Statement by UNICEF Executive Director Henrietta Fore on the disruption of immunization and basic health services due to the COVID-19 pandemic
: “Around the world, the COVID-19 pandemic is overstretching health services as health workers are diverted to support the response. “Physical distancing is leading parents to make the difficult decision to defer routine immunization. “Medical goods are in short supply and supply chains are under historic strain due to transport disruptions. Flight cancellations and trade restrictions by countries have severely constrained access to essential medicines, including vaccines. “As the pandemic progresses, critical life-saving services, including immunization, will likely be disrupted, especially in Africa, Asia and the Middle East where they are sorely needed. “At the greatest risk are children from the poorest families in countries affected by conflicts and natural disasters. “We are particularly concerned about countries that are battling measles, cholera or polio outbreaks while responding to COVID-19 cases, such as Afghanistan, the Democratic Republic of Congo, Somalia, the Philippines, Syria and South Sudan. Not only would such outbreaks tax already stretched health services, they could also lead to additional loss of lives and suffering. At a time like this, these countries can ill-afford to face additional outbreaks of vaccine-preventable diseases. “The message is clear: We must not allow lifesaving health interventions to fall victim to our efforts to address COVID-19. “UNICEF is committed to supporting basic health care and immunization needs in the worst affected countries, and to doing so in a way that limits the risk of COVID-19 transmission. We are working hard to ensure adequate vaccine supplies are available in countries that need them. We are in close communication with global vaccine suppliers to ensure production is not disrupted and supply is managed in the best possible manner under these difficult circumstances. We are also providing greater support to governments to continue the supply of vaccines during this pandemic. “In the days to come, governments may have to temporarily postpone preventive mass vaccination campaigns in many places to ensure that the delivery of immunization services does not contribute to COVID-19 spread, and to follow recommendations on physical distancing. “UNICEF strongly recommends that all governments begin rigorous planning now to intensify immunization activities once the COVID -19 pandemic is under control. These vaccination activities must focus on children who will miss vaccine doses during this period of interruption and prioritize the poorest and most vulnerable children. To successfully roll-out vaccines against COVID -19 when they become available, we need to ensure that our immunization programmes remain robust and can reach those that will need these vaccines the most. “Immunization remains a life-saving health intervention. As the world's biggest buyer and supplier of vaccines, UNICEF will continue to play a pivotal role in supporting governments’ current and future immunization efforts.” Nurse Milka Babic performs immunization UNICEF/UNI218376/Pancic
Measles cases spike globally due to gaps in vaccination coverage: New report
Reported measles cases spiked in 2017, as multiple countries experienced severe and protracted outbreaks of the disease. This is according to a new report published today by leading health organizations. Because of gaps in vaccination coverage, measles outbreaks occurred in all regions, while there were an estimated 110 000 deaths related to the disease. Using updated disease modelling data, the report provides the most comprehensive estimates of measles trends over the last 17 years. It shows that since 2000, over 21 million lives have been saved through measles immunizations. However, reported cases increased by more than 30 percent worldwide from 2016. The Americas, the Eastern Mediterranean Region, and Europe experienced the greatest upsurges in cases in 2017, with the Western Pacific the only World Health Organization (WHO) region where measles incidence fell. “The resurgence of measles is of serious concern, with extended outbreaks occurring across regions, and particularly in countries that had achieved, or were close to achieving measles elimination,” said Dr Soumya Swaminathan, Deputy Director General for Programmes at WHO. “Without urgent efforts to increase vaccination coverage and identify populations with unacceptable levels of under-, or unimmunized children, we risk losing decades of progress in protecting children and communities against this devastating, but entirely preventable disease.” Measles is a serious and highly contagious disease. It can cause debilitating or fatal complications, including encephalitis (an infection that leads to swelling