{"id":41943,"date":"2018-04-26T13:15:42","date_gmt":"2018-04-26T12:15:42","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=41943"},"modified":"2018-04-26T16:24:40","modified_gmt":"2018-04-26T15:24:40","slug":"laura-kerr-using-opportunities-from-polio-eradication-to-address-weaknesses-in-global-immunisation-systems","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2018\/04\/26\/laura-kerr-using-opportunities-from-polio-eradication-to-address-weaknesses-in-global-immunisation-systems\/","title":{"rendered":"Laura Kerr: Using opportunities from polio eradication to address weaknesses in global immunisation systems"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/04\/LK-April-2016-3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-41952\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/04\/LK-April-2016-3-150x150.jpg\" alt=\"\" width=\"150\" height=\"150\" \/><\/a>We all know that vaccines work. Yet <a href=\"http:\/\/www.who.int\/mediacentre\/news\/releases\/2017\/infants-worldwide-vaccinations\/en\/\"><span style=\"font-weight: 400\">one in ten children <\/span><span style=\"font-weight: 400\">in the world<\/span><\/a><span style=\"font-weight: 400\"> still receive no vaccines. Millions more do not receive all 11 WHO recommended vaccines and only <\/span><a href=\"https:\/\/www.gavi.org\/about\/mission\/facts-and-figures\/\"><span style=\"font-weight: 400\">7% of children<\/span><\/a><span style=\"font-weight: 400\"> in the world\u2019s 73 poorest countries are fully immunised. In Nigeria, a recent survey confirmed <\/span><a href=\"https:\/\/www.unicef.org\/nigeria\/NG_publications_mics_201617.pdf\"><span style=\"font-weight: 400\">national immunisation coverage was just 33%<\/span><\/a><span style=\"font-weight: 400\">. In some states, this is as <\/span><a href=\"https:\/\/www.unicef.org\/nigeria\/NG_publications_mics_201617.pdf\"><span style=\"font-weight: 400\">low as 3%<\/span><\/a><span style=\"font-weight: 400\">. In 2017, the Nigerian government declared their low immunisation coverage a state of emergency, and launched a new <\/span><a href=\"http:\/\/nphcda.gov.ng\/inauaguration-national-emergency-routine-immunization-coordination-centre-nericc\/\"><span style=\"font-weight: 400\">National Emergency Routine Immunisation Coordination Centre (NERICC)<\/span><\/a><span style=\"font-weight: 400\"> to tackle the vast inequalities of immunisations across the country. \u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">In the past 18 years, we\u2019ve seen the creation of Gavi, the Vaccine Alliance, a partnership which has completely changed the financing for immunisation programmes and has helped save an estimated\u00a0<\/span><a href=\"https:\/\/www.gavi.org\/about\/mission\/facts-and-figures\/\"><span style=\"font-weight: 400\">9 million lives<\/span><\/a>\u00a0<span style=\"font-weight: 400\">globally. Since its launch the <\/span><a href=\"http:\/\/www.who.int\/immunization\/global_vaccine_action_plan\/GVAP_doc_2011_2020\/en\/\"><span style=\"font-weight: 400\">Global Vaccine Action Plan 2011-2020<\/span><\/a><span style=\"font-weight: 400\"> has defined global immunisation goals, which has driven unprecedented efforts towards immunisation. Immunisation rates are now at an all-time high. But when over <\/span><a href=\"http:\/\/www.who.int\/immunization\/monitoring_surveillance\/who-immuniz.pdf?ua=1\"><span style=\"font-weight: 400\">19 million children<\/span><\/a><span style=\"font-weight: 400\"> every year miss out on the most basic vaccines, something more needs to change.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Doing things differently can be challenging. Few opportunities exist for governments and global health institutions to reflect on what\u2019s been working and what hasn\u2019t<\/span><span style=\"font-weight: 400\">\u2014<\/span><span style=\"font-weight: 400\">until now. We currently have a very rare and unique opportunity to refocus global efforts on routine immunisation to ensure all children receive all 11 WHO recommended vaccines. Both the challenges and opportunities are explored in RESULTS UK\u2019s report, \u201c<\/span><a href=\"https:\/\/www.results.org.uk\/sites\/default\/files\/files\/A%20Balancing%20Act.pdf\"><span style=\"font-weight: 400\">A Balancing Act.