Nearly 5 million children to be immunised against measles and rubella in Rwanda
Rwanda is first among sub-Saharan African countries to introduce the combined vaccine
By Raquel Wexler and Cyriaque Ngoboka
NYARUNGURU, Rwanda: Thousands of children and their parents converged on the hills surrounding Kibeho’s health centre in southern Rwanda as the first combined measles-rubella immunization campaign kicked off in sub-Saharan Africa.
During a three-day period, nearly 5 million children under 15 years of age, or 47 per cent of the population of Rwanda, will be immunised with the new vaccine throughout the country.
Esperance Tuyisenge arrived early at the health centre to vaccinate her six children. “It is important to immunize children because it keeps them from getting sick. Even when a vaccinated child gets sick, the infection is mild, and easy to heal.”
The campaign – as part of the Integrated Child and Adolescent Health Week — has been organised by the Rwandan Ministry of Health, with the support of partners such as UNICEF, WHO and the GAVI Alliance.
The Integrated Child and Adolescent Week is an annual event which promotes immunization through national and community-based advocacy, awareness-raising and immunization activities. By introducing the combined measles-rubella vaccine, Rwanda will be the first country in sub-Saharan Africa to provide 12 vaccines in the country.
More than 6,000 nurses and 18,000 community health workers were mobilised for the project, which began yesterday and will run until 15 March.
Much progress made
Measles is a highly contagious viral infection and easily spread from person to person through coughing or sneezing. The virus attacks the immune system, making children vulnerable to deadly infections. It is particularly deadly to younger children who are malnourished and suffering weakened immune systems.
Globally, measles is one of the leading causes of death of children under the age of five, despite the presence of an effective vaccine. Survivors of measles are often left with life-long disabilities, such as blindness and brain damage.
Rwanda has made huge strides in eradicating measles during the last decade. In 2000, some 2,700 measles cases were recorded in Rwanda, whereas in 2012, there were fewer than 80 reported cases in the country, and zero deaths.
Despite these achievements, an increase in reported rubella cases – 62 cases in 2011 up from 35 in 2008 – raised concern among health authorities that rubella was becoming a rising public health problem.
Rubella, also known as the German measles, causes a rash similar to measles making it difficult for parents and health workers to know the difference. Rubella is generally mild, even in children, but in pregnant women in may lead to fetal death, or cause serious birth defects, known as congenital rubella syndrome.
In response, the Government elected to introduce the combined Measles-Rubella vaccine as a second dose of measles vaccine into the routine immunization system to accelerate measles and rubella elimination goals. Thus two diseases will be controlled with one vaccine, a move that is also cost-effective.
“As one of our objectives is to eradicate measles, and we had a few isolated measles cases among children, it was necessary to plan a national campaign to implement the combined measles and rubella immunization,” said Oda Gasinizigwa, Rwanda’s Minister of Gender and Family Promotion at the event.
“This vaccine will provide children an extra layer of protection not only from measles, which is already being effectively controlled, but from rubella as well,” said UNICEF Rwanda Representative, Noala Skinner. “And this is an investment not only in this generation of Rwandan children, but in the next generation of mothers, and their children.”
UNICEF support to the combined measles-rubella campaign in Rwanda is part of a global public-private partnership, the Measles & Rubella Initiative (M&RI), committed to ensuring no child dies from measles or is born with congenital rubella syndrome. Other partners include the World Health Organization, the American Red Cross, the United Nations Foundation and the U.S. Centers for Disease Control and Prevention. The GAVI Alliance - a broad coalition of public-private partners committed to saving children’s lives and protecting people’s health by increasing access to immunisation in developing countries, provided funding for the measles-rubella vaccines. USAID has provided strategic guidance to national immunization services and successfully supported Rwanda’s efforts to expand the national cold chain system and introduce new vaccines.
With such robust investments in saving children’s lives, Rwanda has attained the MDG4 target on child survival 4 years before the 2015 deadline, and is on track to surpass it.
UNICEF has supported the government in combatting vaccine-preventable child killer diseases in Rwanda for over a decade. UNICEF has successfully helped reduce the high disease burden among children in Rwanda due to pneumonia, diarrhoea and malaria, which has contributed to a decrease in child anaemia and malnutrition.
“These kinds of campaigns quite literally save children’s lives,” continued Ms. Skinner, UNICEF Rwanda Representative. “We believe in zero preventable deaths. No child anywhere should die from a preventable disease. This campaign marks another important milestone towards achieving that goal.”
In support of the combined measles-rubella campaign, UNICEF provided policy advice to the government in submitting its application to GAVI, and technical and financial support to national cold-chain logistics and maintenance. UNICEF also trained health workers nationwide, supported social and community mobilization and supervised the implementation of the campaign. Such activities in support of national immunization efforts will help ensure that children such as Esparance Tuyisenge’s, get the best start in life.
“It is very important to me that my children grow up healthy, and develop,” said Esperance.
Photo essay: Combined measles-rubella campaign kicks off