Jimmy Carter and Kofi Annan tag teamed for an op-ed about the value of vaccination campaigns in the fight against child mortality, which is part of MDG4. Childhood vaccines have a great track record when properly implemented. In fact, they call vaccination campaigns against Measles and Polio among the “world’s most successful childhood health interventions.” The problem is, these gains are starting to slip. The two Elders explain what needs to be done:
Since June 2009, more than 30 African countries have experienced measles outbreaks resulting in more than 89,000 cases and 1400 deaths. The World Health Organization estimates that the combined effect of decreased financial and political commitment may result in a return to over 500,000 measles deaths a year by 2013, erasing progress achieved over the past 18 years. Why is this?
First, prevention is invisible. When immunization is successful, nothing happens. In contrast, disease or injury is highly visible and demands attention. Those who are sick with malaria, TB, or HIV are in immediate need of treatment and can be passionate advocates. In contrast, there are not the same kinds of passionate advocates for prevention as there are for treatment. Furthermore, children do not vote and cannot influence social priorities. So, immunization often receives lower priority.
Second, the global economy and many individual developing country economies are in deep distress. This lessens the likelihood they will invest in low visibility activities despite very high returns.
Third, there is both donor and recipient fatigue. Donors are tired of being asked to give more even though gains are measurable by decreases in child deaths. Recipients often get tired of having to ask for more, especially when they are having difficulty sustaining the costs of new vaccines.
What needs to be done to save more children? We need a balanced immunization investment strategy that reinforces routine immunization, achieves existing initiatives to eradicate polio and reduce measles deaths by 95 percent, and enables introduction of new vaccines. At the global level, developed countries and philanthropies need to recognize that developing country needs are increasing as new life-saving public health measures become available, and adjust their support accordingly. National governments must review budgetary priorities and increase their support of their own programs — for example, many countries are not currently providing the 50 percent of operational costs for follow-up measles campaigns requested by the Measles Initiative. At the local level, people must demand that vaccines and immunization services be made available without barriers. Only by concerted actions at local, national, and global levels can we fully realize the massive potential benefits of vaccines.