New immunisation data – reason to celebrate or cause for concern?

Children in the Afar region of Ethiopia take part in a mass vaccination programme. (photo: Zacharias Abubeker/Save the Children)
Children in the Afar region of Ethiopia take part in a mass vaccination programme. (photo: Zacharias Abubeker/Save the Children)

Global immunisation progress has plateaued in recent years, as highlighted in our briefing Universal Immunisation Coverage: Further, Faster, Fairer, published earlier this year with RESULTS UK. The latest immunisation data just released by WHO and UNICEF doesn’t offer encouraging news – global coverage remains unchanged.

While it is impressive that we have reached 86% global coverage (a 12% increase since 1990), the fact that this has actually only increased 1% since the start of the 2011-2020 Global Vaccine Action Plan (GVAP) offers little cause for celebration. It’s positive that global coverage hasn’t dropped, but we really shouldn’t be complacent about no progress – especially when fewer countries are now meeting the 90% GVAP goal compared with last year.

It’s also concerning that the number of unimmunised children globally has increased. 19.4 million children are currently missing out – 800,000 more children than the previous year. That means that one child in seven is still being excluded from the full benefits of this critical health intervention.

National progress

The story isn’t all grim. If you dig beneath global trends, you come across some positive country successes. Coverage has increased in 62 countries over the last year, most notably in Haiti and Chad with increases of over 19%. In Ethiopia national coverage jumped from 77% to 86%. And in nine countries, coverage increased by over 10%.

While some countries still experience very low coverage, this has improved. In six countries coverage does not exceed 50% – Equatorial Guinea, Ukraine, South Sudan, Syria, Somalia and the Central African Republic. However, this has improved from the previous year when ten countries fell under this category. Twenty-two countries still have coverage not exceeding 70%, a slight increase from last year.

Who is still missing out?

What this new data doesn’t tell us is who is really missing out in countries. As our Immunisation Equity Scorecard shows, 20 out of 40 countries with disaggregated data have poor equity performance and 20 have not made any progress in closing the coverage gap between the richest and poorest households.

The seventh child who is excluded from immunisation is being unfairly left behind because of where they were born or live. He or she is from the poorest of households, from a marginalised ethnic group, living in a neglected or rural area, or affected by conflict. Later this year we will publish a new report that identifies which children are missing out on immunisation and critical issues driving this exclusion that must be addressed. This is part of an ambitious new Save the Children campaign launched earlier this year to help end exclusion and ensure that Every Last Child survives and thrives.

Time for action

We must ensure that every last child, has access to immunisation and other essential health services, aiming towards universal health coverage. Governments have committed to achieving universal immunisation coverage through their endorsement of the GVAP in 2012 and, more recently, in February 2016, the Ministerial Declaration on Universal Access to Immunisation in Africa. At the midpoint of the 2011-2020 Plan, when progress has stalled and is off track, action must accelerate. This will require renewed political leadership, commitment and investment.

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