of the brain), severe diarrhoea and dehydration, pneumonia, ear infections and permanent vision loss. Babies and young children with malnutrition and weak immune systems are particularly vulnerable to complications and death. The disease is preventable through two doses of a safe and effective vaccine. For several years, however, global coverage with the first dose of measles vaccine has stalled at 85 percent. This is far short of the 95 percent needed to prevent outbreaks, and leaves many people, in many communities, susceptible to the disease. Second dose coverage stands at 67 percent. “The increase in measles cases is deeply concerning, but not surprising,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “Complacency about the disease and the spread of falsehoods about the vaccine in Europe, a collapsing health system in Venezuela and pockets of fragility and low immunization coverage in Africa are combining to bring about a global resurgence of measles after years of progress. Existing strategies need to change: more effort needs to go into increasing routine immunization coverage and strengthening health systems. Otherwise we will continue chasing one outbreak after another.” Responding to the recent outbreaks, health agencies are calling for sustained investment in immunization systems, alongside efforts to strengthen routine vaccination services. These efforts must focus especially on reaching the poorest, most marginalized communities, including people affected by conflict and displacement. The agencies also call for actions to build broad-based public support for immunizations, while tackling misinformation and hesitancy around vaccines where these exist. “Sustained investments are needed to strengthen immunization service delivery and to use every opportunity for delivering vaccines to those who need them,” said Dr Robert Linkins, Branch Chief of Accelerated Disease Control and Vaccine Preventable Disease Surveillance at the U.S. Centers for Disease Control and Prevention (CDC) and Measles & Rubella Initiative Management Team Chair. The Measles and Rubella Initiative is a partnership formed in 2001 of the American Red Cross, CDC, the United Nations Foundation, UNICEF, and WHO.
What are vaccines? Vaccines are products that are usually given in childhood to protect against serious, often deadly diseases. By stimulating your body’s natural defenses, they prepare your body to fight the disease faster and more effectively. How do vaccines work? Vaccines help your immune system fight infections more efficiently by sparking your immune response to specific diseases. Then, if the virus or bacteria ever invades your body in the future, your immune system will already know how to fight it. Are vaccines safe? Vaccines are very safe. Your child is far more likely to be hurt by a vaccine-preventable disease than by a vaccine. All vaccines go through rigorous safety testing, including clinical trials, before they are approved for the public. Countries will only register and distribute vaccines that meet rigorous quality and safety standards. Why should I vaccinate my child? Vaccines save lives. Measles vaccines alone are estimated to have prevented over 21 million deaths between 2000 and 2017. Vaccines will help protect your child against diseases that can cause serious harm or death, especially in people with developing immune systems like infants. It’s important to vaccinate your child. If not, highly contagious diseases such as measles, diphtheria and polio, which were once wiped out in many countries, will come back. Can my baby handle all of these vaccines? Yes. Many parents worry that multiple vaccines will overload their child’s immune system. But children are exposed to hundreds of germs every day. In fact, a common cold or sore throat will put a greater burden on your child’s immune system than vaccines. But these diseases are not present in my community. Do I still need to vaccinate my child? Yes. Although the diseases may be eliminated in your country or region, our increasingly interconnected world means that these diseases could spread from areas where they are still present. What is herd immunity? If enough people in your community are immunized against a certain disease, you can reach something called herd immunity. When this happens, diseases can’t spread easily from person to person because most people are immune. This provides a layer of protection against the disease even for those who cannot be vaccinated, such as infants. Herd immunity also prevents outbreaks by making it difficult for the disease to spread. The disease will become more and more rare, sometimes even disappearing entirely from the community. Can a vaccine cause my baby to get sick? Vaccines are extremely safe and serious side effects are rare. Almost all sickness or discomfort after vaccination