From promise to living proof: Three lessons on increasing immunisation coverage

by Doris Mpoumou and Richard Adegbola

Health workers prepare vaccines at a health centre in the Democratic Republic of Congo. Photo: Ivy Lahon/Save the Children
Health workers prepare vaccines at a health centre in the Democratic Republic of Congo. Photo: Ivy Lahon/Save the Children

“We should settle for nothing less than a continent where no child dies from preventable diseases.

Those of us who joined ministers in Ethiopia last week to debate universal immunisation coverage across Africa left with those words from H.E. Jakaya Mrisho Kikwete, global ambassador for immunisation, ringing in our ears.

There’s no doubt the will exists to reach every child – as the conference declaration showed. But as Kikwete went on to say: “As important as declarations may be, more so is their implementation.” With the declaration lacking time-bound, definitive goals, the next challenge will be turning commitments into action.

For Save the Children and GSK, this means working hard together to walk the talk and help more children access vaccination and other essential health services, especially the hardest to reach. This is through our five-year partnership, which aims to help save the lives of one million children. So what are some of the lessons we have learned about increasing access to immunisation?

Power of unexpected partnerships

Innovative partnerships – drawing on complementary skills from government to business and civil society – can help transform access to immunisation. There are two ways in which our partnership is fruitful. Firstly, sharing knowledge and resources. GSK makes vaccines and knows about the cold chain. Save the Children has a strong on-the-ground presence and expertise in supporting governments to strengthen health systems. Together, we have helped to reach more children. In the Democratic Republic of Congo, more than 2,000 children participated in a catch-up immunisation campaign. We also supported the Ministry of Health and others to distribute 100,000 immunisation record cards.

Two voices are louder than one

The second value is in combining our voices. Much of last week’s discussion was around monitoring progress of governments and others, and holding them accountable. Here, speaking together can be effective. Save the Children and GSK have combined their voices in support of increased, equitable immunisation coverage globally and in country. In the DRC, this means building political will and donor support for robust health policies reflecting the needs of the poorest women and children. Drawing on different voices, including from communities themselves, will be vital to ensuring the declaration becomes action – and having these honest conversations will be just as important for holding ourselves to account. As Hon. Oleru Huda, a member of Uganda’s parliament, said, we need to “make sure that declarations won’t be hidden in cupboards”.

Invest in stronger health systems

Refrigerated vaccines at a health centre in the Democratic Republic of Congo. Photo: Jean Claude Bode/Save the Children
Refrigerated vaccines at a health centre in the Democratic Republic of Congo. Photo: Jean Claude Bode/Save the Children

A prevailing theme at the conference was sustainable domestic financing of immunisation – supported by a recent paper which reported that every $1 invested in immunisation delivers a $16 return, increasing to $44 when associated economic benefits were accounted for.  Vaccine companies like GSK have a role in helping ensure vaccines are affordable, including for countries that will move on from Gavi support. This goes hand in hand with investing in stronger health systems. By having a more robust infrastructure – with a skilled, engaged workforce – in reach of all communities, not only will we be able to improve access to vaccination but to other essential health services too. Business and civil society have a role here. In west and central Africa, Save the Children has worked with governments to train more than 5,000 health workers, using funds from GSK reinvesting 20% of its profits from least developed countries back into those nations’ health infrastructures. But governments lead the charge on strengthening their health systems – hopefully our investments will help catalyse that support.

Those lessons have taught us much about increasing access to immunisation – most importantly, showing it is possible. In Africa, huge progress has been made: 23 countries have reached the Global Vaccines Action Plan goal of 90% national coverage. But one in five children still miss out on basic immunisation. By working together, and building stronger health systems, we can help reach those children and support countries across Africa to turn a promise into living proof.

 

Doris Mpoumou is director and AU Representative for Save the Children International. Richard Adegbola is director for scientific affairs and public health in GSK’s vaccines business.

This blog first appeared on Gavi’s Vaccines Work.

 

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