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KaraSuvada
Vaccines are arguably the most important public health intervention in human history, estimated at saving over 2.5 million lives every year.1 Diseases that used to mark death or disability, such as pneumonia, polio, measles, meningitis, and tetanus can now be completely prevented with modern vaccines. However, WHO estimates that around 18.7 million infants have not been vaccinated, and are therefore susceptible to an unnecessary burden of disease.2
The Center for Health Market Innovations (CHMI) profiles 109 programs that have a focus on immunizing populations, many of them targeting pregnant women and children under five years old. Additionally, many of these programs target at risk populations, including those who live in rural areas and the poorest 20 percent of the general population.
In honor of World Immunization Week, CHMI is highlighting five vaccine-preventable diseases (VPDs) and programs working to control, vaccinate against, and eliminate them.
1. Pneumonia
Pneumonia, caused by Streptococcus pneumoniae bacteria, is a disease responsible for 15% of global deaths in children five years and under. Pneumonia causes flu-like symptoms, such as cough, fever, and sneezing, and in severe cases, hypothermia, and unconsciousness. Bacteria colonize the alveolar sacs of an infected person’s lung and cause limited oxygen intake.3 Although there are many strains of bacterial pneumonia, vaccines can prevent the most common infections.
M-CHANJO, a non-profit organization in Kenya, uses mobile technology to create awareness and track child immunizations among the poorest rural and urban. Clinicians and community health workers send SMS messages to parents to remind them of vaccination appointments for their children. M-CHANJO success as an mhealth platform that disseminates information on childhood vaccines is due to the wide availability of cheap phones in the countries of Africa.10 The system focuses on sending reminders about all childhood vaccines, including pneumonia, measles, and polio.
2. Polio
Polio is a severely debilitating disease that can cause fever, fatigue, vomiting, and paralysis.4 Since the inception of the Global Polio Eradication Initiative (GPEI) in 1998, the incidence of viral poliomyelitis has decreased by 99%.5 In fact, since January 2016, there have only been 11 cases of wild-type polio, and these cases have been concentrated to the South-Asian countries of Afghanistan and Pakistan. 4 GPEI uses mobile technology to collect Lot Quality Assurance Sampling (a form of health monitoring surveys), which aids program managers in designing polio elimination and vaccination campaigns through providing data in previous or current epidemic areas. Polio eradication is possible in this generation, and is the goal of GPEI to achieve by 2018.
3. Measles
Before the measles vaccination came to the market in 1980, approximately 2.6 million people died from this viral disease each year. This number has seen a dramatic decrease: in 2014, around 115, 000 people passed away from the infection. However, this number is still high considering the fact that the measles vaccine is cheap and safe.6 Additionally, because of recent anti-vaccine “campaigns” in Western countries, such as the United States, the incidence of measles has seen an increase in higher-income countries.
12 Child Survival Score Card, a government initiative of Cambodia, aims to reduce mortality for children under five. One of the twelve components of this initiative is to immunize every child with the measles vaccine. The Cambodian Ministry of Health manages the provincial and district level implementation of the program, funds capacity building and job training, and partners with local NGOs to carry out the initiative. Specifically, the first dose of the measles vaccine is given to every infant at nine months of age, and the second dose is given thereafter during regular community health worker outreach activities. An impact evaluation shows that the 12 Survival Score Card program increased the percentage of children vaccinated for measles from 77% in 2005 to 84% in 2006.7
4. Hepatitis B
Hepatitis B, which causes chronic live cancer and liver failure, is a viral infection that affects millions of people every year. The World Health Organization estimates that 240 million people have chronic Hepatitis B infection, with a 5-10% prevalence rate in Sub-Saharan African countries and East Asian countries. Hepatitis B is spread through sexual contact and exposure to infected blood. The Hepatitis B vaccine is 95% effective and has been on the market since 1982.8
Teens Health Quarters (THQ), a non-profit in the Philippines, operates as a holistic community center for youth to learn about development and sexual and reproductive health. Not only does THQ educate teens, but also provides pregnancy tests, pap smears, and Hepatitis B vaccinations. THQ creates a positive image of their centers through networking with local school systems. THQ served over 7,000 youths between the ages of 15-24 from 2001 to 2002.
5. Meningitis
Meningococcal meningitis is an extremely serious bacterial infection that causes a 50% mortality rate among untreated patients, and a 10-20% mortality rate among treated patients. Bacteria infect the meninges, a protective lining that forms the blood-brain barrier in the human skull. Once infected, meningitis causes cranial inflammation, fever, headache, and vomiting. Globally, meningitis poses a huge risk to infants and children under five. Although there are many different types and strains of meningitis, many of the most common strains can be prevented via vaccine.9
The Meningitis Vaccine Project (MVP), a collaboration between government agencies, the WHO, and PATH, strive to reduce the number of meningitis cases in Sub-Saharan African countries (once deemed the “Meningitis Belt”). Since the introduction of the cost-effective MenAfriVac® in 2010, over 235 million people in the region have been inoculated. Now, MVP is working to transition from mass vaccination campaigns to routine vaccination so that incidence and prevalence rates continue to decrease.
Immunizations will continue to be one of the foremost public health tools in preventing diseases and saving lives in our time and going forward. As we continue to see emerging infectious diseases, such as Ebola, SARS, and MERS, scientists will continue to race the clock to beat the next pandemic. Similarly, innovative global health programs will continue to make vaccines more accessible and available for the general population as well as the most at risk groups. As vertical programs continue to demonstrate success in targeting individual diseases, horizontal programs will also need to be re-enforced to ensure robust monitoring and program sustainability.
Want more information on World Immunization Week? See WHO’s World Immunization Week webpage.
