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Global Views (/global-views) | Global health (/news/search?query%5B%5D=Global+health)

Opinion: We are at a critical moment to invest inimmunizationBy Kate Dodson (/news/authors/1447474) // 18 March 2019

Global Health (/news/search?filter%5Bnews_topics%5D%5B%5D=Global+Health) Private Sector (/news/search?filter%5Bnews_topics%5D%5B%5D=Private+Sector)

A South Sudanese refugee child is vaccinated at the Nguenyyiel refugee camp in Ethiopia. Photo by: REUTERS / Tiksa Negeri

You’ve seen the alarming headlines from around the world: Asia (https://www.cbc.ca/news/health/philippines-measles-outbreak-1.5023474), Europe (http://www.euro.who.int/en/media-centre/sections/press-releases/2019/measles-in-europe-record-number-of-both-sick-and-immunized), Africa (https://www.nbcnews.com/storyline/measles-outbreak/measles-kills-900-madagascar-according-who-report-n974171?utm_source=Global+Health+NOW+Main+List&utm_campaign=4d422b8969-EMAIL_CAMPAIGN_2019_02_21_01_46&utm_medium=email&utm_term=0_8d0d062dbd-4d422b8969-2978525), South America(https://www.npr.org/sections/goatsandsoda/2019/02/05/691588994/collapse-of-health-system-sends-venezuelans-fleeing-to-brazil-for-basic-meds), and North America (https://www.nbcnews.com/storyline/measles-outbreak/measles-cases-nationwide-rise-101-cdc-says-n970156?icid=related) have seen the highest number of measles outbreaks in decades, and this disease once thought eliminated inmany parts of the world is coming back with a vengeance.

Why are we seeing such staggering rates of infections — and needless deaths — from a disease for which we have a safe and effectivevaccine? Unfortunately, in many parts of the world, fewer children are being vaccinated (https://measlesrubellainitiative.org/learn/the-impact/routine-immunization/). In 2017, 11 countries (https://data.unicef.org/topic/child-health/immunization/) that had previouslyreached 90 percent diphtheria-tetanus-pertussis vaccine coverage fell below this target, and nearly 20 million children wereundervaccinated. This is a worrisome sign we are backsliding in our progress.

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More on vaccination:

► Why can't pregnant women be vaccinated during epidemics? (https://www.devex.com/news/why-can-t-pregnant-women-be-vaccinated-during-epidemics-94079)

► Battle over CEPI's access to vaccines policy deepens (https://www.devex.com/news/battle-over-cepi-s-access-to-vaccines-policy-deepens-94438)

► Can PPPs help ensure vaccine supplies for future global epidemics? (https://www.devex.com/news/can-ppps-help-ensure-vaccine-supplies-for-future-global-epidemics-93314)

To stop measles and other vaccine-preventable diseases in their tracks, we know that countries need to step up their vaccination efforts.While many countries are working to ramp up domestic spending on immunization and health, the international community continuesto play an important role. Bill Gates kicked off the year by making a compelling case for global health, including vaccines, describing itas “the best investment (https://www.wsj.com/articles/bill-gates-the-best-investment-ive-ever-made-11547683309)” he had evermade.

We need to have robust donor support to multilateral organizations working on immunizations globally in order to keep us on the pathto achieving Sustainable Development Goal (https://www.devex.com/news/search?query=Sustainable+Development+Goals) 3: Healthand well-being for all. We have the right collective action tools in our toolbox to ensure no child needlessly gets sick from a disease.Platforms such as Gavi, the Vaccine Alliance (https://www.gavi.org/), Measles & Rubella Initiative(https://www.devex.com/impact/partnerships/measles-and-rubella-initiative-372), and Global Polio Eradication Initiative(https://www.devex.com/news/the-global-polio-eradication-initiative-is-winding-down-what-are-the-risks-91618) allow for actorscommitted to immunization to come together to stop these threats to people’s well-being around the world.

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We know that this year and next will bring critical funding moments for GPEI and Gavi. Meeting the replenishment needs of our mostimportant platforms for collective action on immunization must remain a top priority for donor governments and other philanthropicpartners if we are going to see the tide turn against vaccine-preventable diseases and other threats to the world’s health and well-being.

