Immunisation and global solidarity

Vaccines have dominated the news agenda recently for obvious reasons. But it can be easy to forget that Covid-19 is not the only threat to global health and that many other diseases require essential vaccination programmes to be kept under control. Nevertheless, the current pandemic has made it difficult for these programmes – which vaccinate against life-threatening diseases like measles, yellow fever, and diphtheria – to stay fully operational.

While immunisation services have begun to recover from disruptions caused by Covid-19, millions of children remain vulnerable to deadly diseases, according to the World Health Organisation (WHO), UNICEF, and Gavi, the Vaccine Alliance. During World Immunisation Week, which took place between 24-30 April, the organisations highlighted the urgent need for a renewed global commitment to improve vaccination access and uptake.

A WHO survey has found that, despite progress when compared to the situation in 2020, more than one-third of respondent countries (37 per cent) still report experiencing disruptions to their routine immunisation services.
Mass immunisation campaigns are also disrupted. According to new data, 60 of these lifesaving campaigns are currently postponed in 50 countries. This is putting around 228 million people, mostly children, at risk.

Over half of the 50 affected countries are in Africa, which highlights protracted inequities in access to these critical immunisation services. Measles campaigns account for 23 of the postponed campaigns, affecting an estimated 140 million people. As a result of gaps in vaccination coverage, serious measles outbreaks have recently been reported in countries including the Democratic Republic of the Congo, Pakistan, and Yemen.

The supply of vaccines and other equipment is also essential for child vaccinations. Due to disruptions at the onset of the Covid-19 pandemic, UNICEF delivered 2.01 billion vaccine doses in 2020, compared to 2.29 billion in 2019.
In response to this worrying situation, WHO, UNICEF, Gavi, and other partners have launched the Immunisation Agenda 2030 (IA2030), a new global strategy to build stronger immunisation systems.

Among the strategy’s calls is for the pharmaceutical industry and scientists, working with governments and funders, to continue to accelerate vaccine development, ensure a continuous supply of affordable vaccines to meet global needs and “apply lessons from Covid-19 to other diseases”.

But Covid-19 is shining a new light on how vaccination development, pricing, and indeed purchasing, is often far from equitable.

Recent data from Duke University’s Global Health Innovation Centre show high-income countries currently hold a confirmed 4.7 billion doses of Covid-19 vaccines and, upper middle-income countries hold 1.5 billion. This compares to lower middle-income countries, which hold 732 million doses, and low-income countries, which hold 770 million. Many high-income countries have also advance purchasing of enough doses to vaccinate their population several times over.
Current models predict there will not be enough vaccines to cover the world’s population until 2023 or 2024.

In this context, initiatives such as the COVAX alliance are critical to ensuring equitable allocation of vaccines internationally. It is also essential that the pharmaceutical industry does not price lower income countries out of the market. Without global solidarity, the threat of Covid-19, and its knock-on impact on other vital health services, will continue for years to come.