Delivering beyond 1 billion: The game changers globally

Esther Nasikye

What you need to know:

  • The one billion milestone gave us the motivation needed to reach the remaining millions of children who still miss out on the life-saving benefits of immunisation.

One billion is an astronomical figure by any means, but even more so in counting the number of children reached by Gavi, the Vaccine Alliance thus far.
While this is no mean feat, there is a great deal of work ahead of us to ensure no child is left behind with immunisation. Which begs the question, “What will successfully take us to the finish line?”

During the Vaccine Impact Conference held last month, different speakers echoed the need to look beyond the traditional immunisation partners like governments and United Nations agencies and work with groups that are close to the communities we intend to reach.
We are targeting  zero-dose communities and under-immunised children or those without access to information and services.

Partnerships that will help us address vaccine hesitancy and its root causes, including social-cultural norms and gender practices that hinder children from accessing lifesaving vaccines. That is where civil society partners remain an integral part of the Alliance.
For example, civil society groups in Uganda provided communication-related technical assistance to the government to drive up demand for immunisation services during the Covid 19 pandemic.

They worked hand-in-hand with faith and cultural leaders, community champions, and elected representatives to ensure the continuity of essential immunisation services during the pandemic period.
As we strive to ensure no one is left behind, we must move away from cookie-cutter approaches.

We need to design global, country, and community strategies to reach the zero dose and missed communities that the current systems have traditionally left out.
The place of data in this equation cannot be overemphasized. Robust, accurate, up-to-date data is essential to help advocates and technical and political decision-makers make informed decisions to increase coverage.

In addition, reaching missed populations requires us to be flexible and agile in our work. Embracing new technologies will help us deliver vaccines to the most underserved areas at a reduced cost.

In addition, there is a need to build vaccine confidence and make the most of new digital approaches that can highlight the power of vaccines and ensure they reach every child.
Reaching the last mile and ensuring no one is left behind also calls for community engagement. Ensuring that political and technical decision-makers listen to the community’s voices when allocating budgets, introducing vaccines, addressing hesitancy, and reaching targeted groups, for example, with the HPV vaccine.

Finally, sociocultural barriers, including gender-related barriers to immunisation are prevalent in many countries and require a holistic approach.
For example, to address the barriers to access for the HPV vaccine, we must look at the needs of adolescent girls, the household, the community, and the health system that delivers services for them.

Meanwhile, to reach children who are missing basic childhood immunisation in the poorest, most remote, and most marginalised communities, it is vital to prioritise investment in primary health care. If primary healthcare systems are not built to reach the most vulnerable, they will continue to be missed.

The one billion milestone gave us the motivation needed to reach the remaining millions of children who still miss out on the life-saving benefits of immunisation but we must fine-tune our approach, or else we risk falling short of our targets.

The Alliance, since its inception,  has helped countries to protect people, including children from diseases through injecting funds into the prevention and management of potentially fatal diseases.  It hopes to spend  $10.5 billion (about Shs38.4 trillion) between 2021 and 2025 on meeting its various targets across the world.
Ms Esther Nasikye is the Global MNCH and immunisation advocacy lead at PATH Uganda. She has over 14 years of experience in public health policy, stakeholder engagement and advocacy.