is minor and temporary, such as a soreness at the injection site or mild fever. These can often be controlled by taking over-the-counter pain medication as advised by a doctor, or applying a cold cloth to the injection site. If parents are concerned, they should contact their doctor or health care provider. Extensive studies and research show that there is no evidence of a link between vaccines and autism. What diseases do vaccines prevent? Vaccines protect your child against serious illnesses like polio, which can cause paralysis; measles, which can cause brain swelling and blindness; and tetanus, which can cause painful muscle contractions and difficulty eating and breathing, especially in newborns. For a list of the most common vaccines and the diseases they prevent, see this list of the most common vaccines and the diseases they prevent . Can I delay the vaccine schedule? One of the best ways you can protect your child is to follow the recommended vaccine schedule in your country. Any time you delay a vaccine, you’re increasing your child’s vulnerability to disease. Can I let my child get the chickenpox instead of getting the vaccine? Although chickenpox is a mild disease that many parents will remember from childhood (the vaccine was introduced in 1995), some children will develop serious cases with complications that can be fatal or cause permanent disabilities. The vaccine eliminates the risk of complications from the disease, and prevents children from infecting their siblings, friends and classmates. What is the recommended vaccine schedule? Immunization schedules vary by country depending on which diseases are most prevalent. You can find an overview of the recommended vaccines and approximate dates from your local health centre, doctor or your government’s Ministry of Health. >> Learn more about immunization >> World Immunization Week
Over 20 million children worldwide missed out on measles vaccine annually in past 8 years, creating a pathway to current global outbreaks - UNICEF
– An estimated 169 million children missed out on the first dose of the measles vaccine between 2010 and 2017, or 21.1 million children a year on average, UNICEF said today. Widening pockets of unvaccinated children have created a pathway to the measles outbreaks hitting several countries around the world today. “The ground for the global measles outbreaks we are witnessing today was laid years ago,” said Henrietta Fore, UNICEF Executive Director. “The measles virus will always find unvaccinated children. If we are serious about averting the spread of this dangerous but preventable disease, we need to vaccinate every child, in rich and poor countries alike.” In the first three months of 2019, more than 110,000 measles cases were reported worldwide – up nearly 300 per cent from the same period last year. An estimated 110,000 people, most of them children, died from measles in 2017, a 22 per cent increase from the year before. Two doses of the measles vaccine are essential to protect children from the disease. However, due to lack of access, poor health systems, complacency, and in some cases fear or skepticism about vaccines, the global coverage of the first dose of the measles vaccine was reported at 85 per cent in 2017, a figure that has remained relatively constant over the last decade despite population growth. Global coverage for the second dose is much lower, at 67 per cent. The World Health Organization recommends a threshold of 95 per cent immunization coverage to achieve so-called ‘herd immunity’.
UNICEF launches #VaccinesWork campaign to inspire support for vaccines
– UNICEF is launching a new global campaign on 24 April to emphasize the power and safety of vaccines among parents and wider social media users. The campaign will run alongside World Immunization Week from 24 to 30 April to spread the message that together communities, including parents, can protect everyone through vaccines. #VaccinesWork has long been used to bring together immunization advocates online. This year, UNICEF is partnering with the Bill & Melinda Gates Foundation , the World Health Organization (WHO), and Gavi, the Vaccine Alliance to encourage even greater reach. The Bill & Melinda Gates Foundation will contribute USD$ 1 to UNICEF for every like or share of social media posts using the hashtag #VaccinesWork in April, up to USD$1 million, to ensure all children get the life-saving vaccines they need. Vaccines save up to 3 million lives yearly, protecting children from potentially deadly, highly infectious diseases such as measles, pneumonia, cholera, and diphtheria. Thanks to vaccines, fewer people died from measles between 2000 and 2017 and polio is on the verge of being eradicated. Vaccines are one of the most cost-effective health tool ever invented – every USD$1 spent on childhood immunization returns