This blog post from Taryn Russell, Campaigns Officer - Child Health and Vaccines at RESULTS Canada, is the fourth in our World Immunisation Week series on “Closing the Gap on Immunisations”. Stay tuned for more posts from our ACTION partners around the world! For 3,000 years smallpox was one of the world’s most feared diseases. The virus caused fevers, sore throats, and vomiting in its victims, followed by a rash on the face and body. The rash preceded disfiguring and painful sores and, for 30% of those infected, death. In the 20thcentury alone, it’s estimated that more than 300 million people worldwide died from smallpox but today, the only place you will find a smallpox victim is in the history books. The last known case of wild smallpox occurred in Somalia in 1976. Why is this case? Because vaccines work. In 1798 Edward Jenner made an observation that would save millions of lives and revolutionise medicine. He noticed that milkmaids previously infected with cowpox were not susceptible to smallpox. His experiments with inoculation were refined throughout the next 200 years and resulted in a successful global effort to eradicate smallpox spearheaded by the World Health Organization (WHO) in the 1960s and 1970s. Vaccines are one of the most successful public health interventions ever. The WHO estimates that vaccines prevent between 2 and 3 million deaths annually, not only saving lives, but also allowing people to thrive by protecting them from both disability and illness, and producing major economic benefits. Healthy children stay in school longer, bringing greater long-term benefits to themselves and their families. Vaccines also take the strain of treating preventable diseases off often already overburdened health systems. Progress due to vaccinations over the last century has been nothing if not astounding but there is still much more work to be done. In 2015 it is estimated that 1 in 5 children will miss out of life saving immunizations. This gap means that millions of the world’s most vulnerable children are susceptible to illnesses such as child pneumonia and diarrhoea, both leading causes of child mortality and both vaccine preventable. How do we close the immunization gap? The WHO has identified three key steps which will require a concerted global undertaking to address. First, we must integrate immunization with other health services. By combining the delivery of vaccinations with other health interventions on issues that affect infants and children such as malnutrition and vitamin deficiency we can reduce inefficiencies in delivery and ensure children are getting all the health services they require. Secondly, we must strengthen health systems so that they can continue vaccination through crises. The importance of this cannot be overstated as we saw the decimation of health systems during the recent Ebola outbreaks in West Africa. Lastly, but perhaps most importantly, we need to ensure that vaccines are accessible and affordable to all. This is a real issue as a recent report by Medicins Sans Frontieres found that the cost to fully immunize a child has increased a whopping 68 fold from 2001-2014. The high price of vaccines means that not only are the poorest countries having difficulties procuring and vaccinating their populations but that middle income countries are also being priced out of vaccines and large swatches of the population are going unprotected. Donors have attempted to address these steps by pledging $7. 5 billion over 2015-2018 to Gavi the Vaccines Alliance, the public-private partnership launched in 2000 to provide vaccines to the world’s poorest. Gavi also does work on strengthening health systems and shaping the vaccines market to try to ensure that vaccines are accessible for all. This is a good first step but it will be imperative that countries are held accountable for following through on these pledges. Closing the immunization gap will also require political will along with money as governments need to prioritize immunization within their health budget. Governments as well as civil society also need to emphasize the importance and benefits of vaccines to their populations as everyone needs to fully buy in to power of vaccines if we are to close the immunization gap once and for all. Let’s not make the eradication of smallpox a once in a lifetime anomaly. Let’s repeat this grand success and continue to eliminate vaccine preventable diseases as well as protect against those that are here to stay. It will be important for all governments to support the Global Polio Eradication Initiative as they lead the global effort to permanently rid the world of one of its most debilitating diseases. Polio – you’re up next!” Polio – you’re up next!