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Equity from Birth: An integrated Approach to Immunisation and Nutrition Policy Brief (October 2021)

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Combining vaccines with nutrition a game-changer against COVID-19 and future pandemics say Gavi and SUN

  • Malnutrition and infectious diseases together cause millions of preventable child deaths every year and contribute to a vicious cycle of poor health, stunted growth, poverty and exclusion

  • Rolling out immunisation and nutrition programmes together significantly increases the number of people reached and reduces delivery costs

  • Gavi, the Vaccine Alliance, and the Scaling Up Nutrition (SUN) Movement have now partnered to launch this innovative two-pronged healthcare approach

  • This approach is a game-changer in supporting communities to be resilient to future pandemics, especially for vulnerable people including women and children

**Geneva, 28 October 2021 – **Delivering immunisation and nutrition programmes together is necessary to maximise results and minimise costs of these critical health services, enabling more people to be reached, especially in vulnerable communities. This is the conclusion of a new policy brief launched today and co-authored by Gavi, the Vaccine Alliance, and the Scaling Up Nutrition (SUN) Movement – global leaders in immunisation and nutrition respectively.

The policy brief*, Equity from birth: an integrated approach to immunisation and nutrition*, highlights that malnutrition and infectious diseases together cause millions of preventable child deaths every year and contribute to a vicious cycle of poor health, stunted growth, poverty and exclusion; while malnutrition – both undernourished and overweight – can severely decrease our COVID-19 survival rate.

In advance of the 7-8 December Nutrition for Growth Summit (N4G), being held in Tokyo, Gavi and SUN are calling on global leaders and key decision-makers in all countries to take action and prioritise this two-pronged vaccine-nutrition approach, through clear commitment making.

They are also calling on relevant international health partners to take action to advance the integration of immunisation and nutrition, and to develop clear recommendations governments can use to roll out this urgently needed approach.

“Delivering immunisation and nutrition services together will ensure that more people can be reached, especially the vulnerable, women, and children – and contribute to building communities that are resilient to COVID-19 and future pandemics. Countries must be enabled to advance smart joint packages of support on the ground, where it matters the most,” said Gerda Verburg, United Nations Assistant Secretary-General and SUN Movement Coordinator.

The policy brief highlights that by 2022 alone, the COVID-19 pandemic could result in an additional 2.6 million children suffering from stunting and 9.3 million suffering from wasting. In 2020, the COVID-19 pandemic and associated disruptions on health systems resulted in 22.7 million children missing out on vaccinations – 3.7 million more than in 2019 and the highest number since 2009.

“By integrating immunisation and nutrition efforts, and allowing vaccines and good nutrition to be delivered together we can ensure we reach the most vulnerable populations – effectively and efficiently, to help enhance equity across the world,” said Anuradha Gupta, Gavi Deputy Chief Executive Officer.

The policy brief also recommends that national governments and international health partners are proactive about combining immunisation and nutrition interventions and other essential health services, including through sharing infrastructure and value chains.

“It takes a great deal of effort for health workers to reach the most vulnerable children during immunisation campaigns. If they could use the opportunity to also screen for malnutrition or provide vitamin A supplementation or therapeutic foods for example, they could make a big difference in children's lives,” said Dr Githinji Gitahi, Group CEO, Amref Health Africa.

The N4G Summit comes at a critical time, midway through the United Nations (UN) Decade of Action on Nutrition, with only five years left to achieve the World Health Assembly (WHA) targets on maternal, infant and young child nutrition, and with just ten years left to achieve the Sustainable Development Goals (SDGs). Given this, and the serious disruptions caused by the COVID-19 pandemic, the policy brief underscores now is the time to invest better and smarter, as countries gradually find ways to restore, maintain and strengthen immunisation, nutrition, and other essential services.

“If we are to live up to the SDG principle of ‘leaving no one behind,’” the policy brief’s executive summary concludes, “we must start by identifying and reaching disadvantaged and excluded groups with the most essential interventions.”

Read the full policy brief: https://bit.ly/3jDcL36

Read the policy brief executive summary: https://bit.ly/3jDGjgZ

Key data

  • Routine immunisation and improved nutrition have played a critical role in reducing child under-five mortality by 67% over the last 30 years.1
  • Malnutrition remains an underlying cause for 50% of the 3.1 million child deaths each year.2
  • Immunisation prevents 2-3 million deaths each year from diseases including diptheria, tetanus, pertussis, influenza and measles.3
  • At least 1.5 million people still die from vaccine-preventable diseases each year.4
  • One dollar invested in nutrition provides a US$ 16 rate of return.5
  • One dollar invested in immunisation in Gavi-supported countries provides a US$ 21 rate of return.6
  • Nearly 20 million infants have insufficient access to vaccines each year.7
  • Undernutrition rates among children remain unacceptably high – with 149.2 million children under five years suffering from stunting and 45.4 million children suffering from wasting.8
  • By 2022 alone, the COVID-19 pandemic could result in an additional 2.6 million children suffering from stunting and 9.3 million suffering from wasting.9
  • In 2020, the COVID-19 pandemic and associated disruptions on health systems resulted in 22.7 million children missing out on vaccinations – 3.7 million more than in 2019 and the highest number since 2009.10
  • In 2020, the number of children who have received no routine vaccines, “zero-dose” children increased from 13.6 million to 17.1 million.11
  • Malnutrition and infectious diseases are mutually negatively reinforcing. Acutely malnourished children are 2.5 to 15 times more likely to die from pneumonia12, and up to 8 times more likely to die of diarrhoea – with repeated bouts of diarrhoea associated with up to 43% of child stunting cases.
  • Influenza vaccines for mothers led to a 15% reduction in low birthweight.13