up to USD$44 in benefits. “We want the awareness that #VaccinesWork to go viral,” said Robin Nandy, UNICEF’s Chief of Immunization. “Vaccines are safe, and they save lives. This campaign is an opportunity to show the world that social media can be a powerful force for change and provide parents with trustworthy information on vaccines.” The campaign is part of a global, week-long celebration under the theme, Protected Together: Vaccines Work , to honour Vaccine Heroes – from parents and community members to health workers and innovators. “More children than ever before are being reached with vaccines today,” said Violaine Mitchell, Interim Director of Vaccine Delivery at the Bill & Melinda Gates Foundation. “We are delighted to work with UNICEF and all the global and country partners around the world who are working tirelessly to ensure all children, especially those in the world’s poorest countries, can be protected from life-threatening infectious diseases.” Despite the benefits of vaccines, an estimated 1.5 million children died of vaccine-preventable diseases in 2017. While this is often due to lack of access to vaccines, in some countries, families are delaying or refusing to vaccinate their children because of complacency or skepticism about vaccines. This has resulted in several outbreaks, including an alarming surge in measles, especially in higher-income countries. Uncertainty about vaccines on digital and social media platforms is one of the factors driving this trend. That is why the centerpiece of this UNICEF campaign is a 60-second animated film, “Dangers,” which, along with illustrated animations for social media posts and posters, is based on the relatable insight that kids, by their very nature, are little daredevils who are constantly putting themselves in danger. Available in Arabic, Chinese, French, Hindi, Russian, Spanish and Tagalog, the video explains that while parents can’t prevent all the dangers their kids get themselves into, they can use vaccination to help prevent the dangers that get into their kids. In addition, UNICEF experts will be answering questions about vaccination, including how vaccines work, how they are tested, why children should receive vaccines, as well as the risks of not vaccinating children in a timely manner. Additional quotes from campaign supporters: Angélique Kidjo, UNICEF Goodwill Ambassador and Grammy Award-Winning Singer: “Today nine in ten children receive immunizations, but we cannot leave anyone behind. We must reach every child with life-saving vaccines.” Maisa Silva , 16-year-old, Brazilian TV hostess and actress: "I accepted the invitation to participate in this campaign because I know the importance of vaccines for children's health. It is a way to protect children from various hazards we already know. Health is a very serious matter and we must not forget that vaccines work and are necessary. " ###
20 million children miss out on lifesaving measles, diphtheria and tetanus vaccines in 2018
– 20 million children worldwide – more than 1 in 10 – missed out on lifesaving vaccines such as measles, diphtheria and tetanus in 2018, according to new data from WHO and UNICEF. Globally, since 2010, vaccination coverage with three doses of diphtheria, tetanus and pertussis (DTP3) and one dose of the measles vaccine has stalled at around 86 percent. While high, this is not sufficient. 95 percent coverage is needed – globally, across countries, and communities - to protect against outbreaks of vaccine-preventable diseases. “Vaccines are one of our most important tools for preventing outbreaks and keeping the world safe,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “While most children today are being vaccinated, far too many are left behind. Unacceptably, it’s often those who are most at risk– the poorest, the most marginalized, those touched by conflict or forced from their homes - who are persistently missed.” Most unvaccinated children live in the poorest countries, and are disproportionately in fragile or conflict-affected states. Almost half are in just 16 countries - Afghanistan, the Central African Republic, Chad, Democratic Republic of the Congo (DRC), Ethiopia, Haiti, Iraq, Mali, Niger, Nigeria, Pakistan, Somalia, South Sudan, Sudan, Syria and Yemen. If these children do get sick, they are at risk of the severest health consequences, and least likely to access lifesaving treatment and care. Measles outbreaks reveal entrenched gaps in coverage, often over many years. Stark disparities in vaccine access persist across and within countries of all income levels. This has resulted in devastating measles outbreaks in many parts of the world – including countries that have high overall vaccination rates. In 2018, almost 350,000 measles cases were reported globally, more than doubling from 2017. “Measles is a real time indicator