Africa’s Vaccination Test

Folake Olayinka

In February in Addis Ababa, African health ministers signed a widely celebrated declaration of their commitment to keeping immunization at the forefront of efforts to save the continent’s children from death and disease. Fulfilling that commitment will be no easy feat. Immunization is not just a health issue; it is also an economic challenge.

The case for vaccination is strong. Globally, an estimated 2-3 million child deaths and 600,000 adult deaths are prevented annually through immunization. Moreover, immunization is considered one of the most cost-effective public-health interventions for reducing child morbidity, mortality, and disability. A recent study estimates that every dollar spent on vaccination will save $16 in costs of illnesses averted. Accounting for the value individuals place on longer and healthier lives, net returns on investments in immunization soar to some 44 times the cost. And net returns exceed costs for all vaccines.

Significant progress has been made. In 2014, 86% of children were immunized against diphtheria, tetanus, and pertussis, compared to less than 5% in 1974. And there have been extraordinary advances in the number and kinds of vaccines that are available.

Yet, worldwide, an estimated 18.7 million infants are not being reached by routine immunization services. The problem, of course, is access.

Detailed analysis of immunization reveals significant disparities within and across countries. More than 60% of the non-immunized infants live in just ten countries: the Democratic Republic of the Congo (DRC), Ethiopia, India, Indonesia, Iraq, Nigeria, Pakistan, Philippines, Uganda, and South Africa.

Routine immunization coverage remains particularly low in Africa; indeed, it has stagnated over the last three years, against a backdrop of weak and under-resourced health systems. As a result, one in five African children still do not receive lifesaving vaccination. In 2014, an estimated 42% of all global deaths from measles were in Africa.

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