In September 2022 Gavi reported a second consecutive year of decreased routine immunisation across 57 countries. However, early data for 2022 show promise of improvement. Although there was a coverage drop these countries administered more than 2 billion COVID-19 vaccines according to Gavi’s 2021 Annual Progress Report.
2021: a “challenging year”
Gavi’s report described how basic vaccine coverage dropped by 1 point to 77% across the 57 countries it supports. Chair of the Board, Professor Jose Manuel Barroso, suggested that Gavi had faced “significant challenges”.
“Routine immunisation continued to suffer in many countries as a result of the pandemic.”
However, he was encouraged by the “record number of vaccines doses” as part of routine and COVID-19 programmes. He insisted that focus must remain on “supporting routine immunisation and reaching zero-dose children with life-saving vaccines”.
UNICEF’s Executive Director Catherine Russell is worried that “millions of children are still missing out” on one of the world’s “most effective and cost-effective public health interventions”.
“Working alongside Gavi and other key partners, we need to catch-up on missed children – especially ‘zero-dose’ children who have yet to receive a single immunisation against killer childhood diseases – and make sure lost ground does not become lost lives.”
Dr Seth Berkley, CEO of Gavi, described the recovery in 2021 as “not as strong as we would have liked”. However, “early indications” show that there are “grounds for optimism”. He suggests looking to countries like Chad and Pakistan to identify lessons that can be applied to other areas.
“There is no higher priority for the Alliance in 2022 than keeping routine immunisation progress on track.”
Benefits abound
Routine systems reached 65 million children in countries supported by Gavi, and its work “managed to generate more than US$ 18.9 billion in economic benefits, the report suggests. Furthermore, a 2021 “highlight” was the “record US$ 161 million in co-financing contributed by Gavi-supported countries”. Gavi suggests that this “indicates further progress towards sustainability and country commitment to protecting childhood immunisation”. In addition to routine immunisation, Gavi countries were able to administer more than 2 billion COVID-19 vaccines, protecting “more people than ever before”.
Focus points for 2022
With a worrying increase in the number of zero-dose children, to 12.5 million, Gavi’s 5.0 mission to locate and reach them is “even more pressing”. Zero-dose children have not received their first dose of the diphtheria, tetanus, and pertussis-containing vaccine (DTP1). This leaves them vulnerable to several of the “world’s deadliest diseases”.
Upward trajectory
There may be hope for the future, Gavi suggests, as the WHO has revealed preliminary data indicating that immunisations “may be starting to recover”. 16 countries have reported data from January to May 2022, and from this they have concluded a 2% increase. Further analysis will be done to assess how countries are “restoring” their systems.
Gavi also reflects on “significant change” in 2021. In December 2021 the Board approved funding in support of the roll-out of the first malaria vaccine in sub-Saharan Africa from 2022-2025. Furthermore, the first doses of the licensed Ebola vaccine left a Gavi-funded global emergency stockpile. COVAX, which Gavi, CEPI, WHO, and UNICEF collaborated on, shipped almost 1 billion COVID-19 vaccines to 144 areas around the world by the end of the year.
The Minister of Health and National Solidarity of the Republic of Chad reflected that collaboration had allowed health workers to succeed in “increasing the number of vaccinations by more than 6 percentage points”. Despite the “challenges of the pandemic and the global climate” they were able to reduce the number of zero-dose children.
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