African immunization systems fall short, experts say

In Africa, issues of vaccine supply, financing, and sustainability require urgent attention if the Millennium Development Goals are to be achieved, according to African experts writing in this week's PLOS Medicine.

Shingai Machingaidze, Charles Wiysonge, and Gregory Hussey from the University of Cape Town in South Africa commend for their progress in immunisation programmes but infectious disease outbreaks, for example, polio and 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 world-wide from vaccine-preventable diseases and the authors argue that with the 2015 deadline for the 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."

The authors 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.

The authors say: "Political and financial commitment from governments as well as coordinated 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 Immunization in Africa."

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

More information: Machingaidze S, Wiysonge CS, Hussey GD (2013) Strengthening the Expanded Programme on Immunization in Africa: Looking beyond 2015. PLoS Med 10(3): e1001405. doi:10.1371/journal.pmed.1001405

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