of where we have more work to do to fight preventable diseases,” said Henrietta Fore, UNICEF’s Executive Director. “Because measles is so contagious, an outbreak points to communities that are missing out on vaccines due to access, costs or, in some places, complacency. We have to exhaust every effort to immunize every child.” Ten countries with highest reported incidence rate of measles cases (2018) Coverage with measles first dose (2010) Coverage with measles first dose (2018) 1. Ukraine 56 91 2. Democratic Republic of Congo 74 80 3. Madagascar 66 62 4. Liberia 65 91 5. Somalia 46 46 6. Serbia 95 92 7. Georgia 94 98 8. Albania 99 96 9. Yemen 68 64 10. Romania 95 90 Ukraine leads a varied list of countries with the highest reported incidence rate of measles in 2018. While the country has now managed to vaccinate over 90 percent of its infants, coverage had been low for several years, leaving a large number of older children and adults at risk. Several other countries with high incidence and high coverage have significant groups of people who have missed the measles vaccine in the past. This shows how low coverage over time or discrete communities of unvaccinated people can spark deadly outbreaks. Human papillomavirus (HPV) vaccine coverage data available for the first time For the first time, there is also data on the coverage of human papillomavirus (HPV) vaccine, which protects girls against cervical cancer later in life. As of 2018, 90 countries – home to 1 in 3 girls worldwide - had introduced the HPV vaccine into their national programmes. Just 13 of these are lower-income countries. This leaves those most at risk of the devastating impacts of cervical cancer still least likely to have access to the vaccine. Together with partners like Gavi, the Vaccine Alliance, WHO and UNICEF are supporting countries to strengthen their immunization systems and outbreak response, including by vaccinating all children with routine immunization, conducting emergency campaigns, and training and equipping health workers as an essential part of quality primary healthcare. ###### For photos and broll, please click here . For the 2018 data, click here . The 2018 data will go live only at 09.00 am EST 15 July. About the data Since 2000, WHO and UNICEF jointly produce national immunization coverage estimates for Member States on an annual basis. In addition to producing the immunization coverage estimates for 2018, the WHO and UNICEF estimation process revises the entire historical series of immunization data with the latest available information. The 2018 revision covers 39 years of coverage estimates, from 1980 to 2018. DTP3 coverage is used as an indicator to assess the proportion of children vaccinated and is calculated for children under one year of age. The estimated number of vaccinated children are calculated using population data provided by the 2019 World Population Prospects (WPP) from the UN. Maryana Dzuba, 9, receives her first dose of MMR vaccine on 21 February 2019 in the medical centre of the Lapaivka village school, Lviv region, Ukraine. UNICEF/UN0284080/ Dyachyshyn Maryana Dzuba, 9, receives her first dose of MMR vaccine on 21 February 2019 in the medical centre of the Lapaivka village school, Lviv region, Ukraine, as part of a three-week long catch-up vaccination campaign to increase MMR coverage among school aged children in the region.
WHO and UNICEF warn of a decline in vaccinations during COVID-19
– The World Health Organization and UNICEF warned today of an alarming decline in the number of children receiving life-saving vaccines around the world. This is due to disruptions in the delivery and uptake of immunization services caused by the COVID-19 pandemic. According to new data by WHO and UNICEF , these disruptions threaten to
UNICEF begins shipping syringes for the global rollout of COVID-19 vaccines under COVAX
– UNICEF has sent 100,000 syringes and 1,000 safety boxes for COVID-19 vaccinations to the Maldives by air freight from UNICEF’s humanitarian warehouse in Dubai—part of the first wave of COVID-19-related syringe shipments to begin rolling out in the coming days. Others in the first wave of shipments include Côte d'Ivoire and São Tomé and Príncipe. The 0.5 ml syringes and safety boxes are expected to arrive in Malé, Maldives on Tuesday. Over the next few weeks, UNICEF will ship more than 14.5 million 0.5 ml and 0.3 ml auto-disable syringes to more than 30 countries. While the 0.5 ml syringes are meant for use with the Serum Institute of India/AstraZeneca vaccine, the 0.3 ml ones are to be used with the Pfizer-BioNTech vaccine. “In this global fight against the COVID-19 pandemic, syringes are as vital as the vaccine itself,” said UNICEF Executive Director Henrietta Fore. “It is critical to have adequate supplies of syringes already in place in every country before