Millions of children under the age of five who are at risk of not being vaccinated against polio and dozens of countries that have halted their campaigns against measles. It’s happening. As the world waits for the arrival of a covid-19 vaccine, both its spread and confinement measures and blocking communications have left many places, with fragile healthcare systems, without immunization doses for various preventable diseases. “With the interruption of these services, the fate of millions of young lives is hanging by a thread,” says Robin Nandy, senior adviser to UNICEF and head of Immunization.

The Global Alliance for Vaccination and Immunization (Gavi), a public-private partnership that makes large purchases to reduce its cost to poor countries, has made a special appeal on the occasion of the recent week of immunization , held between April 24 and 30. “Children who are not receiving vaccines should not live their whole lives without that protection,” explained Seth Berkley, CEO of Gavi. This organization, which is supported by the Bill & Melinda Gates Foundation, the World Health Organization (WHO), the World Bank and Unicef, among others, has helped vaccinate more than 760 million minors in the most poor of the world. “The legacy of covid-19 should not include the global resurgence of other deadly diseases like measles and polio,” Berkley said.

How many vaccination campaigns have been stopped by covid-19?

Ten million children under the age of five around the world are at risk of not being vaccinated against polio, as many countries have been suspended from delivering the necessary doses after the Global Initiative for the Eradication of Polio Polio (GPEI) will paralyze its activity on March 24. At the same time, 25 of the countries most affected by measles have also postponed them without a specific date, according to Unicef.

Many of them are found in Africa, but also in Asia, such as North Korea and Burma. Bangladesh and Nepal have postponed their national campaigns against measles and rubella, while Pakistan and Afghanistan have suspended their planned polio campaign. Five of these 25 countries faced measles epidemics in 2019.

Niger was the last country to report new cases of polio, after last December, together with Kenya and Mozambique, ended the disease outbreak after two years

Niger was the last to report new cases of polio, after last December, together with Kenya and Mozambique, they ended the outbreak of this disease after two years. “This country stopped it because of massive vaccination campaigns. Unfortunately, it will not be possible now since we have been suspended by covid-19, which requires global standards for social distancing and hygiene practices in handwashing.” , explains Pascal Mkanda, coordinator of the WHO Polio Eradication Program in the African Region.

Lack of supply is another of the collateral damages that covid-19 has caused. Vaccine shipments have been reduced by 70 to 80% due to the drastic decrease in commercial flights since last March 22. “Dozens of countries are at risk of running out of doses due to delivery delays,” a UNICEF spokeswoman, Marixie Mercado, explained at a virtual news conference from Geneva.

Because of this, countries are using their reserves for emergencies, allowing them to last an additional three months, experts estimate. At the end of April, the Measles and Rubella Initiative (M&RI) already warned that more than 117 million children were at risk of running out of doses of measles from the coronavirus. In 2019, UNICEF distributed approximately 2.43 billion doses in 100 countries for 45% of children under the age of five. Disruption of routine immunization, particularly in places with poor health services, can lead to devastating outbreaks in 2020 and beyond, international organizations fear.

How many children do not receive the polio and measles vaccine?

Even before the covid-19 pandemic, vaccines like polio or measles were already out of reach for 20 million children under the age of one. More than 13 million in that age bracket worldwide did not receive any immunizations in 2018, many in poor countries. It is estimated that 182 million did not receive the first dose against measles between 2010 and 2018, or what is the same, 20.3 million on average per year, according to UNICEF. Among low-income countries, the gap in measles coverage before covid-19 was already alarming. Between 2010 and 2018, Ethiopia had the highest number of children under one year of age who did not receive the first dose of immunization: almost 10.9 million. The Democratic Republic of the Congo (6.2 million), Afghanistan (3.8 million), Chad, Madagascar and Uganda followed, with around 2.7 million each.

Top 10 countries with unvaccinated measles children

1. United States: 2,868,000

2. France: 680,000

3. United Kingdom: 585,000

4. Italy: 482,000

5. Japan: 386,000

6. Canada: 363,000

7. Germany: 195,000

8. Australia: 155,000

9. Chile: 155,000

10. Spain: 141,000

Source: UNICEF. Accumulated data from 2010 to 2018.

Africa, focus of continued epidemics

In Africa, in recent years, the reasons why more children have missed more vaccines is due, among others, to the increase in birth rates and the stagnation of campaigns. As an example, in West and Central Africa, coverage has stagnated at 70% for DTP3 (three doses of diphtheria, tetanus and whooping cough) – the lowest among all regions -, at 70% for polio and in 71% for measles.

Lack of immunization has led to outbreaks of measles in countries like the Democratic Republic of the Congo. To alleviate this situation, the Government of this African country has received help from different organizations, such as Unicef ​​and Doctors Without Borders, with supplies and protective equipment to continue the campaign in the north of Kivu province, where more have been reported. 3,000 cases since January 1. In addition, Doctors Without Borders maintained the vaccination campaign until the end of April, in a country that has already treated more than 50,000 patients and vaccinated 816,000 children in 2019.

For its part, in eastern and southern Africa, the unvaccinated number has remained almost the same during the last decade: around two million. Now, all the regions of the continent, which are also fighting against covid-19, which has already left more than 48,000 infected and more than 1,800 dead, may face a general decline in those preventable and curable diseases and in those Research and science had made great progress. Going back can be up to 20 years, as diagnosed by the director of the WHO Malaria program, Pedro Alonso, on the fight against malaria.

South Asia, a quarter of unimmunized children

Regarding immunization, the situation does not improve in this region of the planet either: almost a quarter of the world’s unimmunized or partially vaccinated children, approximately 4.5 million, reside in South Asia. Most of them (97%) live in India, Pakistan and Afghanistan. In these countries, confinement as a response to the covid-19 pandemic has abruptly interrupted routine vaccination, and parents are increasingly reluctant to take their children to health centers, for fear of getting the coronavirus. Sporadic outbreaks of measles and diphtheria have already been observed in parts of Bangladesh, Pakistan and Nepal.

In the South Asia region are also two of the last countries in the world with endemic polio: Afghanistan and Pakistan. Many of the region’s health centers, where millions of children are normally vaccinated, are closed and outreach sessions have been suspended, adding further difficulties in maintaining this health routine. “Vaccine stocks are being dangerously depleted in some countries in the region, due to disruption of supply chains due to travel bans and flight cancellations. Vaccine manufacturing has also been discontinued, compounding the shortage, ”says Paul Rutter, regional health adviser for the UNICEF Regional Office for South Asia.

What funds are available to combat the lack of vaccines?

Many international organizations provide funds to combat the lack of immunization. The latest contribution has been from the TikTok platform and the Gates Foundation, which on April 29 announced the donation of $ 10 million each to the Gavi vaccine alliance. These $ 20 million will go, in addition to fighting the covid-19 pandemic in Africa, to prevent, in the words of its CEO, Seth Berkley, “a potentially catastrophic impact on immunization programs in the developing world “

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