Zeroing in on unvaccinated children: it is time for Africa to reach every child

By H.E. Amira Elfadil Mohammed, Commissioner, for Health, Humanitarian Affairs and Social Development, Africa Union Commission

The continent and world at large is going through unprecedented times where investments and the gains in health security have been undermined. This year’s African Vaccination Week commemoration from 24^th to 30^th April, under the theme ‘Vaccines Bring Us Closer’, could not have been more timely, as the continent rallies to contain COVID-19, mitigate its effects and ensure that populations are vaccinated. However, focus should not be diverted from the routine immunization programmes across the continent. Africa is on a path to advance towards ensuring that children move from zero dose to full immunization, referred to as the immunization cascade. The immunization cascade is essential towards ensuring that our children receive a full course of both lifesaving vaccines to protect against debilitating and deadly diseases achieving an immunization cascade is a crucial pathway towards realizing the African Unions’ and United Nations' shared goal of securing a healthier future for all.

According to the World Health Organization (WHO) approximately 1 in 5 African children are not receiving all the necessary and basic vaccines. This has devastating consequences, since over 30 million children under the age of five suffer from vaccine-preventable diseases every year.

Aside from the threat of disease outbreaks, non-immunized children might face multiple and often intersecting, social deprivations, drawing on their lack of access to health and other social services. Two-thirds of these children live in underserved communities, in remote rural settings, in nomadic communities or in crowded urban villages that are hard to reach. Reaching these children can expand access to primary healthcare and support better education outcomes, as vaccinated, healthy children are more likely to attend school, grow into a productive workforce and become strong contributors to the economy. Reaching these children is more challenging in the face of a pandemic.

In spite of the challenges associated with reaching every child everywhere, large-scale childhood vaccinations are being carried out successfully on the continent. In 2020, more than 3.3 million children from The Republic of Chad were vaccinated against vaccine-derived poliovirus in one of the largest campaigns of its kind in the continent. During the campaign, the continent witnessed individual volunteers going the extra mile, travelling on horseback for several kilometers a day to vaccinate children living in very remote villages.

This national level ‎of commitment to change continues to prove to the continent that we have the drive to do things differently.‎ For example, national health ministries could work in close partnership with community organizers and civil society organizations to identify unvaccinated children, and then use new digital technologies to track follow-up appointments.

With decades of experience in successfully carrying out several large-scale ‘vaccine introductions’ which is adding vaccines to national immunization programmes, Africa is no stranger to the benefits of immunization. In 2016 Heads of States and Government of African Union Member States endorsed the 2016 Addis Ababa Declaration on Immunization (Assembly/AU/Dec.624 (XXVIII) prioritizing access to safe and effective vaccines and in 2017, The African Union Heads of State and Government called on Member States to ‘mount strong advocacy campaigns to achieve the Global Vaccine Action Plan goals and overall health care delivery systems.’

 Great strides and improvements to the continent’s routine immunization systems have been achieved, a testament to the remarkable work on ground that is being done by national health ministries in partnership with organizations like the WHO and Gavi, the Vaccine Alliance. In West and Central Africa alone, these systems have been used to vaccinate more than 25 million children each year. However, as populations grow in Africa and the communities' needs continue to evolve, we must strengthen immunization programs accordingly to avoid losing the gains made. The recent resurgence in measles cases in some African Member States demonstrates what happens if we fail to act.

Ultimately, how vaccinations are scaled up and zero-dose children are reached will vary from Member State to Member State, but any approach will require innovative and flexible solutions. It is time for Africa to accelerate our efforts and make sure none of our children are left behind from the full benefits of getting vaccinated.