This blog is co-authored by Ariane McCabe, PhD, Director of Global Health and Public Affairs, GSK Vaccines and by Claire Leonie Ward, PhD, Health Advocacy Adviser at Save the Children UK.
As the world’s attention and resources are focused on tackling the global pandemic, what does this mean for those most at risk of exposure to other life-threatening diseases, especially vaccine-preventable illnesses? This question poses major challenges to countries where health systems and economies are already weak.
To date, reports of transmission of COVID-19 to developing countries and fragile settings such a war zones and refugee camps appear relatively limited, but worryingly rates of transmission in these places are starting to increase. In Cox’s Bazar refugee camp – where Save the Children has been working since August 2017 – based on available evidence, no COVID-19 infections have been reported among Bangladesh’s refugee population; although the country has reported COVID-19 cases elsewhere. However, with 914,998 Rohingya refugees residing in 34 refugee camps in Cox’s Bazar, with often as many as five people living in one temporary shelter, it may be only a matter of time before a COVID-19 outbreak happens. The low reported figures may also be symptomatic of weak health care and surveillance systems, limited testing, reporting and available data on the pandemic. Environmental, political and social factors within these countries pose unique challenges for infectious disease prevention and control. Limited access to clean water, soap and primary healthcare services, such as routine vaccination, mean families often already at risk of malnutrition and other underlying health conditions – cholera, measles and pertussis – are the most vulnerable.
The global pandemic brings a further added pressure to these low-income, high-burden country contexts. In Democratic Republic of the Congo (DRC), for example, during the 2019 Ebola outbreak, measles claimed more than three times as many lives as Ebola. In the surge of the current COVID-19 pandemic, Gavi, the Vaccine Alliance, estimates that at least 13.5 million people in 13 of the poorest countries will miss out on vaccines due to cancelled campaigns and postponed vaccine launches. The COVID-19 pandemic is claiming lives across the globe and poses a major risk due to secondary outbreaks from other vaccine-preventable diseases, such as measles, cholera, polio and meningitis – diseases we’ve seen huge strides made in tackling over the last 20 years thanks to increased vaccination availability and coverage.
Informed by lessons learned from past public health emergencies, such as the West African and DRC Ebola outbreaks, secondary vaccine-preventable disease outbreaks must be countered by urgent continued routine immunisation activities in countries. This includes continued support for international organisations with the power to provide widescale support such as Gavi, the Vaccine Alliance, which is investing resources to immunise 300 million people and help save up to 8 million more lives with routine immunisation; strengthen health systems; and support the accelerated scale up of novel vaccine development and delivery, including for COVID-19, when available. Such co-ordinated support is needed to ensure partnerships and investments help countries build strong and resilient health systems, with the capacity to prevent, detect, and respond to disease outbreaks. To sustain these efforts governments must ensure a fully-funded Gavi that can deliver on the commitment of leaving no child behind on immunisation. We welcome the UK’s pledge of an additional £330 million per year for 5 years to support these critical efforts.
Partnerships are essential. The pioneering partnership of Save the Children and GSK combines GSK’s scientific and manufacturing expertise with Save the Children’s on-the-ground experience to find new ways to help bring down the number of children dying from preventable and treatable diseases. Most recently, since 2019, GSK has committed £1.5 million over three years to a GSK–Save the Children partnership project focused on strengthening immunisation programmes in the Somali region of Ethiopia to ensure essential vaccines are reaching the children who need them the most. The global COVID-19 pandemic threatens to disrupt such innovative projects set up to strengthen health systems and protect lives. Routine immunisation systems must be maintained during the outbreak to minimise the risk of further disease outbreaks and loss of life. This requires the availability of effective supply chains, trained health workers, data systems and disease surveillance, which can support outbreak response and resilient health systems. Together, globally, we must make sure health services for children remain open and accessible to families, ensuring a strong platform for primary health care services.
The pharmaceutical industry also has a critical role in the pandemic response. GSK is partnering with companies and research groups across the world working on promising COVID-19 vaccine candidates by offering the use of an innovative vaccine adjuvant technology at scale. The use of an adjuvant (a product added to a vaccine to boost the immune response and provide longer-lasting immunity) is of particular importance in a pandemic situation since it may reduce the amount of vaccine protein required per dose, allowing more vaccine doses to be produced and therefore contributing to protecting more people. Making the adjuvanted vaccine available to the world’s poorest countries is a key part of GSK’s efforts, including donations of this adjuvant, by working with governments and the global institutions that prioritise access.
This global pandemic has joined people together to face the common threat of COVID-19, and yet the risks are not shared equally. Overcoming this pandemic requires global solidarity and coordination, through strong partnerships that can ensure access to resources such as vaccines and that are directed to where they are needed most to save lives and protect the most vulnerable people.