We know that vaccines are one of the safest, most cost-effective tools we have in public health today. We owe much of the global health progress we have seen over the last two decades to their use. But we currently find ourselves at a crossroads where finding a vaccine for COVID-19 is urgent and continuing vaccinations for other deadly diseases is stalling.
Measles is one of these deadly diseases, claiming the lives of 140,000 people in 2018 and anticipated to gain more ground during the pandemic. While vaccination levels were falling long before the pandemic hit, COVID-19 is likely going to severely limit access to measles vaccinations around the world. Last year, cases of measles increased by 300% and the World Health Organization (WHO) announced that four European countries had lost their once-held measles elimination status. In the time of COVID-19, the global health landscape is shifting: some countries are making the difficult decision to pause important vaccination campaigns to decrease the risk of COVID-19 transmission and lighten the burden on health systems. This is when global cooperation on health is more important than ever.
With measles immunization campaigns delayed in 24 countries and cancelled in 13 others, the UN warns that more than 117 million children risk missing out on life-saving measles vaccines. Children younger than 12 months are at an increased risk of dying from measles complications, and during this pandemic, their risk of measles exposure is increasing daily. As COVID-19 strains health systems around the world and forces health systems to reimagine how to carry on with essential health services like immunization, the Measles & Rubella Initiative (M&RI) – a global partnership, founded by WHO, UNICEF, the American Red Cross, the US Centers for Disease Control and Protection, and the UN Foundation – released a statement underscoring the importance of closing immunization gaps as soon as possible. “If the difficult choice to pause vaccination is made due to the spread of COVID-19,” M&RI said in a statement, “we urge leaders to intensify efforts to track unvaccinated children, so that the most vulnerable populations can be provided with measles vaccines as soon as it becomes possible to do so.”
We have the tools and the know-how to stem the tide of outbreaks. But we must ensure that everyone, everywhere can access and utilize life-saving vaccines. This is obviously easier said than done. So how can we fight back against growing disease outbreaks?
The answer: investing in partnerships.
For the last two decades Gavi, the Vaccine Alliance has been one of these critical partnerships, ensuring that access to vaccines for the world’s most vulnerable populations is possible. Together with UNICEF and the Measles & Rubella Initiative they are able to:
- Negotiate vaccine prices: the cost of the measles vaccine is now at an all-time low;
- Help countries identify underserved areas and unreached children;
- Procure vaccines and other immunization supplies;
- Support supplementary vaccination campaigns to address gaps in routine immunization coverage;
- Work with relevant countries to introduce the second dose of the measles vaccine in the national immunization schedule, and
- Introduce innovations like the use of solar power and mobile technologies to maintain vaccines at the right temperature.
Ensuring vulnerable people get the life-saving healthcare they need is becoming increasingly complicated in the global lockdown. WHO issued new guidelines to help countries sustain immunization efforts while they simultaneously fight the pandemic. “WHO is working constantly with partners and scientists to accelerate vaccine development for COVID-19, but we must also ensure people are protected against those diseases for which vaccines already exist,” said Dr. Kate O’Brien, Director of the Immunization, Vaccines and Biologicals Programme at WHO. The WHO guidelines recommend that governments undertake careful risk-benefit analysis when deciding whether to delay vaccination campaigns. If they must be canceled, WHO urges governments to deploy urgent “catch-up” vaccinations as soon as possible, prioritizing the most at-risk.
It’s a global balancing act. On one hand, maintaining measles vaccinations and on the other, ending the COVID-19 pandemic as quickly as possible. The former will dramatically improve if the latter is successful. The Coalition for Epidemic Preparedness Innovations (CEPI) is using long-standing knowledge of measles prevention to accelerate research into a COVID-19 vaccine. CEPI hopes using characteristics of measles will allow the immune system to create a response to prevent a pathogen like COVID-19. This research and development approach using the measles vaccine has been successful in the past at developing vaccines against SARS, MERS, and Lassa fever. CEPI receives some funding for COVID-19 vaccine research from donations to the COVID-19 Solidarity Response Fund, which the UN Foundation helped set up six weeks ago. The more we know about measles, the more it could help us fight COVID19.
Finding a vaccine, supporting weakened health systems, and guiding a balanced response to COVID-19 that maintains other life-saving services is all possible through the coordinated efforts of global health partners like CEPI, WHO and UNICEF. This is the power of global cooperation.
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Photo: UNICEF/ Alejandra Pocaterr