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Finding the Final Fifth: making equity a priority in immunisation

Today we launch our new report, entitled Finding the final fifth: Inequalities in immunisation, produced in partnership with ACTION, and endorsed by the World Health Organisation (WHO), RESULTS Educational Fund and IVAC. This report centralises the issue of inequalities in immunisation coverage.

Also today, the 65th World Health Assembly opens, where national delegations from across the world  to address priority issues in global health. On Thursday the agenda will turn to the Global Vaccine Action Plan (GVAP), which sets out priorities for immunisation over the coming decade.

That evening, our report will also be presented by the CEO of Save the Children International, Jasmine Whitbread, at a side event we are co-hosting with the WHO, UNICEF, GAVI Alliance, Decade of Vaccines, GAVI CSO Constituency and the Red Cross.

Finding the final fifth: prevailing injustice for the world’s most poor and vulnerable

Despite impressive global and national progress in expanding coverage of vaccinations, almost a fifth of the world’s children were not reached with three doses of diphtheria-, typhoid- and pertussis-containing vaccines (DTP3) in 2010.

These 19.3 million children are no random selection: they are the most poor and remote, for whom this basic right to health is denied.

The final fifth of children who are without full immunisation are also those who need it most: they are more likely to fall sick, and least likely to have access to the care they need. They are the children who are needlessly dying from preventable causes.

Adressing inequalities brings value for money

Addressing inequalities is the right thing to do from both a moral and an economic perspective.

Reducing inequalities is cost-effective, produces more sustainable outcomes, and increases the impact of every dollar invested, accelerating progress towards global and national development goals.

In just twelve countries, Save the Children’s analysis suggests that overcoming wealth inequalities in immunisation coverage in just 12 countries could prevent 370,000 child deaths each year.

Strengthening health systems and lowering vaccine prices

To scale-up coverage and sustain progress, countries must strengthen health systems. Only with a health worker in reach of every child, who is appropriately trained, supported, remunerated and equipped, will we achieve this goal.

Countries must also have sufficient access to the vaccines they at prices they can afford. We have a collective responsibility to lower vaccine prices and make appropriate vaccines for the children who need them and the contexts in which they live.

A call to commit to equity on Thursday

The world can no longer be complacent about this injustice – it’s time to make addressing inequity our common priority. As Anthony Lake, Executive Director of UNICEF commented, reaching the final fifth “will take political will, new investment, and community engagement.”

On Thursday, Member States have the opportunity to assert this political will, making an explicit commitment to put equity at the forefront of their approach.

Passing a strong resolution on the GVAP would acknowledge the importance that no child is left behind as efforts are made to expand immunisation coverage.

National priorities

National strategies must reflect this priority and adopt disaggregated targets, so that the world can see that we are taking steps to realise the right of all to immunisation as part of their right to health.

Wide civil soceity and other stakeholder consultation informed the development of the GVAP. It is essential that this continues to ensure meaningful participation as the GVAP is translated into country owned strategies and operationalised.

Clear steps must be set out to establish a transparent mutual accountability framework, coordinated by the WHO, with disaggregated targets, as mentioned above.

A strong resolution on the GVAP will focus attention on the final fifth of children who don’t receive the basic vaccinations they need and are entitled to. We urge you to lobby your country’s delegation to secure this commitment.

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