Worries Over Vaccine, Immunisation Gaps

Odimegwu Onwumere writes that meningitis and other vaccine-avertable diseases have become somewhat a recurring decimal in Nigeria and in some countries of sub-Saharan Africa that include Senegal, Niger, Chad, Benin, Mali, Burkina Faso which make up ‘Meningitis Belt’ due to poor innovative approach to delivery of vaccines

By April 17, 2017, Nigeria lost about 800 lives and had 8,000 cases of Cerebro Spinal Meningitis (CSM), in six states of Katsina, Kebbi, Zamfara, Niger, Sokoto and Yobe due to embarrassing vaccine approach, informed the News Agency of Nigeria (NAN). Since 1996, there are data showing that meningitis and other vaccine-avertable diseases have killed thousands of people in Nigeria and by extension, in some sub-Saharan African countries of Senegal, Niger, Chad, Benin, Mali, Burkina Faso which make up ‘Meningitis Belt’ due to poor delivery of vaccines.

Checks reveal that no fewer than 11,000 people were killed by meningitis alone in Nigeria in 1996 and by 2009, 600 people died. Like a recurring decimal, this dangerous disease that science says is “caused by viral or bacterial infection, and marked by intense headache and fever, sensitivity to light, and muscular rigidity and most affected age group is 5-14 years of age” impinged on approximately 10,000 people in 2015, and exterminated over 1,000 people in Nigeria.

The world is embarrassed by the outdated vaccine delivery systems in the country, because Nigeria prefers to buy vaccines from the international market instead of set up vaccines manufacturing plants for local consummations. The highlight of this is that records show that Nigeria only delivered (1.3m vaccine doses for a country that has a population of over 180m people) during the recent impasse. These vaccines, according to media reports, about 800,000 doses were mostly ordered from United Kingdom. Yet, according to Dr. Seth Berkley, CEO of Gavi, the Vaccine Alliance, “Too many children still lack access to lifesaving vaccines because of outdated and inefficient supply chains.”

Dr. Berkley was of the belief that, “There is need to drive change and deliver comprehensive improvements now, countries won’t have the systems in place to protect the next generation of children, particularly the most vulnerable.”

The Nigerian Medical Association (NMA) was caught up in vaccines and immunisation ruckuses in July 2013. The then President of the association, Dr. Osahon Enabulele frowned that the federal government failed to curtail the sprinting of hepatitis in the country due to its over dependence on foreign delivery of vaccines. At the occasion of the 2013 World Hepatitis Day, Enabulele said, “Hepatitis virus A, B, C, D and E were accountable for the millions of death in the country, because they caused sensitive and unremitting infections and inflammation of the liver, the government did not bellyache.”

If the country had been vaccines conscious, these deaths could not have occurred. In the light of this, the World Health Organisation (WHO) in one of its reports, held, “Vaccines prevent an estimated two to three million deaths every year, but an additional 1.5 million deaths could be avoided if global immunisation coverage improves.”

The international body supposed that in 2015, an estimated 19.4 million infants worldwide did not receive routine immunisations. What that suggests is that Nigeria, which includes the countries of the world, is awful in the way she sees to vaccines and how they are handled. The hullabaloo is that this oil rich country prefers to order vaccines from the Americas and Europe during outbreaks, whereas in the advanced world, such methodology of delivery of vaccines has been regarded as outdated and compromising that put the lives of people in danger.

The argument is that health and immunisation are not regarded with the attention they needed in Nigeria. According to news, “President Muhammadu Buhari submitted a budget of eight billion naira for the funding of routine immunisation and polio eradication. But the budget that came back from the National Assembly was cut by about 50 per cent. There is need for the legislature to understand the intricacies of immunisation financing and support fulfillment of the government of Nigeria’s commitment to sustainable immunisation at all levels.”

Dr. Aminu Magashi-Garba, Lead Project Director, Routine Immunisation Sector of the Partnership for Advocacy in Child and Family, who is also Coordinator of the Africa Health Budget Network was befuddled in the above commentary on April 22, 2016 in Lagos, when he succinctly declared that the budgetary allocation for routine immunisation including eradication of poliomyelitis was slashed by the National Assembly during its review and passage of the 2016 budget. This could have formed the view by Dr. Matshidiso Moeti, the WHO regional director for Africa.

Dr. Moeti said, “We must act to close the global immunisation gap. Achieving the Global Vaccine Action Plan goal of universal access to immunisation by 2020 would benefit the health of millions of Africans.” This is given that pundits have said that the best ways to save lives of children, condense cost of healthcare and give the children the prospect to live up to their aptitude is through immunisation.

But according to Magashi-Garba, the cut in the budget meant, “We are going to have shortage of vaccine procurement this year and early next year if enough funds are not available for the vaccines to be procured completely. This also poses a problem because the funding was tied to two international commitments and it will also create a serious challenge in the sector in ensuring that all eligible children are immunised.”

In the advanced world, the innovative approaches are being put in place to help augment vaccine ease-of-use and publicity. But Nigeria is still gasping for the air on where to source for vaccines during emergencies. Hear Dr. Robin Nandy, principal advisor and chief of immunisation at UNICEF, “Expanding the use of freeze alarms and rigorous temperature monitoring is critical to ensuring that all children have access to potent, lifesaving vaccines. In the long-term, we must work toward the development of products that can better withstand temperature variations.”

However, the WHO has been concerned that 1.5 million children that include Nigerians who are yet to receive lifesaving vaccines they need, do not have access. Hence, April each year is mapped out by the international body to create this attention. But on May 25, 2017, at an award ceremony on health innovation given to Alma Sana, a non-governmental organisation (NGO) at the Transcorp Hilton Hotel, Abuja, the NGO introduced a bracelet that was launched by Glaxosmithkline.

The bracelet was said to be worn on the leg or wrist of infants to remind mothers the type of vaccines they have given their children and the time they need new vaccines. While speaking at the rite, wife of the Senate President and founder of Wellbeing Foundation Africa, Toyin Saraki, believed, “We need to work towards adapting a vaccine dependable Nigeria. One of the problems faced with vaccinations is most mothers forget to take their children for immunisation and this bracelet is supposed to help tackle that issue since the bracelet will be on the child from first vaccination till the age of one.”

While the bracelet is believed to “deal with the problem of timeliness, completion of vaccine doses and that of wider coverage to know the extent immunisation has been covered in a locality.” According to Dr. Jean Marie Okwo-Bele, director of WHO Department of Immunisation, Vaccines, and Biologicals, in commenting on a study, “For too many countries, it is nearly impossible to collect and harness data to forecast vaccine requirements and deliver vaccines when and where they’re needed. But there are innovations such as electronic data systems that are being piloted and scaled up in developing countries that could and should be more widely adopted.”

Last year, Dr. Orin Levine, the director of vaccine delivery at the Bill and Melinda Gates Foundation suggested four innovative ways of vaccines delivery during the world vaccine week. Inter alia, Dr. Levine said that first, for vaccines to be safe and effective; they need to be kept cold, hence the invention of Sure Chill refrigerator, which is said to be using “hydro and solar power to keep vaccines cold for days without energy and are being used in more than 30 countries and have become an important tool in humanitarian response efforts when distributing vaccines for cholera or measles can be especially critical.”

In spite of this, Dr. Levine added, “Immunisation is one of our biggest public health success stories, but safe, effective vaccines don’t deliver themselves. With consistent, visible support from national and local leaders, every community can have 21st Century systems that reliably deliver lifesaving vaccines to everyone who needs them.”