Guest post by Sabrina Gaber, Agence de Médecine Préventive (AMP)
“Are you up-to-date?” That’s the question the World Health Organization (WHO) will be asking during this year’s World Immunization Week.
It is widely recognized that immunization is one of the most successful and cost-effective health interventions of all time. Vaccines prevent between 2 and 3 million deaths each year. Yet, around 20% of children still miss out. WHO estimates that during 2012, 22.6 million infants were not reached with routine immunization services.
Why? A number of factors come into play: inadequate supply of vaccines, lack of access to health centers, weak vaccine distribution systems, and inadequate knowledge of vaccines (schedule, benefits, safety, and so on). In some cases, children may receive the first vaccine dose, but not the follow-up doses necessary to achieve full immunization benefits.
Since 1972, the French NGO Agence de Médecine Préventive (AMP) has been working with governments worldwide, especially in Francophone, Africa, to overcome these obstacles and improve access to life-saving vaccines for all populations, from the most remote villages to urban centers.
Achieving this goal takes interventions that address the multiple determinants of health and immunization system performance. That’s why AMP works across various related areas: vaccinology research to enhance scientific evidence to determine optimal immunization policies; immunization and health services strengthening to improve vaccine delivery and coverage; health policy and institutional development to promote contextually appropriate, evidence-based immunization policies; and human resources for health and training to tackle the global health worker shortage.
Current priorities include the following:
Helping developing countries take ownership of their immunization programs
Because immunization is an integral part of economic development, AMP strives to ensure that low- and middle-income countries take responsibility for their national immunization programs. One example is the SIVAC initiative, funded by the Bill & Melinda Gates Foundation. SIVAC aims to develop or strengthen National Immunization Technical Advisory Groups (NITAGs) to encourage evidence-based decision-making for the development of immunization programs and policies. SIVAC currently works in around 15 countries in Africa, Asia, Europe, and the Middle East.
Ensuring safe immunization
Immunization is only efficient under certain conditions: the personnel need to be trained, for example, and supply chains and logistics optimized. To this end, AMP helps to improve vaccine administration and immunization coverage via two major programs. EpiVacPlus strengthens immunization program performance through applied vaccinology training, technical support, translational research, and network coordination. LOGIVAC, a joint AMP-WHO project, supports capacity building and professionalization of African supply chain managers to improve health and vaccine logistics.
AMP is also mindful of vaccine safety. For example, in support of the yellow fever vaccine initiative, it helped develop vaccine pharmacovigilance systems from scratch in several West African countries. AMP is currently expanding activities in vaccine pharmacovigilance in cooperation with international and regional partners.
Routine immunization as an individual act
One of the great challenges of routine programs is to reinforce and expand the idea that immunization is an individual medical act delivered on a routine schedule rather than an intervention imposed on a population at random times (like with mass campaigns). This framework in turn is essential to ensuring the long-term sustainability of immunization programs. AMP works on this process both in terms of training workers and on a logistical level. AMP also works in the field and with partners to collect the evidence needed to develop the best routine vaccine schedules and to adapt these to different contexts.
Having all children up-to-date and maximizing the benefit of immunizations isn’t easy. But if we continue to work together to find innovative solutions and spread evidence-based scientific knowledge on vaccination—to both policy makers and local populations—we might just get there; 22 million children are counting on us!
Sabrina Gaber is manager of group communications and project development at AMP, which she joined in 2009.