases do not respect borders – to prevent another pandemic, investing in routine childhood immunization programs is essential.

You can read more about the work some InterAction members are doing on vaccines and public health here:

HOPE project
save the children
International Medical Corps
International Rescue Committee

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