Immunization is successful when countries prioritize it, engage and involve communities and ensure sustainable funding. This message during a day-four side event led by Gavi, the Vaccine Alliance underscored the importance of governments owning the process and committing to reaching every child.
Jacqueline Lydia Mikolo, Minister of Health and Population of the Republic of Congo and session chairperson, emphasized that cross-sector collaboration, community ownership and good data quality are necessary for successful immunization coverage. Success, she added, includes strengthening both routine and supplementary immunization.
The Director of Programme Management in the WHO Africa Regional Office, Dr Joseph Cabore, acknowledged that political commitment to immunization is at its highest in the region and, because of it, the average immunization coverage rate is nearly 70%. However, he pointed out, this falls short of the global target of 90%. “We need to reach at least 200 million children to close this gap, and hopefully, the new Gavi strategy will enable countries to get to hard-to-reach areas,” he said.
That Gavi strategy, according to Pascal Bijleved, Director Country Support for Gavi in Geneva, was recently adopted for 2021–2025 and represents a significant shift in focus to overturn the stagnation affecting immunization coverage. The vaccine investment takes a life-course approach and involves building new delivery platforms that will strengthen primary health care by providing more moments in which a child, adolescent or adult is in contact with health workers. It also includes approval for investment in studies to address gaps in knowledge.
He also pointed out that the new strategy considers options for supporting middle-income countries, which may include support for post-immunization processes rather than direct funding or purchasing of vaccines. Gavi funds around 1 000 varieties of vaccines and is looking to add six more by 2021, he said.
Andres Ambrosio Lopez, UNICEF Deputy Representative in the Republic of the Congo, commended the work of Gavi and countries and said the gains made in immunization are due to such effective partnerships. He said focusing on every child and ensuring equity is important. He indicated that increasing immunization coverage will require strong leadership and accountability, integrating routine and supplemental immunization, strengthening logistics and cold chain systems as well as empowering youths.
After lauding all WHO Member States and Gavi on progress to date, three delegates highlighted their respective country experiences with expanding immunization coverage. The Minister of Health and Social Welfare of Liberia, Bernice Dahn, spoke about how Gavi helped the country develop a community-based immunization strategy after the Ebola outbreak. The system uses community health assistants to register and refer immunization clients and to develop community profiles and records while also working with traditional healers.
Dr Amir Aman Hagos, Minister of Health of Ethiopia, described how only women were employed as community health workers. “Our belief is that the mother is essentially the first physician of the baby,” he said. The women are trained for two years and supported to meet often to discuss and plan together.
A representative for the Ministry of Health and Social Action of Senegal acknowledged the key roles played by Gavi and other partners in the attainment of the country’s 77% immunization coverage rate and the efforts being made to improve coverage, including in island territories. She also said that, jointly with WHO experts, they took to the media to overcome rumours about vaccines, some of which were spread by doctors and other influential people.