Kate O'Brien, Director of the Department of Immunization, Vaccines and Biologicals at WHO
In February, we marked the revitalisation of the Measles and Rubella Initiative, under the new banner of the Measles and Rubella Partnership, together with UNICEF, US CDC, the American Red Cross, Gavi and the Bill and Melinda Gates Foundation. The Measles and Rubella Initiative was launched in 2000: From 2000 to 2021, the annual number of estimated measles deaths decreased 83 per cent.
Then came the pandemic, and as a result of COVID and related disruptions we have witnessed the worst continued backsliding in global immunization coverage in 30 years. Measles vaccination coverage has suffered, with the latest data indicating that 40 million children missed at least one dose of measles vaccine in 2021 alone. The goal of the Measles and Rubella Partnership (MRP) is to collaborate with countries and partners to achieve the Immunization Agenda 2030 (IA2030) target to save another 50 million lives through access to essential vaccines by the end of 2030, with measles immunization contributing a large percentage.
The transition comes at a time when we need to work more closely than ever before to address the majority of missed and unimmunized children born during 2019 and 2022, noting that in 2021 alone, 25 million children who missed at least one essential vaccine in 2021 and the 18 million children who received no vaccines at all. Our action on immunization in the years leading to 2025 will shape how the story of the pandemic is written. If we fail, we will see tragedies like unprevented cervical cancer and increased child mortality, leading to more deaths in generations that should have been living longer.
We commend the countries have made great strides in recovering immunization programmes during the height of the pandemic, while noting more remains to be done. Under the banner 'The Big Catch-up', WHO, and partners will coordinate a year-long global push to mobilize and amplify country plans and implementation for catching up on missed children, commitments and plans for catch up, recovery and strengthening. The sum of WHO and partners' year-long activities will be targeted to help achieve catch-up of: (1) individuals who missed out on vaccinations during the pandemic period (by 2023 and at latest by 2025); (2) immunization programme recovery to at least 2019 coverage levels (by 2023); and (3) immunization programme strengthening, to get back onto the 2030 trajectory (by 2023 and at latest by 2025). These partner efforts will mobilize and accelerate country commitments and plans for catch up, restore and strengthening, while also mobilizing public support to vaccinate the millions of children and adolescents who have or will be missed, unless action is taken now.
In 2023, World Immunization Week (WIW), 24-30 April, will be a foundational pillar in this year-long advocacy and communications push, 'The Big Catch-up', to recover lost progress in essential immunization through catch-up, recovery and programme strengthening efforts.
WHO will use the WIW 2023 platform to highlight successes from countries from the last few years, with a 'Week of Wins' programme of activities to inspire action by showcasing progress. The visual identity for WIW is being finalized and soon we will share with you the social media hashtags, toolkit and assets. We anticipate the utility and adaptability of developed assets and cross sharing through the WHO website linking to assets regional and country content, as well as an external WIW microsite to showcase WHO and partner activities.
During my recent visit to Kenya, I lauded the Ministry of Health's leadership for its resilience in sustaining immunization through COVID-19 and for the positive impact of the malaria vaccine, with nearly 400,000 children reached with the malaria vaccine in the country as of March 2023, resulting in a substantial reduction in severe malaria and a drop in child deaths. Kenya very recently launched expansion of malaria vaccine delivery into new areas that will more than double the number of children with access to the life-saving vaccine. Across the three pilot countries of Ghana, Kenya and Malawi more than 1.3 million children are protected by the malaria vaccine and more than 4.0 million doses have been administered. Demand for the vaccine is unprecedented with at least 28 countries expressing interest in applying for Gavi support to introduce the vaccine. Of these, 12 countries have submitted a formal application at the first opportunity in the January 2023 application round. The three pilot countries have already been approved by Gavi to receive vaccine support to maintain vaccination services in the pilot areas once the pilot programme ends at the end of 2023.
Kenya like many other countries is experiencing outbreaks and I had the opportunity to observe the campaign to mitigate the current cholera outbreak during my visit. Through our ongoing efforts and commitments for catch up, recovery and strengthening, we are amplifying the urgency to act. We must support countries to avoid multiple outbreaks of life-threatening diseases like cholera, diphtheria, measles and yellow fever and to help every child catch up on their measles, polio and other vaccines.
We commend the African Union (AU) for its leadership on two recent events, demonstrating political alignment and leadership on immunization recovery efforts and strengthening in Africa. We welcome the AU declaration on "Building momentum for routine immunization recovery in Africa" at the Heads of State Summit on 19 February, in Addis Ababa, Ethiopia. The declaration can be found here.
In 2023 we will continue to implement our collective work on our portfolio of highest priority activities including HPV, measles, malaria and zero dose towards securing the interruption of wild polio transmission, reducing zero dose and achieving measles control, while recognizing the need for immunization programme strengthening cannot be overstated.
Looking forward to welcoming you all to follow our meeting of The Strategic Advisory Group of Experts on Immunization (SAGE), 20-23 March 2023. The link to the agenda can be found here.
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