Rwanda is first sub-Saharan African country to introduce dual measles and rubella vaccine
By Suzanne Mary Beukes
24–30 April is World Immunization Week. Immunization is a successful and cost-effective way to save children’s lives. UNICEF has been a driving force behind universal immunization since the 1980s – behind reaching each and every child.
UNICEF and its partners are now intensifying their efforts to ensure that the poorest and most disadvantaged children have access to immunization.
Rwanda has become the first country in sub-Saharan Africa to introduce a dual vaccine to protect children against measles and rubella.
NYAKARIRO, Rwanda, 25 April 2013 – Giovance Kyomugisha and her family live in a small rural village about a three-hour drive from the capital, Kigali. A year ago, Ms. Kyomugisha was terrified. All five of her children had developed a high fever, diarrhoea and a rash on their skin.
UNICEF correspondent Suzanne Beukes reports on a vaccination programme that is protecting Rwandan children from measles and rubella.
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“When the children first became sick, we did not know what the problem was,” she recalls. “Then, a health worker visited a friend who told me that it is measles.”
Dual vaccine, dual prevention
Over the past few years, Rwanda has seen a significant drop in cases of measles. In 2012, there were no reported deaths as a result of the disease. However, in the past three years, the number of cases of rubella – or ‘German measles’ – has increased.
The two diseases display the similar symptoms of fever and skin rash, and both are highly contagious. Measles can be deadly for children with poor nutrition and a weakened immune system. It causes about 430 deaths per day worldwide, mainly in developing countries.
Rubella may cause miscarriage or severe birth defects known as congenital rubella syndrome, if a woman contracts it during the first trimester of pregnancy. An estimated 100,000 children around the world are born with this syndrome each year.
Rwanda recently became the first country in sub-Saharan Africa to introduce a dual vaccine to protect children against both measles and rubella. The programme was made possible through support from the GAVI Alliance, the World Health Organization, UNICEF, the Red Cross and others belonging to the Measles and Rubella Initiative.
The dual vaccine will become part of the government’s routine immunization strategy by 2014.
Recently, a dual vaccination campaign targeted some five million children between the ages of 9 months and 14 years.
Protecting children – and future children
Ms. Kyomugisha found out about the campaign on the radio. There was no question that she would have her children immunized – particularly after last year’s bout with measles.
“It is extremely significant for child survival that the measles–rubella combined vaccine is introduced in Rwanda today,” says UNICEF Rwanda Representative Noala Skinner. “It will literally save lives.
A child receives a vaccination against measles and rubella. Rwanda has seen a significant drop in cases of measles. However, in the past three years, the number of cases of rubella has increased.
“Those girls who have been vaccinated today – the future mothers – are now also protected. So, there is a layer of protection around the children, and around the future children,” she adds.
The introduction of the dual vaccine in Rwanda is seen as yet another positive addition to an already impressive record on child survival, which has included investment in the public health sector at all levels.
“Rwanda has made great strides over the past four years in child survival by introducing vaccines against leading childhood killers, including pneumonia and diarrhoea,” says Rwanda’s Minister of Health Dr. Agnes Binagwaho. “The introduction of the combined measles–rubella vaccine is one more important step to ensuring that all children in Rwanda receive the full immunization package.”
A community mobilized
Vaccine delivery depends on local support. In Rwanda, community health workers ensure children are vaccinated.
Belina Dusenge is one such worker. She lives down the road from the Kyomugisha family. She ensures that families in her village are informed about the importance of the dual vaccine and other vital health services that will protect children from disease.
“[W]hen the vaccination period is about to begin,” she explains, “we document all children who are supposed to be vaccinated, and we send that information to the health centre and keep a copy of the records, ourselves. When the campaign begins, we go to the vaccination sites and cross-check the information to know who is being vaccinated, and who is not.”
A moment of pain, a chance at a healthy life
The prick of a needle sends 1-year-old Gift Kyomugisha into a frenzy of tears. His mother nurses him while Hope, 6, and Ukwishaka, 8, have their vaccinations.
Once Gift has calmed, the family sets off for home with blue vaccination cards that show the children have received the measles–rubella vaccine.
Ms. Kyomugisha feels confident she has given her children the best defence against these two diseases, and a chance at a healthy life.
GAVI is offering the opportunity to all eligible countries – generally among the poorest in the world – to apply to introduce the measles–rubella vaccine. Through this support, more and more countries introduce the dual vaccine every year. The vaccine is expected to have a major impact on efforts to eliminate measles, and to control rubella and congenital rubella syndrome.