Recently, the media has been awash with alarming headlines about a proposal to provide family planning for children as young as 10 years. The media is doing a great job to bring these issues to the fore front for debate. This is the only way to garner meaningful and collective insight on issues affecting young peoples’ heath and rights.
In January, President Museveni together with other African Heads of State, endorsed the Addis Declaration on Immunisation, a Pan-African commitment to invest in immunisation programmes and give all children equal access to lifesaving vaccines. Because vaccines hold so much promise for children, I am hopeful this public commitment will result in accelerated efforts in Uganda to extend the benefits of immunisation to everyone.
Already, good progress has been made to increase access to immunisation throughout the continent, including a 50 per cent decline in child deaths, higher vaccine coverage, interruption of wild poliovirus transmission, and near elimination of a strain of meningitis that has long plagued this region. At the same time, universal immunisation has not yet been achieved. New efforts, investments, and strategies will be required to reach 90 per cent immunisation coverage in all African countries by 2020, a goal set forth in the African Vaccine Action Plan.
Here in Uganda, immunisation coverage has stagnated in recent years, with just over three-quarters of Ugandan children receiving all recommended vaccines. But that means that nearly one in four Ugandan children receive only some vaccines, or in some cases, none at all. Despite efforts to rectify the situation, health worker shortages and high turnover rates combined with lack of funds to transport vaccines and keep them cold are hampering immunisation efforts in many parts of the country. This, of course, is coupled with global stock-outs of some vaccines like pneumococcal conjugate vaccine.
To overcome these issues, the Uganda National Immunisation Technical Advisory Group (NITAG) was established in 2015 with a goal to provide guidance on decisions relating to the introduction of new vaccines and programmatic issues. Ugandan leaders also formed a Parliamentary Forum on Immunisation to draft an Immunisation Act that aims to increase demand for immunisation from the community and tasks the government with increasing domestic financing for immunisation. The NITAG was instrumental in including a provision in the Act for an immunisation fund that will ensure that more government funding is available for immunisation services, especially at the local level. What’s needed now is oversight to ensure that these funds are actually allocated to immunisation and disbursed on time. I am hopeful that by signing the Addis Declaration, our President and other heads of state will follow through on the promises already made in Uganda and elsewhere in Africa.
In 2016, PATH took a group of Ugandan immunisation officials to Vietnam to learn about their cold chain equipment maintenance programme. This learning trip was an opportunity to share lessons and innovations that have since been introduced to the Uganda immunisation programme; more of these are planned to build local immunisation supply chain and logistics capacity. PATH was also instrumental in generating and providing data to the NITAG to help them make decisions around the human papillomavirus vaccine introduction.
I believe that no one should suffer or die for lack of or inaccessibility to a vaccine. A shot in the arm or a few drops of vaccine in a child’s mouth can be the difference between a child’s healthy future and a family’s grief.
With equitable access to vaccines, children have a better chance of reaching a healthy adulthood and exercising their full potential. The children of Uganda are counting on leadership from the highest levels of government to turn political commitments like the recent endorsement of the Addis Declaration into action and extend the full benefits of immunisation to all.
Dr Atuhebwe, MD, MPH is the Africa and Asia Regional Technical Advisor for vaccines and immunisation with PATH’s Centre for Vaccine Innovation and Access.