Experts caution against the stagnation of immunisation coverage

By Carol Natukunda

The experts attending a recent biannual Regional Immunisation Technical Advisory Group (RITAG) meeting expressed worry over the stagnation rates of immunisation.

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African countries must strengthen their routine immunisation to curb preventable diseases, experts have said.
The experts attending a recent biannual Regional Immunisation Technical Advisory Group (RITAG) meeting expressed worry over the stagnation rates of immunisation.
Over the past five years, immunisation coverage in sub-Saharan Africa has stagnated at 72%, exposing populations to vaccine-preventable diseases and outbreaks, the World Health Organisation(WHO) regional office said in a statement.
In Uganda, the immunisation coverage rate - measured by the percentage of children receiving the third dose of the diphtheria-tetanus-pertussis vaccine (DTP3) varies by region.
Based on coverage for the first three quarters of 2017, the country's immunisation coverage was 95%.
While this is commendable, considering that it is above the Global Vaccine Action Program recommendation of 90%, coverages varied significantly from, for instance about 60 % for Bulambuli district and 168% in Arua district. Officials attribute this to several factors including long distances to health centers, vaccine stock-outs, poverty, the risk of mothers having competing priorities and poor attitudes and behaviors by health workers.
In an earlier interview with New Vision, Dr. Opar Bernard Toliva, the programme manager of Uganda National Expanded Programme on Immunisation said the health ministry would ensure a massive campaign to sensitise the population on the benefits of immunization.
The country currently has 11 vaccines in the routine Immunisation Schedule. These vaccines are; Measles, Polio, BCG against tuberculosis, Diptheria, Whooping cough (Pertussis) and Tetanus, Hepatitis B, Heamophilus influenza type b, Pneumoccocal conjugate vaccine (PCV), Human Papilloma Virus vaccine (HPV) and Inactivated Polio Vaccine (IPV) and more recently Rota Virus vaccine against diarrhea.
Now, immunisation experts emphasized the importance of increased domestic investment in disease surveillance and the need for community engagement to drive vaccine deployment during outbreaks.
"The regional experts' meeting presented a unique opportunity to assess current and future immunization needs in Africa," said RITAG Chair, Professor Helen Rees.
"We have mapped out what can and must be done to secure the future of millions of children on this continent."
According to the WHO statement, nearly 31 million children younger than five years in Sub-Saharan Africa suffer from vaccine-preventable diseases every year. More than a half million of them die due to lack of access to the vaccines they needed.
In 2017, Heads of State from across Africa endorsed the Addis Declaration on Immunisation, a historic pledge that envisions an Africa in which every child, no matter their economic circumstances, has access to vaccines.
This year, 2019, WHO Regional Office for Africa, in partnership with the African Union Commission, will launch a progress report on the implementation status of the 10  commitments outlined in the Addis Declaration. The report will take stock of progress made over the past two years, highlight gaps and issue recommendations to guide progress towards stronger immunisation systems.
"By vaccinating children, we are doing more than preventing diseases and saving lives. We are also ensuring that children get the education they deserve and returning valuable time to their families because they no longer need to make long hospital visits. Vaccinations also release scarce government funds," said Dr. Matshidiso Moeti, WHO Regional Director for Africa.
According to WHO data, illness and deaths due to vaccine-preventable diseases cost sub-Saharan Africa US$13 billion each year - funding that could be channeled towards strengthening health systems and building economies. 
"The experts also discussed a range of pressing issues, including the ongoing Ebola outbreak, polio eradication, and progress against the Regional Strategic Plan for Immunisation," WHO stated.
The Democratic Republic of the Congo is grappling with the second-largest Ebola outbreak in history, with more than 650 confirmed cases so far. Despite challenges in reaching areas marred by long-term conflict, nearly 60 000 people have been vaccinated, including approximately 20 000 health workers and front-line workers. The country's Ministry of Health has launched its first randomized control trial for experimental Ebola treatments.
However, WHO said continued efforts were to ensure the outbreak is contained.
"In contrast, other diseases, such as polio, are on the brink of eradication. The last case of wild poliovirus in Africa was reported in August 2016 in the north-eastern state of Borno, Nigeria. If no new cases of wild poliovirus are detected in Nigeria by August 2019, Africa will attain the wild poliovirus eradication goal," WHO said in a statement
The agency observed, however, that as the world nears polio eradication, funds for fighting the disease are declining.
"Between 2016 and 2019, the Global Polio Eradication Initiative budget more than halved, from US$ 322 million to US$ 153 million. That initiative provides more than 90% of all funding for disease surveillance in sub-Saharan Africa, including 16 polio-funded laboratories that process clinical and environmental samples for acute flaccid paralysis surveillance (used for detecting poliomyelitis) and other vaccine-preventable diseases, such as yellow fever and measles," WHO reported.
The Regional Immunisation Technical Advisory Group emphasised the need for greater government ownership of disease surveillance programmes to ensure that the progress made in curbing vaccine-preventable diseases is not reversed.
"The fact that most sub-Saharan African countries continue to rely on external funding for immunization financing is a strong indicator of the work that remains to be done," said Dr. Richard Mihigo, Programme Manager for Immunization and Vaccine Development at the WHO Regional Office for Africa. "Governments have a central role to play to fill upcoming funding gaps and ensure immunization programmes remain strong and vigilant.