OAKLAND, California — More than 4 million children living in the Sahel and the Horn of Africa have never been vaccinated as of 2020. This population is referred to as zero-dose children and accounts for almost half of vaccine-preventable deaths. In June 2022, the Global Alliance for Vaccination and Immunization or Gavi partnered with the governments of said countries along with other organizations to launch the Zero-dose Immunization Programme (ZIP).
The lack of vaccines is directly related to the extreme poverty rates in these communities. In Gavi-supported countries, less than one-third of zero-dose children live above the poverty line of $1.90 a day. Mortality rates are high for both children and mothers, who die during childbirth after not receiving antenatal care or birth attendance because their child will not receive vaccinations. In addition, barriers such as child marriages, teen pregnancy, gender-based violence, household perceptions of health care and mothers’ access to education all play into systemic ways of continuing zero-dose populations.
The International Rescue Committee (IRC) and World Vision
The International Rescue Committee (IRC) and World Vision will lead the project across the Horn of Africa and the Sahel region. Both organizations are based in the United States and together will reach a total of 11 countries.
The IRC and World Vision are working with many local organizations to carry out the project which should reach completion by December 2025. Some of these organizations include the African Christian Health Association Platform (ACHAP), Food for the Hungry, CORE Group, Acasus, Flowminder, IOM and ThinkPlace.
World Vision holds an immunization approach that consists of “listen, inform, dialogue, empower.” Many know this motto to be successful, for WV deployed it when fighting polio in Moradabad, India. Listening to concerns regarding the polio vaccine and developing community champions in restaurants, barbers, taxi drivers, Imams and local stores had more success than doctors and political leaders where mistrust is often present, according to World Vision. The same approach could be successful when tackling zero-dose children across Africa.
The international Rescue Committee has extensive experience carrying out mass vaccinations and childhood immunizations to combat diseases such as polio, measles, meningitis and cholera– all of which have high mortality rates. Having worked in 31 countries in remote and crisis-stricken areas, the IRC aims to “help reach the last mile and reduce cases of zero-dose children,” according to its website.
The Zero-dose Immunization Programme ensures that recipients will receive ongoing vaccinations and not just an initial dose. Adding to the thoroughness of the project, ZIP aims to address why the broader communities and health care systems in receiving countries still have zero-dose children at all.
The program begins with a three-month inception phase that determines why zero-dose children lack immunization. The program prioritizes children in areas outside of government outreach along with nomadic children and refugees. At the end of this three-month phase, plans to distribute immunizations will undergo development for each population, according to Gavi.
Within these plans will be an address to the barriers previously preventing these populations from immunization. Respective governments will play a crucial role in the “inception and implementation phases” and will be involved throughout the entire process, Gavi stated.
Children are dying of preventable diseases due to many socio-economic, culture and gender-based barriers. Immunizations are a low-cost high-impact process with a 44% return on their cost. Gavi has employed $100 million to find and vaccinate this population over the next two and a half years. With highly experienced and dedicated partners, there is hope to create sustainable plans for continuous immunizations and stronger health care programs across the Horn of Africa and Sahel.
– Jordan Oh