With one in five children worldwide not receiving essential vaccines, achieving equitable vaccination coverage rates is a global priority. This World Immunization Week, the global community rallies together to “Close the Gap.”
At USAID, our goal to save the lives of 15 million children and 600,000 women by 2020 demands that we apply our resources to interventions with the greatest potential to achieve this ambitious goal.
The bottom line is we know that vaccines work: they save lives and money. The challenge is ensuring that every child, everywhere, receives the vaccines that he or she needs to grow up healthy, while also being protected from malnutrition, malaria, and other potential killers.
Ketcia Orilius, a USAID-supported health worker in Robin, Haiti, gives three-month-old Orelus vaccines to protect against multiple childhood illnesses. [David Rochkind, USAID]
Investing in a Healthy Future
If vaccines were stocks, investors would be scrambling to buy up shares.
That’s because vaccines have been shown to yield a 16-fold return on investment -- the amount of money generated or saved relative to the amount invested -- when looking at averted health care costs alone.
When that analysis was expanded to a full-income approach, which goes beyond averted health care costs and additionally takes into account the value associated with people living longer, healthier lives, vaccines were found to yield net returns at 44 times the initial costs.
But you don’t need to be a financial analyst to appreciate the value of vaccines. Globally, child mortality rates have been reduced by more than half since 1990, thanks in part to increases in vaccination coverage. And each and every day, vaccines continue to save the lives of children around the globe. And when it comes to efficiency and “bang for the buck”, few interventions are able to rival immunization.
Polio, for instance, is now closer than ever before to being eradicated. Before 1988, there were 350,000 cases of polio annually across 125 countries. That year marked the launch of the Global Polio Eradication Initiative, and in 2015 -- less than 30 years later -- there were just 74 cases of wild polio virus, limited to two countries.
The Need for Political Commitment
Each and every year, 130 million newborns need to be immunized, or we risk losing the gains that we have made. We must also ensure that the world’s 650 million children under five have received their full course of recommended vaccines.
At the Ministerial Conference on Immunization in Africa in Addis Ababa, Ethiopia, earlier this year, I was inspired by the participation and enthusiasm of the ministers present. Ministers of health and finance -- both vital to sustainable programming -- from countries across the continent convened to sign a Ministerial Declaration on universal access to immunization’s foundational role for health and development across Africa.
Surrounding this conference, these ministers were highly engaged and vocal in both formal and informal settings. Ngozi Okonjo-Iweala, the new Chair of Gavi, the Vaccine Alliance, led an animated discussion on financial sustainability and the need to mobilize domestic finances. Other ministers emphasized integration, from embedding immunization in universal health care to thinking strategically about the “polio legacy.”
The role of communities and civil society organizations (CSOs) was also a prominent theme: CSOs can play a vital, unique role in advocacy, mobilization, and accountability. Engaging local, in-country CSOs in advocating for routine immunization within strong primary healthcare services, and ensuring such services are delivered, are a necessary complement to global and national efforts, and are vital for long-term sustainability and funding.
At the USAID-supported Smiling Sun Clinic in Tongi, Bangladesh, Raja brings her infant in for a measles vaccine. [Amy Fowler, USAID]
World Immunization Week 2016: Closing the Gap
At USAID, our immunization work is centered on a comprehensive approach that views immunization as a crucial part of a strong health system, rather than as a stand-alone activity. We support the goals of the Global Vaccine Action Plan (GVAP) and work with countries to meet the targets that it has set.
Through our work with Gavi, the Vaccine Alliance, USAID supports global efforts to expand immunization coverage for children living in the world’s poorest countries, with a specific emphasis on increasing equitable use of new and underutilized vaccines. Our efforts help align the resources and investments of donors, national governments, and other Alliance partners. In 2015, the U.S. Government pledged an historic $1 billion to Gavi over four years, subject to Congressional approval in annual appropriations, to immunize 300 million children and save 5 million lives by 2020.
Our support for Gavi goes hand-in-hand with another central element of USAID’s immunization efforts: strong, resilient, and sustainable routine immunization systems. Through engagement with Gavi governance bodies, including my position on Gavi’s Board of Directors that I have been honored to hold for the past two years, we are able to link Gavi-specific engagement to our Missions’ work in supporting the development of robust national immunization systems.
And it is crucial that the immunization programs and policies that we help build are there to stay. Gavi was founded with the objective of making affordable, life-saving vaccines available to countries that otherwise could not pay for them, but as countries’ economies grow, long-term support must come from the countries themselves. Sustainability is vital to ensuring that we achieve high levels of immunization coverage -- and that they stay high, long after the transition from Gavi support.
USAID’s work helps ensure that health workers have the capacity to deliver safe and effective vaccines in a timely manner. Many vaccines must be kept cold to remain effective, which is why we work to improve “cold-chain” capacity. We collaborate with country governments to develop sound immunization policies, strategies, and guidelines.
These are not easy tasks, and they require the commitment of individuals at all levels -- from international governing bodies to the health workers who deliver the vaccines themselves.
Yet I have faith that we, working together with our partners in countries across the globe, will be able to build strong immunization systems that will keep children alive and healthy for years to come.
About the Author: Katie Taylor serves as USAID's Deputy Child and Maternal Survival Coordinator and a Deputy Assistant Administrator in the Bureau for Global Health.