Immunisation allows people to live in freedom from the fear of disease. Coronavirus has laid this truth bare - as humanity is exposed to a disease it has no protection from, life as we know it totally alters.
The COVID-19 pandemic has caused the largest shift in the way humans operate since the Second World War. No single issue has had such a drastic impact on our lives, significantly affecting all parts of our society. Politics has responded to the crisis by implementing an unimaginable shift in the focus of our health systems. Within weeks the UK government, and governments around the world, were desperately fighting to ensure that health systems were focused on tackling the pandemic. While this shift is both important and essential it has brought substantial knock-on effects, with the fall in the delivery of immunisation services among the most concerning.
Immunisation saves 2-3 million lives each year, enabling people to survive, thrive and reach their full potential. If we allow COVID-19 to disrupt the delivery of routine immunisation services the results will be severe. A recent assessment of the Africa region by the World Health Organisation (WHO) estimates that 46% of countries have partially or fully halted outreach services, and 67% of countries have delayed supplementary immunisation activities (the follow ups to initial vaccines, often an essential part of ensuring full immunity). Gavi, the Vaccine Alliance (Gavi), has also seen its immunisation services reduced in 21 countries. These very rapid drops in key immunisation services could have a drastic impact for millions of people, and we are at risk of seeing diseases such as polio and measles increase in number, undoing years of hard work. It is important to remember the lessons learned from previous disease outbreaks - for example, twice as many people died from measles in the 2019 Ebola outbreak in Democratic Republic of Congo than Ebola itself. We cannot afford to overlook the secondary impacts of COVID-19.
It is vital that we acknowledge the critical role global health multilaterals like the Global Polio Eradication Initiative (GPEI) and Gavi will play in this crisis. Gavi’s position as the pre-eminent vaccine delivery multilateral will allow it to distribute the Covid vaccine equitably in the world’s poorest countries once a vaccine becomes available. It is therefore essential that the UK government commits to Gavi ahead of this year’s Global Vaccines Summit, and continues as the leading donor while encouraging other countries to make strong pledges. Gavi and the GPEI will be needed not only to respond to the outbreak but also to help develop strong and resilient health systems in some of the world's poorest countries. This will be vital for mitigating the impact of future pandemics whilst also helping to develop a strong global health infrastructure capable of protecting some of the world’s most vulnerable people.
Gavi and the GPEI’s response to the COVID-19 outbreak has led to a potentially significant reduction in the GPEI’s capacity to deliver routine polio immunisation services. This could mean a large increase in the number of children who suffer from polio. The WHO estimates that an outbreak of polio in an area which hasn’t been immunised sufficiently could lead to around 200,000 new cases of polio spreading all over the world within 10 years. Given how close we are to eradicating this incredibly debilitating disease, to lose momentum now would be a travesty.
As we mark World Immunisation Week, we have to ensure that everyone, no matter where they come from, have access to all the vaccines that they need. The response of Governments like ours, research and development institutions and pharmaceutical companies to push for the development of a Covid-19 vaccine is testament to our understanding that vaccines allow us, as a global society, to stay safe. This unprecedented reaction has shown how adaptive the global health community can be, but it can’t be at the cost of other diseases.