the vaccine arrives so that the vaccine can be administered safely. This would allow immunization to start immediately and help turn the tide on this terrible virus.” The countries that will receive syringes in this initial tranche are from those included in the COVAX indicative distribution and that have put in requests to UNICEF to supply syringes. These shipments will support the country rollout of COVID-19 vaccines, and is part of work by the COVAX Facility to provide vaccines to all participating countries. The 0.5 ml syringes are being dispatched from UNICEF’s humanitarian warehouse in Dubai, while the 0.3 ml & 2 ml syringes will be transported directly from a manufacturer in Spain. The consignments will also include safety boxes for the safe disposal of syringes. Both syringes are of the auto-disable type, which means they cannot be used again after a single dose of vaccine has been administered. This reduces the risk of infection from blood-borne diseases as a result of syringe re-use. In all, UNICEF will be supplying up to 1 billion syringes and 10 million safety boxes to countries in 2021 to ensure they are ready for COVID-19 vaccinations. In order to meet the demand for these vital supplies, UNICEF created a stockpile of almost half a billion syringes in its warehouses in Copenhagen and Dubai in preparation for the broader rollout of COVID-19 vaccines in 82 low- and lower middle-income countries. UNICEF has been working with airlines, logistics operators and freight forwarders to ensure the syringes are treated as priority freight, whether they are being shipped direct from a manufacturer or from UNICEF warehouses to the destination country’s port of entry. Although the first deliveries will be transported by air, most of the syringes and safety boxes will be transported by sea due to the large amount of space they take up as cargo. UNICEF is aiming to make 2 billion COVID-19 doses available for delivery in 2021. Even before COVID-19, UNICEF was already the largest single vaccine buyer in the world, procuring over 2 billion vaccines annually in order to reach almost half of the world’s children under 5. In addition, the agency procures and supplies around 600-800 million syringes for regular immunization programmes annually. COVAX is a global collaboration co-led by Gavi, the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations (CEPI) and WHO, and includes UNICEF, which leads on procurement and delivery, as well as getting countries ready to receive vaccines. ##### Двое мужчин на складе с коробками UNICEF/UN0419486/Pableo
UNICEF to stockpile over half a billion syringes by year end, as part of efforts to prepare for eventual COVID-19 vaccinations
– As the world awaits a COVID-19 vaccine, UNICEF has begun laying the groundwork for the rapid, safe and efficient delivery of the eventual vaccine by purchasing and pre-positioning syringes and other necessary equipment. As soon as COVID-19 vaccines successfully emerge from trials and are licensed and recommended for use, the world will need as many syringes as doses of vaccine. To begin preparations, this year, UNICEF will stockpile 520 million syringes in its warehouses, part of a larger plan of 1 billion syringes by 2021, to guarantee initial supply and help ensure that syringes arrive in countries before the COVID-19 vaccines. During 2021, assuming there are enough doses of COVID-19 vaccines, UNICEF anticipates delivering over 1 billion syringes to support COVID-19 vaccination efforts on top of the 620 million syringes that UNICEF will purchase for other vaccination programmes against other diseases such as measles, typhoid and more. “Vaccinating the world against COVID-19 will be one of the largest mass undertakings in human history, and we will need to move as quickly as the vaccines can be produced,” said Henrietta Fore, UNICEF Executive Director. “In order to move fast later, we must move fast now. By the end of the year, we will already have over half a billion syringes pre-positioned where they can be deployed quickly and cost effectively. That’s enough syringes to wrap around the world one and a half times.” In line with the longstanding collaboration between the two partners, Gavi will reimburse UNICEF for the procurement of the syringes and safety boxes, which shall then be used for the COVID-19 Vaccine Global Access Facility (COVAX Facility) and for other Gavi-funded immunization programmes if necessary. Besides syringes, UNICEF is also buying 5 million safety boxes so that used syringes and needles can be disposed in a safe manner by personnel at health facilities, thus preventing the risk of needle stick injuries and blood borne diseases. Every safety box carries 100 syringes. Accordingly, UNICEF is “bundling” the syringes with safety boxes to ensure enough safety boxes are available to go along with the