Last week, World Immunization Day presented an opportunity for broader discussion on the global necessity for universal immunization against deadly diseases. At the Wellbeing Foundation Africa we advocate for the universal immunization of children in West Africa, working to increase awareness of the huge benefits of this simple procedure to public health outcomes across the board.
Immunization is the process whereby a person, typically a child, is given a small dose of a disease – a vaccine - that stimulates their immune system to protect them from subsequent infection, without inducing infection. Immunization practice has come a long way over the years; in 2015, a record 86% of infants worldwide received 3 doses of the diphtheria-tetanus-pertussis vaccine, protecting them against these potentially fatal diseases. Additionally, recorded cases of polio have declined by 99% since 1988, and the World Health Organization estimates that globally, immunisation now prevents 2 to 3 million deaths per year. These figures are commendable, and a testament to the effectiveness of vaccination in preventing the spread of deadly infections.
However, despite vast progress in the field, there remains a clear space for improvement. Although there is broad scientific consensus on the importance of immunisation – both in the elimination of infectious diseases and in achieving the UN’s Sustainable Development Goals – 1.5 million children die unnecessarily each year from vaccine-preventable illness. In Sub-Saharan Africa, which suffers the lowest rate of immunisation in the world, only 42% of people are vaccinated against measles. In Nigeria, the country of my birth, just 10% of children receive the required 3 doses of the dangerous haemophilus influenza type b vaccine. These statistics highlight the need for increased awareness of vaccinations, and greater investment in their distribution.
What sets vaccinations apart from other medical practices is their ability to protect not just an individual, but a community. Immunisation is vastly more effective when everyone in the community is protected, and in areas with a small percentage of vaccinated persons, the vaccine is likely to become redundant. When a disease is contagious, levels of infection are significantly reduced when others are protected – in other words when a large portion of a community is protected there are fewer avenues of transmission to other people, and the disease will quickly disappear. This is called herd immunity, and is key to the argument for universal immunisation.
Yet sadly there has been significant backlash in recent years against vaccination. Some argue that vaccinations are dangerous and ineffective, with some pseudo-science even hypothesising the link between vaccinations and autism. Although the scientific and medical communities unanimously agree that vaccinations are pivotal in mitigating preventable diseases and achieving the SDGs, an anti-vaccination movement in the West has increasingly jeopardised the effectiveness of vaccinations for others.
In the developing world, vaccinations for various diseases have become widely available, including diphtheria, hepatitis B, and mumps, to name a few. However, the uptake of new and underused vaccines is now also on the rise, presenting an exciting opportunity for the eradication of other diseases.
Cervical cancer vaccines have been available for the past decade, increasingly reaching developing nations in recent years. Cervical cancer is one of the biggest killers of young women around the world, and the Wellbeing Foundation Africa has actively pushed for more widespread cervical cancer vaccinations in Nigeria. However, universal vaccination for the cancer-causing HPV virus is yet to come in to effect in Nigeria, or many other African nations.
This year a breakthrough in malaria immunisation has seen the first ever trial of the vaccine being introduced in 3 pilot countries: Kenya, Malawi and Ghana. Although currently not 100% effective, the vaccination has the potential to save thousands, if not millions of lives in the future.
Perhaps one of the most successful vaccination campaigns worldwide has been against polio, which declined by 99% in just 30 years. In 2016 polio remained in just 3 countries: Afghanistan, Pakistan and Nigeria, sadly appearing in Nigeria for the first time in 2 years in August of last year. The reappearance of polio in Nigeria marked a huge setback to global eradication efforts, triggering an emergency polio campaign in the affected area. In addition to polio, Meningitis C has also made a recent and unwelcomed comeback in Nigeria, with nearly 5,000 suspected cases this year. Better disease surveillance and improved monitoring systems to catch potential outbreaks early are essential if lives are to be saved. This requires stronger training for health workers, and greater funding to make this happen.
This year we have witnessed the re-emergence of diseases previously thought eradicated from our borders. This serves as testament to the critical need to drive a sustained and tireless effort towards universal immunisation in order to eradicate diseases such as these forever.
At the Wellbeing Foundation Africa we strive to ensure that all mothers and health workers can track and monitor their babies’ immunisations, so that no child under our watch goes unvaccinated. What’s more, by keeping child records we secure verifiable identities in a region where so many go undocumented.
As the founder-president of the Wellbeing Foundation Africa, I have spent much of my life advocating for greater investment and commitment to improving health outcomes in Africa. These objectives cannot be realised in the absence of universal vaccinations. In 2016 South East Asia become the second of 6 WHO regions to achieve maternal and neonatal tetanus elimination, after Europe. We want and expect the same for Africa. Vaccinating against these preventable diseases is a simple life-saving mechanism, and last week we celebrated progress in the field, while continuing to strive for universal immunisation in all corners of the globe for a better future.