KINSHASA, Democratic Republic of Congo — The Decade of Vaccines (DoV) was supposed to be the decade that saw the eradication of vaccine-preventable diseases. The global health community developed the DoV Collaboration in 2010 to stimulate the discovery, development and delivery of life-saving vaccines. The vision of the group was a world in which individuals and communities could enjoy lives free from vaccine-preventable diseases. The recent measles outbreak in the DRC may inhibit the DOV’s goal.
In July 2019, measles became the deadliest disease in the Democratic Republic of Congo (DRC). More than 100,000 cases of measles exist in the DRC, surpassing the 2,500 cases of the Ebola virus. Since there is no treatment for measles, vaccination remains a crucial component for slowing the spread of the disease. However, government officials and the global health community have different views on the best way to move forward. Here are three proposed solutions to eliminate the measles outbreak in the DRC:
In early August 2019, Rwanda temporarily closed the border it shared with the DRC. The reason for the closure remains unclear. However, many speculate the main culprit was the Ebola outbreak occurring in the DCR. African officials from countries with high vaccination rates, such as Ghana (95 percent), Senegal (90 percent) and Kenya (89 percent) are under pressure to follow Rwanda’s decision.
Unvaccinated children and adults may be a cause of the spread of measles they hold a high risk of getting sick. To reduce the risk of spreading the disease, African officials are considering issuing travel restrictions for unvaccinated travelers. On one side, travel restrictions would allow countries to control disease and prevent it from spreading. On the other, a travel restriction would not address the root of the problem: low vaccination numbers.
Research on Vaccinations
The Alliance for International Medical Action (ALIMA) believes vaccination coverage can improve through research. Africa employs heavy research into access to vaccines. Research teams tend to conduct their studies in countries with working healthcare systems.
Ghana is a top choice for research teams. The country has 95 percent vaccination coverage. However, the best results come from well-rounded research. Research teams will also need to facilitate studies in countries with weaker healthcare systems like the DCR. Unlike Ghana, the DCR has a low vaccination coverage level. Noticeably, the measles has primarily affected the DCR and not Ghana.
Another benefit of research is that it gives health professionals guidance on how to improve vaccination coverage. Research shows that lack of storage for vaccines causes limited access to vaccinations. As a result, health communities have started combining activities. When a food distribution event is going on in a low-income area, ALIMA is also present to provide vaccinations to individuals and families. Research has also shown that vaccine waste is a serious problem. ALIMA is proposing smaller doses of vaccines to prevent vaccinators from disposing of extra vaccine doses.
African healthcare workers are getting new training sessions. The Clinton Health Access Initiative (CHAI) is leading the charge. Healthcare workers are tested for effective immunization and vaccine management. The improvements come after healthcare workers score a competency level of 65 percent when tested on effective immunization and vaccine management. In other words, health care workers handle 35 percent of immunization and vaccine practices inaccurately. This is a red flag because it dictates the level of vaccine accessibility in the region. If people mismanage immunizations and vaccines, the results are smaller levels of vaccinations as well as inaccurate immunizations.
Text-heavy, impersonal lectures were part of the problem. In collaboration with government officials, CHAI is approaching the situation with onsite training and mentorship through peer-led learning programs. The interpersonal and interactive approach reinforces classroom training and increases frequency for practical learning opportunities among workers. This method could aid in the eradication of the measles outbreak in the DRC as well as other vaccine-preventable diseases.
Obstacles to Success
There are several reasons vaccine-preventable diseases continue to spread in the DCR. Increased violence makes accessing vaccines more difficult and can result in diverted resources. Furthermore, there is a lot of mistrust towards medical teams.
However, one major obstacle to success in 2019 will be the Ebola crisis. The number of Ebola-related deaths in Africa has risen dramatically. As a result, medical professionals diverted the resources to deal with the Ebola crisis that they once allocated to the prevention of measles. The diversion is creating problems since more than 2,000 people have died from measles in 2019 compared to 1,665 Ebola-related deaths in the DCR.
The Decade of Vaccines
One year remains to measure the success of the Decade of Vaccines. While there are many obstacles ahead to eliminate the measles outbreak in the DRC, there is still time for the DoV Collaboration to eliminate vaccine-preventable diseases.
– Paola Nuñez