Above, photo by Nina Raingold Save the Children, UK Creative Team
Pneumococcal vaccine before it is administered at Lodwar County Hospital, Turkana region, Kenya. Babies are routinely offered the pneumococcal vaccine at age 6 weeks to prevent them from contracting pneumonia. However, many families don't have the means to travel to hospital to obtain the vaccine.
By: Kirsten Mathieson, Save the Children UK
The coming year will be critical to getting it right for the nearly 20 million children still missing out on immunization. Governments and national and global immunization partners must step up to the plate so that all children have access to this and other vital health services.
The post-2020 global immunization vision for the next decade is being crafted this year for approval at the 2020 World Health Assembly. Simultaneously, Gavi, the Vaccine Alliance, is developing its next five-year strategy – which will guide its support to eligible countries (traditionally low-income countries with gross national income per capita less than or equal to US$1,580) – and is gearing up for its third replenishment.
The next global immunization plan and Gavi 5.0 give us an opportunity to reflect on the path ahead and align all stakeholders around an agenda of equity, access and sustainability. In the year ahead, three key questions require focused attention and discussion.
1) How can the countries and the global community can step up efforts to close the immunization equity gap? Far too many children are still missing out on immunization. Inequalities in coverage across and within countries mean that children from the poorest families, the most remote areas and marginalized groups continue to be systematically left behind and excluded from this critical health intervention. Our Recent analysis shows that more than half of Gavi-supported countries with available disaggregated data (29 out of 55) have poor performance in terms of equity. Meanwhile, two-thirds of unimmunized children are living in conflict-affected countries.
2) How can the next global plan and Gavi 5.0 prioritize strengthening immunization systems as part of comprehensive primary healthcare? Primary health care (PHC) is a critical foundation for equitably and sustainably delivering immunization and other critical services. Increased public investment in primary healthcare systems should be at the core of global immunization efforts. An integrated, strategic approach to immunization is critical to ensuring equitable allocation of resources to neglected regions, areas and groups and should be a priority for national governments. Support from donors and global stakeholders must also be seen through this lens, getting behind national UHC priorities and plans, and supporting domestic resource mobilization.
3) How can Gavi, UNICEF, countries & vaccine manufacturers intensify efforts to improve vaccine affordability & access? There is little doubt the years ahead will see a significant focus on pricing issues as we address the complex issues that shape the vaccine market. Immunization stakeholders must explore how best to incentivize sustainable affordable pricing and develop innovative ways to leverage the purchasing power of UNICEF and countries. In addition, increased efforts are needed to strengthen demand forecasting, vaccine procurement and price negotiation. Future efforts and proposals will be needed to determine how global pricing can evolve to maintain healthy vaccine markets -with robust innovation and diverse suppliers- while simultaneously ensuring vaccines are affordably priced, so all children have access, regardless of where they are born.
Now is the time to focus on these key areas and build the programmatic and financial sustainability of immunization programs everywhere, as part of comprehensive primary health care. As these globally reaching strategies are developed, it’s crucial we get them right – the stakes couldn’t be higher!
About the author: Kirsten Mathieson is Save the Children UK’s Head of Health Advocacy. She leads the organization’s immunization policy and advocacy work, delivering strategies, strengthening partnerships and engaging in policy debates to drive progress towards universal immunization coverage.