Vaccines: Prioritising the most vulnerable

This week is World Immunisation Week: a time to acknowledge the importance of immunisation as a cost-effective intervention that is critical for child survival, healthy lives and equitable and sustainable development.

Vaccine summit in Abu Dhabi

On 24^th– 25^th April, Bill Gates and the Crown Prince of Abu Dhabi are co-hosting a summit to celebrate this commitment to immunisation, and to focus efforts on implementation of the Global Vaccine Action Plan. This is a framework to guide global efforts on immunisation over the coming decade, endorsed by Member States at the World Health Assembly last year.

This summit provides an opportunity to increase funding to facilitate the eradication of polio (see Kofi Annan’s recent blog) and expand equitable access to routine immunisation, with better integration with other essential services and strengthened health systems for lasting gains.

Leaving no child behind

Just last week, Vaccine journal launched a special supplement on the ‘Decade of Vaccines’. In this supplement, I co-authored an article with colleagues from John Snow Inc., UNICEF and WHO calling for addressing inequalities in immunisation to be the focus of the ‘Decade of Vaccines’.

As a proven cost-effective intervention, access to essential vaccinations is a human right. The world has made huge progress on expanding immunisation coverage, with 83% of children worldwide receiving three doses of a diphtheria, tetanus and pertussis containing vaccine in 2011.

But this left over 22 million children behind. Those missed are the most poor and vulnerable. They are also the children who need vaccines most. The world’s failure to deliver essential healthcare to these children must not be tolerated.

Responding to vulnerable populations

Reaching the unreached must be our priority, and it must be approached through ways that respond to the complex and integrated health needs of vulnerable populations, and through ways that will sustain the gains that are made.

This involves expanding the focus from vaccines to vaccination: the whole system through which children are immunised, including there being an appropriately trained, equipped, supported and paid health worker in reach of every child.

Match ambition with action

Small steps are being made. Last week GAVI announced that they have negotiated a record low price for pentavalent vaccines with an Indian supplier, dropping the cost by 30%.

But we must go further, and match the ambition of the Global Vaccine Action Plan with sufficient investment to make it access to immunisation and healthcare a reality for all people, everywhere. This requires political resolve and public demand.

The recent death in the UK from measles reminds us of the importance of universal coverage of recommended vaccinations (see this recent article).

Achieving universal coverage of immunisation by 2020 could save 20 million lives. Let’s hope the summit stimulates sufficient profile for increased investment to bring an end to polio and realise the full benefits of immunisation for all in this coming decade.