Scaling up immunisation to 90% will avert $17bn economic losses, say experts

 

Medical experts say scaling up immunisation to cover 90 percent of the Nigerian population will save 600,000 lives and avert US$17 billion in economic losses.

This is as the World Immunisation Week comes to an end Sunday April 30.“There is the need to raise the importance of pneumococcal vaccination for adults, elderly and risk groups, older children and adolescents (6-17 years) with underlying medical conditions as sickle cell diseases, immune-compromised and asthma.”

 

The theme for  the World Health Organisation (WHO) World Immunisation Week 2017 is #VaccinesWork, which aims to raise awareness on the critical importance of full immunisation throughout life, and its role in achieving the 2030 Sustainable Development Goals. Highlighting the need for larger immunisation reach, WHO is emphasising on the importance of countries to expand immunisation services beyond infants and children to cover the whole life course, and determine the need, as well as the most effective and efficient means of reaching other age groups within integrated health service provision.

 

“Currently, globally, about 2 – 3 million deaths are prevented every year from immunisation with the basic/routine vaccines (deaths that would have resulted from diphtheria, tetanus, pertussis (whooping cough), and measles) Sadly, globally, nearly 20 million infants are still not receiving these basic/routine vaccines annually”  said Annette Akinsete,  a consultant, public health physician and CEO, Sickle Cell Foundation, Nigeria.

 

Proffering solution on the way forward, Akinsete states “Government has already instituted policies and programmes for immunisation in Nigeria. Political will is strong. A major challenge is the variation in vaccine coverage across the geo-political zones of the country. This continues to pull down our coverage statistics.

“Specifically-tailored interventions (that address socio-cultural and religious considerations) need to target the North West and North East zones where coverage is by far the least in the country. Furthermore, non-governmental actors should be mobilised to collaborate with government in implementing its policies, plans and programmes,” she said.

 

Sadly, some people do not necessarily see the need for vaccination and Abdulrazaq Habib, a professor of infectious diseases at Bayero University Kano, and President, Nigerian Infectious Diseases Society, is of the opinion that when you are vaccinating, you are vaccinating healthy people and in that sense, it is not perceived as high priority. For him, people may believe that it’s not worth the investment at that time, even though vaccination is probably the most cost effective health intervention that any country should invest in.

In his words, “it’s a great shame that as a country, we do not pay enough attention to vaccination. Only now, when the epidemic is raging and there have been over 500 deaths and over 8,000 patients affected that we are running helter-skelter to get the vaccine. It’s the same reason for the lack of priority. Government will prefer to address the already sick people than safeguard the healthy, and this shouldn’t be the case

“Continued enlightenment, sensitisation, political will, active or pro-active engagement of leadership and traditional community leaders will make great and positive impact. If communities realise that even their traditional leadership is involved, and they are informed of vaccinations and immunisations, then it becomes much more acceptable.

“Also, I think we may have to consider such rules and regulations that obtain in other parts of the world, like when it comes to enrolling a child into a school, potentially you may want to see his vaccination card before such child is enrolled,”  Abdulrasaq said.

Vaccines are indeed the most inexpensive ways of improving health and reducing death and diseases caused by infectious organisms but sadly, there are several bottle necks and barriers to routine immunization in Nigeria which according to Magdalene Odunvbun, Consultant Pediatrician/Senior Lecturer, University of Benin/University of Benin Teaching Hospital is quite sad, especially as the political will to drive immunisation in Nigeria is very poor.

“Nigeria operates a three-tier system of government and each tier of government has its own role in immunisation. The Federal Government is solely for procuring vaccines and providing technical support. Adequate budgets must be made at this level to buy vaccines and this can only be achieved if the government considers immunization a priority.  Primary health care and immunisation are the responsibility of the Local governments. Funds are usually not available to drive an effective immunization programme. The fund constraints identified were due to failure to expand than failure to budget.

“There are federal and state budgets for routine immunisation, but the release of this fund is neither guaranteed nor timely. The same occurs at the Local Government Areas, provisions are made but funding disbursements are not made.

“The end result is that immunisation programmes are poorly conducted because the programme managers and health care workers complain of lack of funds to fuel their vehicles to go to the state or LGA stores to collect vaccines, they are unable to power their generators to maintain the cold chain necessary to preserve the vaccines”. Odunvbun revealed.

For Odunvbum, The government must realise that immunisation is actually the cheapest way to protect the health and wellbeing of their populace and should therefore invest more on it instead of waiting for international donors. She further stressed the need for financial guarantee and flexible funding which she believes will improve the likelihood that funds budgeted for vaccines are used solely for that purpose.

“The government should provide legislation, build national capacities, improve monitoring and data quality, improve vaccine management, safety and regulation, research and innovation. They should strengthen the immunisation system through adequate staffing, adequate resources, and adequate supply of vaccines.

“Scaling up immunization coverage to 90% will avert $17 billion USD in economic losses and will save more than 600,000 lives over the next 10 years.” She added.

Little global attention has been paid to the social and economic costs and consequences of older adults not being vaccinated against pneumonia. Pneumococcal disease has been estimated to cause 1.6 million deaths per year worldwide, of which an estimated one million of these are children aged under 5 and 600,000 – 800,000 are adults.

Decreased birth rates and longer life spans indicate that the global population is aging, although rates of aging differ between countries.

While the role of vaccination in protecting children from vaccine preventable infectious diseases is well recognized, there is a need to build the case for the value of such preventable measures on adult health.

 

KEMI AJUMOBI