syringes. Injection equipment such as syringes and safety boxes have a shelf life of five years. Lead-times for such equipment are also long as these items are bulky and need to be transported by sea freight. Vaccines , which are heat sensitive, are normally transported more quickly by air freight. In addition to saving time, early purchase of syringes and safety boxes also reduces pressure on the market and pre-empts potential early spikes in demand when vaccines do become available. As the key procurement coordinator for Gavi, the Vaccine Alliance, UNICEF is already the largest single vaccine buyer in the world , procuring more than 2 billion doses of vaccines annually for routine immunization and outbreak response on behalf of nearly 100 countries. Every year, UNICEF provides vaccines for almost half of the world’s children and procures and supplies around 600-800 million syringes for regular immunization programmes. COVID-19 vaccines will likely treble or quadruple that number, depending on the number of COVID-19 vaccines that are ultimately produced and secured by UNICEF. “Over two decades, Gavi has helped an additional 822 million children from the world’s most vulnerable countries access critical, life-saving vaccines,” said Seth Berkley, CEO of Gavi. “This would not have been possible without our partnership with UNICEF, and it is this same collaboration that will be essential to Gavi’s work with the COVAX Facility.” To make sure that vaccines are transported and stored at the right temperature , UNICEF, along with WHO, is also mapping out existing cold chain equipment and storage capacity – in the private as well as public sector – and preparing necessary guidance for countries to receive vaccines. “We are doing everything we can to deliver these essential supplies efficiently, effectively and at the right temperature, as we already do so well all over the world,” Fore said. Even prior to the COVID-19 pandemic, with support from Gavi and in partnership with WHO, UNICEF has been upgrading the existing cold chain equipment across health facilities in countries to ensure that vaccines remain safe and effective throughout their journey. Since 2017, over 40,000 cold-chain fridges, including solar fridges, have been installed across health facilities, mostly in Africa. In most countries, UNICEF is promoting solar technologies to help countries maintain supply chains. In South Sudan , the least electrified country in the world, where temperatures frequently exceed 40 degrees Celsius, more than 700 health facilities have been equipped by UNICEF with solar power fridges, approximately 50 per cent of health facilities in the country. A health volunteer fills a syringe UNICEF/UN070241/Hatcher-Moore
Alarming global surge of measles cases a growing threat to children
1. Ukraine 30,338 2. Philippines 13,192 3. Brazil 10,262 4. Yemen 6,641 5. Venezuela 4,916 6. Serbia 4,355 7. Madagascar 4,307 8. Sudan 3,496 9. Thailand 2,758 10. France 2,269 Globally, 98 countries reported more cases of measles in 2018 compared to 2017, eroding progress against this highly preventable, but potentially deadly disease. Ukraine, the Philippines and Brazil saw the largest increases in measles cases from 2017 to 2018. In Ukraine alone, there were 35,120 cases of measles in 2018. According to the government, another 24,042 people were infected just in the first two months of 2019. In the Philippines so far this year, there have been 12,736 measles cases and 203 deaths 2 , compared to 15,599 cases in the whole of 2018. "This is a wake up call. We have a safe, effective and inexpensive vaccine against a highly contagious disease – a vaccine that has saved almost a million lives every year over the last two decades,” said Henrietta H. Fore, UNICEF’s Executive Director. “These cases haven’t happened overnight. Just as the serious outbreaks we are seeing today took hold in 2018, lack of action today will have disastrous consequences for children tomorrow." Measles is highly contagious, more so than Ebola, tuberculosis or influenza. The virus can be contracted by someone up to two hours after an infected person has left a room. It spreads through air and infects the respiratory tract, potentially killing malnourished children or babies too young to be vaccinated. Once infected, there is no specific treatment for measles, so vaccination is a life-saving tool for children. In response to these outbreaks, UNICEF and its partners are supporting governments to urgently reach millions of children in countries around the globe. For example: In Ukraine, UNICEF has provided ongoing support to accelerate routine immunization across the country and address vaccine hesitancy, including additional efforts to stop the most recent outbreak that has claimed 30 lives since 2017. In February, the Ministry of Health, with UNICEF’s support, launched an immunization drive at schools and clinics in the worst-hit Lviv region in western Ukraine, where negative attitudes toward immunization, and previous shortages in vaccine supply, have resulted in low vaccination rates. In the
