Universal Health Care & defeating poverty through immunization

By Dr Werner Schultink and Siddharth Chatterjeeis

This week marks World Immunization Week – a global effort to focus the world’s attention on the importance of immunization for child health and survival. For Kenya, it is of double significance as it coincides with the announcement that Kenya is one of the three African countries that will be getting the world’s first malaria vaccine.

It is also a fitting time to consider the place of immunization in universal health care, a major plank of the country’s Big Four Agenda.

The leading health concerns in Africa are infectious diseases, and as far as pathways towards reducing that burden go, immunization is perhaps only rivalled by provision of clean water.

Vaccines for the routine immunization of children are the safest and most cost-effective way of protecting children from life-threatening diseases, such as measles, diphtheria, tetanus, polio. The positive impact of immunization can not be underlined enough. For example, the lives of an estimated 20 million children have been saved globally through measles immunization between 2000 and 2016.

Dr Seth Berkley, the CEO of Gavi, the vaccine alliance in an illuminating article, Vaccinating Against Poverty, writes,“By modeling the health and economic impact of childhood vaccines for ten diseases in 41 of the poorest countries, researcher estimate that from 2016 to 2030, these vaccines will prevent 36 million deaths. But their analysis found something else: during the same period, vaccination will also prevent 24 million people from falling into poverty because of the cost of medical treatment.

Yet, one in three children under five years of age in Kenya is at risk of vaccine-preventable diseases. It is estimated that 1.7 million children born between 2013 and 2017 did not receive all of their scheduled vaccines, with Mandera, Kisii, Kakamega, Nairobi and Trans Nzoia counties having the highest number of unvaccinated children. In 2017, over 500,000 children across the country were not adequately vaccinated.

Immunization is a basic right defined by the Constitution of Kenya and outlined in the Children’s Act. To ensure UHC, preventive and primary health care must reach all people. Low-cost high impact interventions, like 100% immunization coverage, will accelerate UHC.

The pay-offs from an effective immunization program are broad. Vaccines provide relief from the vicious cycle of disease, ultimately playing a role in promoting healthy physical and cognitive growth. This means children can perform better in school and in turn increase individual and family productivity and economic growth.

A 2017 UNICEF study, Narrowing the Gaps: The Power of Investing in the Poorest Children, proves that health investments in children living in the poorest communities save almost twice as many lives per dollar invested compared to equivalent investments in better-off communities. In fact, every shilling invested in immunization saves an average of 16 shillings in the health system.

The wider economy also benefits by more than 44 shillings per child, by preventing later health complications that burden the health system and supporting the economy by keeping parents at work.

Each year, the Ministry of Health allocates an estimated 14 million USD to procure vaccines and related supplies. The cost of vaccines to Government is expected to increase to 50 million USD by 2026 when new vaccines will be put to use. National and county budgets must guarantee adequate investment in vaccines, and strengthen their ability to plan and budget for essential supplies as they transition out of donor funding.

It is crucial that budgets at both county and national levels incorporate immunization programmes and engage relevant stakeholders and community leaders to prioritize the immunization agenda through their County Integrated Development Plans.

The UN family in Kenya remains committed to collaborate with the Government of Kenya to ensure the timely availability of safe vaccines for routine immunization will continue to support partners for additional campaigns to help missed communities catch up and ensure health system strengthening keeps the cold chain efficient and safe.

As Kenya moves towards ensuring that its citizens get the care they need without the risk of being pushed further into poverty, ensuring all children and other vulnerable populations receive the recommended vaccines must remain a top priority.

Dr Werner Schultink is UNICEF’s Representative to Kenya. Siddharth Chatterjeeis the UN Resident Coordinator to Kenya.

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