GAVI warns that vaccine progress in developing countries ‘in danger of stalling

New WHO/UNICEF figures released this week show that in 68 of the world’s poorest countries, while close to a million more children received the basic diphtheria-tetanus-pertussis vaccine in 2016 compared to 2015, the coverage rate has remained at 80% for the past three years. Millions of children remain under-vaccinated in countries torn apart by conflict, from Syria to South Sudan.
The WHO and UNICEF Estimates of National Immunisation Coverage 2016 (WUENIC 2016) figures show that 19.5 million infants globally did not receive all three doses of diphtheria-tetanus-pertussis (DTP3) vaccine.
“The extraordinary improvement in immunisation coverage made since 2000 is in danger of stalling, with conflict, human and animal migration, urbanisation and vaccine hesitancy adding new barriers to global vaccination efforts,” Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance, said today.
“Since 2000 an unprecedented international effort to improve immunisation in the world’s poorest countries has helped to save millions of children from killer diseases like measles, tetanus and whooping cough,” said Dr Berkley. “Thanks to vaccines more children are now living to see their fifth birthday than at any point in history.
DTP3 coverage in Liberia increased to 79% from just 52% in 2015, while coverage in India edged up to 88% from 58% in 2000. Nigeria has overtaken India as the country with the greatest number of under-vaccinated children, with 3.4 million children missing out on DTP3 compared to 2.9 million in India.
In 2016 coverage of Haemophilus influenzae type b (Hib), pneumococcal and measles vaccines for the 68 countries in which Gavi works increased markedly. Coverage of children receiving three doses of Hib rose from 67% to 78%, pneumococcal from 35% to 41%, and the second dose of measles vaccine from 43% to 50%.
“However, while these figures need to verified by detailed country surveys, they appear to show that this extraordinary progress is in danger of stalling,” he said. “Growing trends like human and animal migration, urbanisation and vaccine hesitancy, as well as conflict, are combining to make the challenge of reaching every child even tougher. The fact that Nigeria has overtaken India as the country with the greatest number of under-vaccinated children, despite having less than a seventh of the population, is particularly concerning. We now need to work twice as hard to meet these challenges and ensure no child goes without lifesaving vaccines.”
One-quarter of infants in Gavi-supported countries are now protected against rotavirus, one of the leading causes of diarrhoea, with supported vaccines.The difference in DTP3 coverage between Gavi-supported and high-income countries is now half of what it was in 2000 (2000: 33%, 2016: 16%).
“There are positives we can take from this data,” said Dr Berkley. “Newer vaccines protecting against the leading causes of pneumonia and diarrhoea are reaching millions more children across Africa. Liberia’s health system is recovering after the damage wrought by Ebola and India’s commitment to routine immunisation is also continuing to pay dividends.”
In the 68 countries supported by Gavi an additional 5.4 million infants received their second dose of measles vaccine in 2016, 4.8 million more children were vaccinated against the leading cause of pneumonia and 2.3 million more were vaccinated against rotavirus, the leading cause of severe diarrhoea.

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