BERLIN, Germany — Infectious diseases pose one of the greatest threats to the lives of people living in extreme poverty. Sub-Saharan Africa, which accounts for a large proportion of new infections worldwide, is affected more than any other region. In 2021, the six most significant viral infectious diseases associated with poverty—COVID-19, HIV/AIDS, acute hepatitis, dengue fever, rabies and Ebola—claimed 8.7 million lives, accounting for 12.8% of all global deaths, according to the study “Global Burden of Viral Infectious Diseases of Poverty.”
Even regarding bacterial infections, the region stands out from the rest of the world. A study by the Institute for Health Metrics and Evaluation shows that in 2019, pathogens such as Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae and Pseudomonas aeruginosa caused 230 deaths per 100,000 people in sub-Saharan Africa, the highest rate in the world.
The impact on the region’s economic growth is “significant”: The World Health Organization (WHO) estimates that diseases cause annual losses of $2.4 trillion. Well-planned vaccination campaigns are an important tool for preventing life-threatening infectious diseases among vulnerable populations and promoting the region’s development. However, the effective distribution of vaccines faces major challenges.
Digital microplanning gives health organizations a way to reach vulnerable groups in even the most remote areas, despite the logistical challenges involved. This helps them find and vaccinate “zero-dose” children—those who have never received a routine vaccination, according to the WHO’s definition. Most are under one year of age.
Infectious Diseases in Sub-Saharan Africa Pose a Global Threat
Due to their warm and humid climate as well as rich biodiversity, African countries offer ideal conditions for the growth of bacteria and viruses. In particular, the spread of infectious diseases disproportionately affects extremely poor people—according to the World Bank, about 43% of the population in sub-Saharan Africa by 2026. People living in poverty often have weakened immune systems due to malnutrition and poor hygiene, and this is just one of the reasons why infectious diseases affect them more frequently. According to a report by the United Nations Children’s Fund (UNICEF), more than 840 million people across the African continent lack access to clean drinking water.
Dense populations and close interactions between humans and animals—driven by deforestation, the wildlife trade and rapid population growth—are leading to an increase in zoonotic diseases, that is, the transmission of viruses from animals to humans. Over a 10-year period, from 2012 to 2022, these specific types of diseases increased by 63% in Africa, according to WHO. The outbreak of certain diseases not only threatens the country’s population—it also has the potential to trigger global pandemics.
Zero-Dose Children in Sub-Saharan Africa
These people live in the most remote areas, where sanitation and health infrastructure are inadequate—a situation that a shortage of medicines worsens. Vaccines must stay at a very specific temperature throughout the entire supply chain. Frequent power outages, lack of transportation infrastructure and a limited availability of maps make distribution difficult, leaving millions of children unprotected.
According to a meta-analysis by the University of Pretoria, only about 51% of children under the age of five received a full course of vaccinations. Furthermore, the study points out that children in rural areas and children of mothers with higher parity—women who have already given birth to several children—are less likely to receive a full course of vaccinations. The study found that about 13% had received not a single dose of vaccine.
Digital Microplanning in Sub-Saharan Africa
To address vaccination gaps, digital microplanning in sub-Saharan Africa offers a cost-effective and scalable solution that can more efficiently overcome existing barriers. Healthcare professionals, in collaboration with organizations such as eHealth Africa and Terre des Hommes, gather information about each remote community to create a carefully tailored micro-plan for that community’s specific needs.
Satellite data provides health workers with useful information about roads, settlements, health centers, schools and police stations, enabling them to carry out tailored vaccination campaigns and organize the necessary logistics for distribution centers.
A Geographic Information System (GIS) then visualizes the data using artificial intelligence (AI) and can even identify hidden or remote settlements. With real-time monitoring (RTM), health workers can track the progress of vaccinations instantly via mobile or web apps and optimize campaign strategies to reach the zero-dose population.
Data management systems provide important information on the exact quantities of vaccines, cold chain storage capacity, transportation logistics and staffing requirements. The Electronic Immunization Registry (EIR) links administrative data—such as vaccination history—with geographic information to identify communities where vaccinations have not yet taken place or where children still need doses to complete the series.
UNICEF and WHO have already carried out successful vaccination campaigns in Zambia and Uganda using digital microplanning. With the help of real-time monitoring, health workers in Uganda reached nearly 19.5 million children with measles and rubella vaccinations, and younger children also received the polio vaccine. In Zambia, RTM systems helped achieve a vaccination coverage rate of about 95% during a polio immunization campaign.
Conclusion
Digital microplanning of vaccination campaigns in sub-Saharan Africa has the potential to improve the distribution of medical supplies and reach children even in the most remote areas. Nevertheless, major challenges remain. Power outages, an underdeveloped digital infrastructure, gaps in technical capacity and poor data quality hinder the full realization of positive outcomes.
Foreign aid and support are vital for expanding digital infrastructure, as well as transportation, energy, water and health infrastructure, to continue driving economic development in sub-Saharan Africa. This will enable organizations to recruit and train sufficient health care workers and equip them with the necessary skills to use digital tools. In the future, these efforts will not only protect the poorest populations in developing countries but also reduce the risk of pandemics.
– Oliwia Kowalak
Oliwia is based in Berlin, Germany and focuses on Technology and Solutions for The Borgen Project.
Photo: Flickr