Vaccines work. 2 to 3 million lives are saved every year through immunisation. That’s pretty extraordinary in itself, right? In fact, it almost seems that this blog could end here with that up-beat, celebratory sentence - 2 to 3 million lives are saved every year. But immunisation is actually much more than saving lives. As our new policy briefing shows, putting immunisation at the heart of the health system is a sensible, economical and beneficial policy which reaps rewards far beyond saving 2 to 3 million lives.
For the strongest societal benefits, every child must be reached with essential vaccines. This means reaching the poorest and most marginalised in society, the people who may be missed by other health services. It seems a waste to reach these people, provide them with a vaccine, and then ignore everything else, doesn’t it? It makes much more sense to use this process as a way to widen access to more health services so that those who have previously been left behind aren’t just vaccinated, they’re made healthier and they’re empowered.
But how can routine immunisation strengthen the health system in this way? Think of a Community Health Worker (CHW) who has brought vaccines to a remote community, far away from health centres or hospitals. There’s already been investment in their training to be able to safely deliver the vaccine. With just slightly more investment that same health worker can weigh the baby and provide support against malnutrition, they can test the mother and support their postnatal recovery, and perhaps they’ll suspect that a sibling has malaria and if so they can then prescribe tablets. Routine immunisation programmes gets these people to the communities. It’s a waste if their impact isn’t scaled up.
That’s already an impressive addition by vaccinators beyond vaccinating, but there’s more. If a community is hard to reach, it’s also hard to understand. How can policymakers, at national or local level, be best informed if they don’t understand? Who does understand? The people getting to those communities can understand by speaking to those communities. Vital data can be collected which can ensure better suited policies meaning those with the most need are met with the most support.
So for the policymaker designated with the task of strengthening a health system it all seems logical so far, but the question remains in their heads no doubt, ‘how am I going to fund this?’
This is an important question and one we might too often forget. Resources, particularly for developing countries, are finite. But there are incredible economic benefits to prioritising immunisation. Every US$1 invested sees US$16 saved. The long-term economic output of a community is increased with healthier children who are able to study longer and who will have less demand on the health system. And if you’re making a budget, you can plan for an immunisation campaign based on the price of vaccines, the price of training etc. This can be reviewed and adjusted as required meaning financial modelling for the whole health system.
Responding to an epidemic of an unvaccinated against, infectious disease is far more damaging to the treasury with uncertainty and reactive spending creating economic instability for internal markets as well as the view of the country on the global level. In fact, immunisation processes can help stave off epidemics that cannot currently be immunised against. Nigeria’s polio infrastructure was instrumental in bringing the Ebola outbreak under control allowing for real-time monitoring and tracking of the outbreak meaning a single-digit number of cases.
Putting immunisation at the heart of the health system is already happening with great success. The time is now to ensure that this success continues. Public health emergencies do not respect borders or boundaries and in our interconnected world we are all responsible and vulnerable to disease. National governments, donors and development partners must ensure that we strengthen health systems to build global resilience. Routine immunisation is the foundation stone for that resilience.