The Global Vaccine Action Plan was developed with an aim to improve health, granting benefits of immunization to all regardless of location or other factors, by the year 2020. If resources are to be utilized effectively, between 24.6 and 25.8 million deaths could be avoided by the end of the decade–not to mention the gain of billions of dollars in productivity, and the invaluable education that comes along with unleashing a vaccine’s potential.
The GVAP has brought together many stakeholders involved in immunization, such as the Bill & Melinda Gates Foundations, GAVI Alliance, UNICEF, US National Institute of Allergies and Infectious diseases, and WHO.
However, despite these ambitious goals and expanded breadth of education regarding vaccination and immunization, progress has fallen short of expectations.
The initial targets of the GVAP are as follows:
- DTP3: National vaccination coverage of 90% in all countries by 2015
- Introduction of under-utilized vaccines: At least 90 low or middle-income countries to have introduced one or more such vaccines by 2015
- Polio: No new cases after 2014
- Maternal and neonatal tetanus: Complete elimination by end of 2015
- Measles: Elimination from three WHO regions by end of 2015
- Rubella: Elimination from one WHO region by end of 2015
In the assessment by the Strategic Advisory Group of Experts on Immunization, most of those goals have seen very poor progress, and “The Decade of Vaccines” is not on proper course to achieve appropriate results. Despite good progress being made in some countries, those improvements will have to become normal in other countries if the movement is to get back on track.
Two major problems thus far are elimination strategies for maternal and neonatal tetanus, and for measles and rubella; and the monitoring itself of the GVAP. It is imperative for individual countries to have plans consistent with the GVAP’s requirements, and by the same token, it is essential for the World Health Organization to create frequent progress reports to ensure constant participation and development.
Somalia has a devastatingly high infant mortality rate, with twenty percent of children not even reaching their fifth birthdays. In places such as Somalia, war, a collapsed government, and limited funds lead to a damaged healthcare system, creating an environment where viruses can easily thrive. Despite these grave circumstances, Somalia has prevented two major polio outbreaks, thanks to devoted local immunization efforts. Child health support by WHO and UNICEF have greatly increased coverage, but this does require external funding.
Good progress is slow, but it’s there. The GVAP target for introduction of new or under-utilized vaccines is currently on-track worldwide, with introduction and sustenance of 128 vaccines since 2010 in 86 low and middle-income countries. For example, the Ebola candidate virus vaccines were created and tested quickly, providing potential to protect a fatal disease.
India is now free of maternal and neonatal tetanus, proving that it is possible to rid of this disease even among difficult circumstances. (India is among the list of countries with the largest numbers of unimmunized children.) In addition, Africa has not seen a wild poliovirus case since August of 2014, and Nigeria joins them in no longer being a polio-endemic country.
What leads to success in vaccination and immunization education is quality of data, community involvement at big and small levels, and of course, supply of the vaccines themselves.
The sad truth is that millions of children die as a result of completely preventable diseases and their complications. Moving forward, we as a global society must focus on accountability, responsibility, and leadership. As important as it is for countries to independently dedicate themselves to The Global Vaccine Action Plan’s goals by the end of “The Decade of Vaccines”, it is also essential to be personally educated and aware on a smaller scale–whether you are a doctor administering vaccines, or a patient receiving them.
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Sources: The World Health Organization (WHO); 2014 and 2015 Assessment Reports of the Global Vaccine Action Plan (Strategic Advisory Group of Experts on Immunization)