Few expect this task to be easy. Increasing hostility to multilateralism, declining trust in institutions, and nativist and nationalistic turnsare becoming more commonplace, including in donor countries that have been the bedrock of financing(https://www.cgdev.org/blog/development-agencies-fit-future) for multilateral global health efforts for well over a decade.

To counter these impulses, we must come together to support replenishment efforts with a persuasive and compelling vision of theoutcomes we will be able to achieve.

Over 1.5 million children die annually from vaccine-preventable deaths.— UNICEF (https://www.unicef.org/immunization)

(https://devex.zendesk.com/hc/en-us/articles/115000959453).

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It starts with hammering home the message on the progress (https://www.devex.com/news/opinion-what-2017-taught-us-about-vaccines-91793) we’ve already made together. It is telling that the pace of global progress in reducing child mortality was twice as fast(http://apps.who.int/iris/bitstream/handle/10665/200009/9789241565110_eng.pdf?sequence=1) during the MillenniumDevelopment Goals period than during the ‘90s, and the largest gains(http://apps.who.int/iris/bitstream/handle/10665/200009/9789241565110_eng.pdf?sequence=1) came from a reduction in vaccine-preventable diseases, especially measles, pneumonia, and rotavirus.

But as we’ve seen, this progress is fragile and can be easily undone. Most of the world’s underimmunized children live in fragilecontexts, including areas that face ongoing humanitarian disaster, conflict, refugee and migrant flows, and poor health infrastructure,so they are unable to access basic health services. Many also face cultural, social, financial, and logistical barriers to immunization.

This is why wemust redoubleour efforts andwork toreaffirm theworld’scommitment toglobal health.

The SDGsprovide an

opportunity to support comprehensive immunization efforts that will help reduce preventable maternal and child deaths, combat arange of communicable and noncommunicable diseases, advance universal health coverage, and strengthen health systems to benefitindividuals during all phases of life. If we succeed, 1.5 million people could be saved (https://www.unicef.org/immunization) each yearthrough better immunization coverage.

The trouble is, despite a period of robust and remarkable growth, concurrent with the progress of the MDGs era, health-focuseddevelopment assistance has largely flatlined. According to the Institute for Health Metrics and Evaluation(https://www.devex.com/organizations/institute-for-health-metrics-and-evaluation-ihme-52790), from 2010-2017, it only grew 1percent (http://www.healthdata.org/sites/default/files/files/policy_report/FGH/2018/IHME_FGH_2017_fullreport_online.pdf). Thisis a worrisome trend, precisely as global ambition is accelerating toward the SDGs.

The bottom line: Over the next 10 years, it is imperative that countries step up their own domestic resources for health, and receiverobust, flexible, and coherent development assistance for health, combined with smart support where they are transitioning from majorfinancial and technical support for health programs.

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The October 2018 Global Action Plan for Healthy Lives and Well-being for All (http://www.who.int/sdg/global-action-plan) has thepotential to drive continued, high-level commitment, innovation and coordination across major global health players. It could enhancethe effectiveness of external support by fostering collaboration on supply chain efforts, data and monitoring, demand-creation among

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populations, and domestic resource mobilization.

Domestic financing and development assistance alone will not be enough to meet the challenges ahead. To maintain progress onimmunization, build strong health systems and reach the SDG targets, we will need new paradigms of partnership between countries,development partners, and the private sector.

Donors, the private sector, and governments will need to pull together in the same direction in 2019 and make good on the pledge toleave no one behind. Our children and our world are depending on it.

About the author

Kate Dodson (/news/authors/1447474)Kate Dodson is the vice president for global health at the United Nations Foundation. In this role, Kate works to ensure that the UN Foundation is delivering on its commitments to addressthe health-related Sustainable Development Goals and builds synergies with U.N. agencies and other key multilateral partners. Previously, Kate spent several years as the UN Foundation'sdirector of global health and has also served as executive director of program integration, focused on cross-department and cross-issue collaboration.

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