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Namibia: challenges in strengthening immunisation programmes

I attended the third Annual Regional Conference on Immunisation workshop and the Decade of Vaccine (DoV) consultative meeting organised in Windhoek, Namibia with a theme of “Towards a Polio-free Africa” .

The DoV is an effort under the leadership of the WHO, UNICEF, the Bill & Melinda Gates Foundation, and the Institute of Allergy & Infectious Diseases. 

In January 2010, Bill & Melinda Gates called for the next ten years to be the “Decade of Vaccines”. The announcement included a commitment of $10 billion over the next 10 years to save millions of lives by increasing investments and accelerating efforts.

More can be found on http://www.dovcollaboration.org/consultation/


Three main discussion points were focused on: achieving Polio eradication milestones, strengthening immunisation systems and accelerating control of vaccine preventable diseases.

Accordingly, great progresses have been achieved over the last 40 years. Over 3 million lives have been saved, polio eradication is nearing completion, and new vaccines have been introduced.

These are steady and sustained improvements observed in African countries.


Vaccine preventable diseases remain the leading cause of under-five morbidity and mortality, indicating there are significant challenges remaining.  

These include lack of implementing political commitments, poor community level linkages of activities, inequities among countries and within countries, and delayed response to outbreaks and immunisation campaigns.

Above all, lack of adequate evidences for some critical challenges; epidemiologic age shift of measles outbreak in some African countries, paradoxical occurrences of outbreaks immediately following immunisation campaigns, and resistance from some community groups to vaccination programmess are the major ones.

Best practices and recommendations

There are some best practices witnessed in a few sub Saharan African countries. Burkina Faso successfully introduced new meningococcal vaccine (MenAfriVac).

Angola established a good public private partnership with non-health actors in immunization financing, and Zimbabwe achieved political leadership and support in convincing community groups persistently resisting immunisation.

To scale up the best practices and effectively tackle some of the challenges, various action points were recommended:

  • active involvement of civil society organizations,
  • the need to better understand root causes of poor performances
  • country leadership as the central role in sustainable financing
  • creating grass root level ownership.

It was strongly emphasised that it should be implemented in the child survival framework and context of specific countries.

Role of civil society

Although immunisation is the core of public health, it has been getting less attention due to various reasons including competing new programs, community management of common childhood illnesses, emerging chronic non-communicable diseases and HIV/AIDS.

Hence, the concept of primary health care should be revitalised  in order that immunisation should get top priority.

Apparently, there are long lists of activities for civil society groups, especially in African countries where the national health system is weak.

Save the Children has been advocating for and supporting vaccination programs globally, and recently published paper:Vaccines for all: Help save 4 million lives by 2015

Similarly, Save the Children should continue advocating, supporting community level activities, and generating evidences and the introduction of country specific new vaccines.

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