African immunisation systems fall short, say UCT experts

In Africa, issues of vaccine supply, financing, and sustainability require urgent attention if the Millennium Development Goals are to be achieved, say UCT experts writing in the most recent issue of PLOS Medicine.

This is an open-access, peer-reviewed medical journal.

Shingai Machingaidze, Dr Charles Wiysonge, and Prof Gregory Hussey of UCT's Institute of Infectious Disease and Molecular Medicine, commend African countries for their progress in immunisation programmes but infectious disease outbreaks, for example, polio and measles outbreaks, as well as high vaccine dropout rates across the region, indicate failures within the immunisation system.

The authors argue that wide inter- and intra-country differences are responsible for large numbers of African children remaining unreached, unvaccinated, under-vaccinated, and still dying from vaccine-preventable diseases.

In 2010, an estimated 1.5 million children died worldwide from vaccine-preventable diseases and the authors argue that with the 2015 deadline for the Millennium Development Goals approaching, it is necessary for Africa to take stock, critically assess its position, take ownership of the regional and country-specific problems, and develop precise strategies to overcome the challenges identified.

The authors say: "We believe that in order for Africa to take advantage of the new decade of vaccines and extend the full benefits of immunisation to its citizens by 2020 and beyond, a critical assessment is a fundamental first step."

They argue that immunisation systems strengthening is essential, as most are under-staffed with inadequate resources to function efficiently, but also argue that increased political will is also necessary.

"Political and financial commitment from governments as well as co-ordinated national and continental evidence-informed efforts by all immunisation stakeholders are needed to both maintain current achievements and make additional progress for the Expanded Programme on Immunisation in Africa."

The authors add: "African leaders must be held accountable for meeting agreed country targets and honouring international commitments made."