Co-authored by Vinny Wooding, Chhavi Bansal, Harry Bignell and Ruthie Walters
During World Immunization Week (24-30 April), people around the world come together to highlight the importance of vaccines and how they protect us against diseases. So, for World Immunisation Week, at RESULTS, we have reflected on the advocacy we’re doing around vaccines, why it’s important, and what it’s got to do with an end to poverty.
Put simply, RESULTS sees health as a building block to ending poverty, and vaccines an essential element of good health. Vaccines can prevent disease, and the provision of vaccines, along with other health provisions, is a strong indicator of whether a health system is effective and who it reaches. While we need to see increased access to existing vaccines, we also need to see the development of new vaccines.
One area of our work, which we refer to as Child Health, focuses on access to routine childhood immunisation. This goes far beyond just protecting a child against one disease - it can have life-long ripple effects on the health and prosperity of children. Immunisation services can be an early entry point for a child to access other essential health services such as nutrition. It is also an opportunity to engage with a child’s parent or guardian with health services and take an integrated, family approach to health. This approach can not only be helpful to identify more missed communities where ‘zero dose’ children (children who didn’t receive a single dose of any routine vaccines) may be, but it has also been shown to improve a community's health. For example, when vitamin A was administered during polio immunisation campaigns, coverage for both services exceeded 90%. And we’ve seen recently how this integrated approach to vaccines and health services has been important in the COVID-19 pandemic response, with polio healthcare workers supporting the surveillance of the virus among many other things.
However, in the past two years, there has been widespread disruption to immunisation services. 2020 saw almost a 30% increase in ‘zero dose’ children from the previous year. Due to postponed immunisation campaigns, by 2021, around 228 million people - mostly children – have been at risk of diseases such as measles, yellow fever, and polio. The impact of the COVID-19 pandemic also led to disruptions to efforts to maintain immunity against poliovirus. These are significant setbacks in immunisation efforts and risk decades of hard-won progress.
Despite the setbacks in immunisation coverage, there have been great efforts to restore immunisation services and strengthen health infrastructure to withstand existing and future challenges. To help ensure that all children have access to a comprehensive package of services, including immunisation, the UK Government must continue its support to Gavi, the Vaccine Alliance. As part of its commitment to ending preventable deaths and its pledge made in 2019, the UK Government should also recommit to supporting the Global Polio Eradication Initiative (GPEI) by delivering on its promise of £100 million a year until 2023 for polio eradication efforts. The news that a child was recently paralyzed in Pakistan as a result of wild polio, the first case in 15 months, further highlights the importance of the GPEI’s work with countries and communities worldwide in totally eradicating this disease - and the need for funding towards global efforts to #EndPolio.
People to people to #EndPolio! A clipping from a grassroots campaigner’s letter, advocating for better funding of #polio eradication and making the case for a strong UK investment in GPEI’s work. Thank you for your support to finish the job! @resultsuk pic.twitter.com/nMqhgkg8Vo
— Aidan O'Leary (@WHOPolDirector) February 10, 2022
Given the disruption that COVID-19 has caused and continues to cause, it quickly became clear that RESULTS needed to advocate for improved access to treatments, diagnostics and vaccines that could help the world end the pandemic. Tackling the COVID-19 pandemic is also a step in getting the world back on track to tackling other health issues, and lessons can be learnt from the pandemic and applied to other health services - and vice versa.
Whilst COVID-19 vaccines were developed at an unprecedented speed and over 11.02 billion vaccine doses have been administered to-date, the global distribution has been vastly unequal. Just 14.4% of people in low-income countries have received at least one dose, in contrast to 72.2% of the UK population having received at least two doses
With the current vaccination rate of low-income countries, like Burundi, we could be living with the virus until the year 2214!
— ONE in Africa (@ONEinAfrica) February 7, 2022
To redress this imbalance, we’ve been advocating for a number of important interventions, such as up-scaled manufacture of vaccines and other health tools, and a temporary, comprehensive waiver of intellectual property barriers (international trade rules that protect intellectual property rights such as patents). Known as a ‘TRIPS waiver’, this would ensure that global manufacturers have the know-how and technology to manufacture COVID-19 vaccines, tests and treatments themselves. And there are already mechanisms in place, such as the COVID-19 Technology Access Pool and the mRNA Hub established in South Africa, to achieve the necessary collaboration.
Two years since #COVID19 was declared a pandemic and billions have not received a first dose. Over 100 countries are united in demanding equitable vaccine access whilst the UK opposes them. @BorisJohnson side with people not big pharma. #EndCOVIDMonopolies #PeoplesVaccine pic.twitter.com/wBAPZC7geJ
— Oxfam (@oxfamgb) March 11, 2022
We need to learn from, and be informed by, the failures of the COVID-19 pandemic response to achieve more equitable responses to future pandemics. For this, reliable and sustainable funding for pandemic preparedness and response mechanisms are needed. The COVID-19 inquiry launched by the UK Government in Spring is the perfect opportunity to examine the failures of global solidarity to-date, and to ensure that future pandemic preparedness and response is free from the pitfalls that have contributed to an uneven global response to COVID-19.
We have advocated for an end to TB for decades, but these last 2 years have really highlighted how neglected the disease is, and the critical importance of developing a new TB vaccine. The COVID-19 pandemic has exposed the severe lack of innovation in tools for TB and the vast imbalance in funding for Research and Development (R&D) for the two diseases. After COVID-19, TB is the world’s second most deadly infectious disease, killing 1.5 million people in 2020.
Since 2020, 18 COVID-19 vaccines were made available and rolled out. Since 1921, there has been ONLY one TB vaccine and it offers poor protection in adolescents & adults. To #EndTB, we need at least one new, effective, safe & accessible #TBVaccine. #LeaveNoOneBehind pic.twitter.com/vyehD5AhsO
— RESULTS UK (@resultsuk) July 19, 2021
Yet there is only one existing TB vaccine - the BCG. While it is effective against some serious forms of childhood TB, the BCG provides little protection against the most infectious and deadly forms of adolescent and adult TB. Treatments for TB are also lacking. Current treatment methods take a minimum of three months, and often take much longer. Drug regimens are expensive and complex and can cause debilitating side effects. This means that patients are often unable to complete their treatment course. This can result in reinfection and can often lead to the development of drug-resistant and multi-drug resistant TB (DR-TB and MDR-TB)
On 18th July 1921, the first child received the BCG #TBvaccine to protect against TB. 100 years later, we are still using the same vaccine, which offers poor protection in adolescents & adults. It’s time for the TB community to join together to demand a new #TBVaccine by 2025. pic.twitter.com/WXsMpAsGsq
— GCTA (@G_C_T_A) July 13, 2021
The development of more effective TB vaccines is critical for pandemic preparedness and tackling antimicrobial resistance (AMR). More effective TB vaccines will help to combat AMR by being effective against drug-resistant forms of TB, reducing the need for antibiotics by preventing TB disease and potentially reducing the duration of treatment.
The Government should ensure that TB receives a significant uplift in R&D funding, benefitting from some of the £20 billion announced by the Chancellor of the Exchequer for R&D in the November 2021 budget. We also need to see an ambitious pledge to the Global Fund to Fight AIDS, TB and Malaria this year, given that it provides 77% of all international financing to efforts to end TB.
RESULTS’ vaccine-related advocacy will hopefully not only lead to people being protected against life-threatening diseases, but will also lead to better health services and good health for all - an important block in paving the way toward a world without poverty and inequality.