Immunisation: No More Failure


Fresh alarm raised recently by two United Nations agencies about the failure of immunization inNigeria calls for urgent need by the three tiers of government and stakeholders in the health sector to redefine their strategies for a sustainable immunisation programme.
The World Health Organisation and United Nations Children’s Fund, which gave strong signal of Nigeria’s deteriorating health indicators at an African Vaccination Week said, diseases are escalating in the country because immunisation programmes are handled with levity.
Putting it in proper perspective, UNICEF said, “Ignorance, religion, culture and rumour are some of the reasons for the failure of nursing mothers and pregnant women to complete their immunisation schedule….” Immunisation, a bulwark against deadly diseases such as tuberculosis and diphtheria, is also failing in Nigeria because of inadequate funding and corruption.
According to UNICEF,Nigeria has the world’s second highest number of deaths in children under five, losing around 2,700 every day from a ratio of 120 per 1,000 in 2016, although it has declined since 2003, down from more than 200 per 1,000. Only one out of three babies is delivered in a health facility. The poorest among Nigeria’s population continue to be most in peril, whatever their age. While there have been drops of 31 per cent and 26 per cent in under-five and infant mortality rates, respectively, over the last 15 years, the decline in deaths of newborns over the same period is just 20 per cent, highlighting an urgent need to scale up interventions targeting the youngest in the country.
The indices indicate that the uptake of routine immunisation remains poor and full immunization coverage has failed to gain traction as only one in four children are fully vaccinated. The situation for rural children causes greatest concern – only 16 per cent are fully immunized, compared to 40 per cent of children in urban areas. Measles vaccination coverage has now fallen below 50 per cent.
Despite making significant progress in the eradication of polio, which led to Nigeria being declared polio-free in 2015, insurgency in the northeast and the resultant insecurity is beginning to reverse these gains: four new cases of wild poliovirus (WPV) re-emerged in Borno State.
Diseases such whooping cough, tuberculosis, diphtheria, polio, chicken pox and measles, some of which have been totally eradicated in several parts of the world, are still wasting away lives here because of the failure of immunisation. A disturbing May 2017 survey by the Abuja-based coalition, the Association for the Advancement of Family Planning, concluded that 90 per cent of women in northern Nigeria delivered their children at home because they did not have access to antenatal care, hospital and transport fees.
Immunisation was developed to prevent diseases, not to cure them. It protects children from contracting a broad range of dangerous diseases, including hepatitis and cervical cancer. Described as one of the greatest breakthroughs in modern medicine, British health authorities say “no other medical intervention has done more to save lives and improve quality of life.” For instance, small pox, which killed thousands of Europeans in the 18th century, was wiped out in 1980 through vaccination. If it were still common, it would have led to two million deaths annually.
WHO says that through immunisation, two to three million children are saved from vaccine-preventable deaths annually? The global measles mortality has declined by 79 per cent from 651,600 deaths in 2000 to 134,200 in 2015 as a result of immunisation. In 2016, a 22-year strategy saw the United States becoming the first country to eradicate measles. Finland’s determined immunisation drive has wiped out measles, mumps and rubella. With extensive vaccination, only Afghanistan, Pakistan and Nigeria still had cases of polio as at 2016.
The challenges before Nigeria are tough: First, vaccines are expensive. According to WHO, a dose of MMR costs £200. The National Primary Healthcare Development Agency, at the height of the meningitis outbreak, a disease which had killed 813 from 8,000 infections as at 2017 April, said that Nigeria required $1.1 billion to procure vaccines to stem the person’s fatalities. This is enough to call on government at all levels to allocate more resources to the sector, and also manage the funds more transparently, devoid of corruption that allows officials to sell vaccines, meant to be distributed free to those in need, at exorbitant prices.
It is on this premise The Tide welcomes the recent move by the Rivers State Government in collaboration with other agencies to address the challenges of immunization in the State. We believe that such a synergy will not only assuage the financial burden of getting children immunised, but will also encourage easy and unimpaired accessibility.
We equally urge other states of the federation to emulate the Rivers example and get serious about the political, social and technical constraints bedeviling immunisation campaigns. Efforts should be stepped up to make vaccines widely available and to motivate health workers to penetrate the rural areas. Research has linked immunisation to politics, lifestyle, religious beliefs, culture and trust of authority, in conjunction with access. There is therefore the need to disabuse the minds of the people who still feel that some vaccines are capable of causing sterilisation and other ailments.
While we commend the integrated awareness crusade currently put together by the Rivers State Government to sensitisethe people of the benefits of immunisation, the joint effort should target and weave the campaign around health organisations, religious leaders, educational institutions, the media and traditional institutions to achieve maximum impact.
Heartwarmingly, the world of medical science is developing new vaccines to combat diseases. One of such is the malaria vaccine, which should have been put on clinical trial in three African countries between 2018 and 2020. Through collaboration, all stakeholders have to key in to such projects, and also develop the local capacity to produce vaccines in partnership with our research institutions and the universities.
We also enjoin parents to take advantage of the efforts of government and their collaborators to ensure their children within the specified ages are brought forward for immunization. The fight against child killer diseases must be total and won now.