How can we ensure all children are vaccinated?

Where a child is born – the mere fact of geography – plays an important role in determining his or her future success, most critically whether or not that child lives to see his or her fifth birthday.

This harsh reality is something I have encountered time and again through my travels for Gavi, the Vaccine Alliance. I was reminded of it when reading the results of the annual State of the World’s Mothers report published this month bySave the Children. As the report emphasizes, a child’s Zip Code (postal code) should not determine the child’s fate.

Yet it does. The report notes that the “best” places to be a mom is in five Nordic countries: Finland, Iceland, Denmark, Sweden and my home nation, Norway. The so-called “worst countries” for mothers are five of the poorest places in Africa: Somalia, DR-Congo, Central African Republic, Mali and Niger.

Yet as informative as these results are, we must not draw the wrong conclusion. As the Chair of Gavi, I have had the chance to travel to some of these African countries, meet parents and cradle their children in my arms. I have seen with my own eyes the commitment of parents to the health and well-being of their children – no more and no less than those of us in northern Europe.

One of the strongest examples of geographic disparity is in vaccine availability, a key topic at the World Health Assembly gathering of nations in Geneva on 18-26 May. In order to achieve the same protection for their children against deadly diseases as mothers in wealthier countries, those who live in the poorer parts of Africa often must expend significantly greater effort to get their children vaccinated.

In remote areas, often parents must travel very long distances on foot, over rough terrain, sometimes in the dark of night, to reach their nearest clinic. I have seen some of these vaccine clinics, set up under a tree or in a field, with mothers arriving from all directions, babies strapped to their bodies. I have seen clinics in urban slums, where it can be difficult to reach parents to let them know that life-saving vaccines are available and free. These mothers and their children – in places like the African countries already mentioned – are the uncounted, the unreached, the “hidden.”

In these parts of the world infant mortality is often very high, but this doesn’t mean that mothers in poor parts of the world love their children any less or any more than those in wealthy countries. It just means that some parents have the advantage of geography in protecting their children in the life-saving blanket of vaccines.

The world can do much better in redressing the balance, to give mothers and children the world over a fair chance at a healthy life. Despite remarkable progress made by Gavi in helping to immunise half a billion children since 2000, nearly one-in-five children are still missing out, with 1.5 million dying from vaccine-preventable diseases each year.

Working closely with our country partners – including the 73 poorest countries – the Vaccine Alliance has brought new and underused vaccines to the remotest parts of the world, including the 5-in-1 pentavalent vaccine, which includes five vaccines in a single shot.

But introducing a vaccine into a country is just the beginning. That vaccine also must reach every child, no matter how remote, how difficult the terrain or how “hidden” the family.

That is why serious disparities remain, with vaccine coverage high in some regions but virtually non-existent in others. Gavi’s challenge in support of the world’s children and mothers is clear: end this disparity in coverage. Help these poor countries establish equitable, sustainable vaccine programmes.

To this end, Gavi is now embarking on a goal to increase to 50% from 5% the number of children who receive all 11 vaccines recommended by World Health Organization. By doing so, we expect to save 5 million to 6 million more lives.

This article is published in collaboration with Bill and Melinda Gates Foundation. Publication does not imply endorsement of views by the World Economic Forum.

To keep up with the Agenda subscribe to our weekly newsletter.

Author: Dagfinn Høybråten is Chair of the Board of Gavi, the Vaccine Alliance. He also is Secretary General of the Nordic Council of Ministers and previously served as Vice President of the Norwegian Parliament and Minister of Health.

Image: A child receives a polio vaccination during an anti-polio campaign on the outskirts of Jalalabad. REUTERS/ Parwiz