<\/span><\/a><span style=\"font-weight: 400\">\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">As we near polio eradication, one of the world\u2019s largest health partnerships, the <\/span><a href=\"http:\/\/polioeradication.org\/\"><span style=\"font-weight: 400\">Global Polio Eradication Initiative (GPEI<\/span><\/a><span style=\"font-weight: 400\">) is winding down. This process has already started, with the GPEI budget <\/span><a href=\"http:\/\/polioeradication.org\/wp-content\/uploads\/2017\/07\/TIMB_Report-no1_Jul2017_EN.pdf\"><span style=\"font-weight: 400\">reducing by 50%<\/span><\/a><span style=\"font-weight: 400\"> between 2017 and 2019. The GPEI has had a <\/span><a href=\"http:\/\/polioeradication.org\/wp-content\/uploads\/2016\/07\/BeyondPolio_FactSheet.pdf\"><span style=\"font-weight: 400\">global impact far beyond polio eradication<\/span><\/a><span style=\"font-weight: 400\">, with health workers also spending time in local communities on routine immunisation and other primary healthcare services. There are hundreds of health volunteers and workers who have worked together to ensure every child in the hardest to reach communities are immunised against polio. Micro-planning systems which map and target the hardest to reach children, engagement with communities and faith leaders, and global and country mechanisms which ensure immediate responses to outbreaks, have all helped efforts to eradicate polio.<\/span><\/p>\n<p><span style=\"font-weight: 400\">But what could happen if instead of focusing on one disease, we focused all our efforts on building stronger systems which can deliver all 11 WHO recommended vaccines, thereby ensuring the highest level of protection against vaccine preventable diseases, enhancing global health security, and developing a strong foundation of a primary healthcare system as a stepping stone towards universal health coverage?<\/span><\/p>\n<p><span style=\"font-weight: 400\">Historically, the polio programme and other routine immunisation efforts have been largely separate\u2014even though both are an essential part of the same immunisation system. Polio is one of the 11 WHO recommended vaccines and strong routine immunisation systems are required to deliver the inactivated polio vaccine (IPV) for at least 10 years after polio eradication to ensure that the world remains polio free. Addressing this separation, working towards one end goal of robust, sustainably financed, and country owned routine immunisation systems is the only endpoint we can collectively work towards if we want to ensure vaccines reach all children.<\/span><\/p>\n<p><span style=\"font-weight: 400\">No other health partnership of similar size to GPEI has ever faced a transition of this kind. With large unknowns and a complex web of country, regional, and global planning, managing the wind-down of the GPEI effectively will be a formidable task. Without concentrated efforts, we risk blindly looking for ways to replace one financing mechanism with another. We need to take a long term view of what is needed to create stronger, functioning routine immunisation.<\/span><\/p>\n<p><span style=\"font-weight: 400\">If we act now, we can turn the wind-down of the GPEI into a once in a generation opportunity to address weaknesses in global immunisation systems. We can capture best practices to reach the children who are left behind, learn from and adapt existing systems, and ensure that the health and wellbeing of a child is at the centre of what comes next, not a specific disease.<\/span><\/p>\n<p><span style=\"font-weight: 400\">If we are serious about making vaccines work for all children we need to change something, and the moment to do that is now.<\/span><\/p>\n<p><i><span style=\"font-weight: 400\"><strong>Laura Kerr<\/strong> is the senior policy advocacy officer at RESULTS UK. She leads RESULTS child health policy portfolio and leading on engagement with DFID, Gavi and GPEI. She is also a member of the Gavi CSO Steering Committee. Twitter:\u00a0<a href=\"https:\/\/twitter.com\/lauramakerr?lang=en\">@lauramakerr<\/a>\u00a0<\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400\"><strong>Competing interests<\/strong>: None declared.<\/span><\/i><\/p>\n","protected":false},"excerpt":{"rendered":"<p>We all know that vaccines work. Yet one in ten children in the world still receive no vaccines. Millions more do not receive all 11 WHO recommended vaccines and only [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/04\/26\/laura-kerr-using-opportunities-from-polio-eradication-to-address-weaknesses-in-global-immunisation-systems\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":41781,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[263],"tags":[],"class_list":["post-41943","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-global-health"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Laura Kerr: Using opportunities from polio eradication to address weaknesses in global immunisation systems - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/04\/26\/laura-kerr-using-opportunities-from-polio-eradication-to-address-weaknesses-in-global-immunisation-systems\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Laura Kerr: Using opportunities from polio eradication to address weaknesses in global immunisation systems - The BMJ\" \/>\n<meta property=\"og:description\" content=\"We all know that vaccines work. 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Yet one in ten children in the world still receive no vaccines. 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