By Joyce Ojanji
An estimated 51.2 million lives have been saved through the Expanded Programme on Immunization (EPI) initiative in the African region over the past 50 years.
The initiative was launched by the World Health Organization (WHO) in 1974 as a global endeavor to ensure equitable access to life-saving vaccines for every child, regardless of their geographic location or socioeconomic status.
For every infant life saved over that period, close to 60 years of life are lived, a new report by WHO which assesses the life-saving impact of vaccines, released recently at the start of this year’s African Vaccination Week and World Immunization Week being marked from 24–30 April under the theme “Safeguarding Our Future: Humanly Possible”, finds.
According to the report, most countries in the region provide antigens for 13 vaccine-preventable diseases, up from the initial six when the EPI was introduced, through continuous support from WHO, United Nations Children Emergency Fund (UNICEF) and Gavi, the Vaccine Alliance and many others.
It also states that there has been a reduction in measles deaths with an estimated 19.5 million deaths averted over the last 22 years. The region has also witnessed a sharp decline in meningitis deaths by up to 39% in 2019 compared with 2000.
Moreover, according to Dr Matshidiso Moeti, WHO Regional Director for Africa, the success story of vaccines is a compelling one, from disease prevention to eradication. “We have half a century of momentum and have accomplished so much. Now we must sustain and expand vaccine equity to end the threat of vaccine-preventable diseases,” she noted.
“Today, we celebrate the monumental advances governments and partners have taken across Africa in the last fifty years to ensure so many more children on the continent are living past their fifth birthday thanks to vaccination,” said UNICEF Regional Director for Eastern and Southern Africa, Etleva Kadilli.
“Leaders, partners and donors must strive to protect immunization gains in the region, especially in the face of backsliding rates in recent years.”
The report notes that through Gavi, an alliance of immunization partners including WHO and UNICEF established in 2000 to expand the impact of the EPI, countries are supported to deliver vaccines against vaccine-preventable diseases including cervical cancer and malaria, and to respond to outbreaks of diseases such as Ebola and cholera.
Thabani Maphosa, Managing Director of Country Programmes Delivery at Gavi adds that ‘’the evidence is clear: vaccines are one of the most impactful and cost-effective investments in health and development in history. Over the past two decades, Gavi has worked with 40 African countries to expand immunization coverage while delivering new innovations like the HPV and malaria vaccines and responding to deadly outbreaks – saving millions of lives and generating billions in economic benefits.’’
However, while progress in vaccine coverage has been made, the report says that the region still faces challenges in achieving and sustaining high immunization coverage rates for most of the vaccine-preventable diseases.
These challenges include ensuring equitable vaccine access across the continent, with a significant number of children yet to receive a single dose of life-saving vaccines while others are not receiving enough doses.
In addition, the disruptive impact of COVID-19 further strained immunization efforts. The region is yet to fully recover from the pandemic’s disruptions to immunization.
Therefore, efforts to address gaps in immunization coverage have been intensified through the “Big Catch-Up” initiative that aims to reach children who have been underserved or missed by routine vaccination programmes. Innovative initiatives such as the Zero-Dose Immunization Programme have also been established to reach communities that are living in conflict and fragile areas with essential health services.
Also, further efforts are needed to accelerate progress to meet the goals of the Immunization Agenda 2030, a strategy endorsed during the WHO World Health Assembly in 2020, which seeks to reduce mortality and morbidity from vaccine-preventable diseases, ensure equitable access to vaccines and strengthen immunization within primary health care. A regional framework to implement the Immunization Agenda has been adopted.
Additionally, the report notes that key strategies need to be implemented to sustain the progress. These include controlling protracted and frequent outbreaks of vaccine-preventable diseases; increasing investment in health systems and infrastructure for effective vaccine delivery; enhancing surveillance systems to respond swiftly to outbreaks; addressing vaccine hesitancy and misinformation; bolstering domestic funding for immunization programmes; increasing the use of innovation and technology for better vaccine delivery; and investing in research and development for vaccine development
