Vaccination protects the whole community – the more children who are fully immunized the safer everyone is – and it is one of the most cost-effective public health interventions. South Asian countries cannot meet the Millennium Development Goal to reduce under-five child mortality by two-thirds by 2015 without massive vaccination programmes.
Although most countries in South Asia achieved over 80 per cent immunization coverage in the early 1990s, later these efforts began to slide, especially in the three most populous countries – Bangladesh, India and Pakistan. Routine immunization remains low in several areas due to lack of planning at the district level, lack of funds to conduct outreach, and poor supervision and monitoring systems to track progress.
Nevertheless, overall immunization targets are being achieved and maintained in Bhutan, the Maldives, and Sri Lanka.
Following a decade of immunization campaigns that reached over 150 million children, polio is now found in only three South Asian countries – India, Pakistan and Afghanistan – mostly in small geographical pockets of resistance. Its eradication depends on the tenacity and commitment of national governments to fulfil their promise to immunize every child and on donors continuing to give maximum assistance.
Measles is a highly contagious disease that kills thousands of children every year; it is the fifth leading cause of child mortality in Bangladesh. Though it is vaccine preventable, almost 8 million children in India and 2 million in Pakistan have not been immunized.
UNICEF continues its role as the world’s leading supplier of vaccines to developing countries as well as playing a central role in harnessing support for immunization.
The Reaching Every District (RED) strategy introduced by UNICEF and the World Health Organization (WHO) in South Asia has five components: re-establishing outreach to all communities with poor access to regular services; improving supervision and on-site training; regular meetings between communities and health staff; using monitoring data to plan actions, chart doses, map populations, etc.; and planning and managing human and financial resources. The RED approach has been initiated in Afghanistan, Pakistan, Bangladesh and Nepal, with Nepal’s initial results demonstrating encouraging improvements in vaccination coverage.
Polio eradication campaigns have shown that micro-planning to reach every eligible child, sound communication, and mass social mobilization are the keys to success. UNICEF has helped Pakistan, Afghanistan, India and Nepal to train and use female volunteers to administer polio drops and promote immunization against maternal and child tetanus.
A UNICEF/WHO campaign to combat measles mortality helped Bangladesh to carry out the world’s biggest measles vaccination campaign in early 2006, vaccinating 33.5 million children between 9 months and 10 years old in only 20 days. Nepal and Pakistan carried out measles campaigns in 2005, and Afghanistan saved 35,000 under-five deaths a year after its 2002-2003 campaign vaccinated 11.2 million children.