More than 117 million children at risk of missing out on measles vaccines, as COVID-19 surges
“As COVID-19 continues to spread globally, over 117 million children in 37 countries may miss out on receiving life-saving measles vaccine. Measles immunization campaigns in 24 countries have already been delayed; more will be postponed. “During this challenging period, the Measles & Rubella Initiative (M&RI) expresses solidarity with families, communities, governments and emergency responders and joins our global immunization and health partners, including those within Gavi, the Vaccine Alliance and the Global Polio Eradication Initiative (GPEI) in our collective focus and fight against the threat of COVID-19. The pandemic sweeping the globe requires a coordinated effort and commitment of resources to ensure frontline health workers around the world are protected, as they face and respond to this new threat. At the same time, we must also champion efforts to protect essential immunization services, now and for the future. “The World Health Organization (WHO) has issued new guidelines endorsed by the Strategic Advisory Group of Experts on Immunization -- to help countries to sustain immunization activities during the COVID-19 pandemic. The guidelines recommend that governments temporarily pause preventive immunization campaigns where there is no active outbreak of a vaccine-preventable disease. M&RI partners, which include the American Red Cross, the U.S. Centers for Disease Control and Prevention, UNICEF, the United Nations Foundation and WHO, strongly agree with these recommendations. We also urge countries to continue routine immunization services, while ensuring the safety of communities and health workers. The recommendations also ask governments to undertake a careful risk-benefit analysis when deciding whether to delay vaccination campaigns in response to outbreaks, with the possibility of postponement where risks of COVID-19 transmission are deemed unacceptably high. “If the difficult choice to pause vaccination is made due to the spread of COVID-19, we urge leaders to intensify efforts to track unvaccinated children, so that the most vulnerable populations can be provided with measles vaccines as soon as it becomes possible to do so. While we know there will be many demands on health systems and frontline workers during and beyond the threat of COVID-19, delivering all immunization services, including measles vaccines, is essential to saving lives that would otherwise be lost to vaccine-preventable diseases. “The M&RI supports the need to protect communities and health workers from COVID-19 through a pause of mass campaigns, where risks of the disease are high. However, this should not mean that children permanently miss out. Urgent efforts must be taken now at local, national, regional and global levels to prepare to close the immunity gaps that the measles virus will exploit, by ensuring that vaccines are available and that they reach children and vulnerable populations, as quickly as possible, to keep them safe. “Despite having a safe and effective vaccine for over 50 years, measles cases surged over recent years and claimed more than 140,000 lives in 2018, mostly of children and babies – all of which were preventable. Against this already dangerous backdrop, preventive and responsive measles vaccination campaigns have now been paused or postponed in 24 countries to help avert further spread of COVID-19. Campaigns expected to take place later in 2020 in an additional 13 countries may not be implemented. Together, more than 117 million children in 37 countries, many of whom live in regions with ongoing measles outbreaks, could be impacted by the suspension of scheduled immunization activities. This staggering number does not include the number of infants that may not be vaccinated because of the effect of COVID-19 on routine immunization services. Children younger than 12 months of age are more likely to die from measles complications, and if the circulation of measles virus is not stopped, their risk of exposure to measles will increase daily. “The M&RI salutes the heroism of health and emergency workers across the globe, and we recognize the vital role they play in delivering clear, trusted information, as well as preventive and supportive care within their communities. We must invest in health workers and ensure they are protected from infection and empowered as part of sustainable and functioning primary health systems. They are the first line of defense against global epidemics. We also recognize the role of parents and caregivers in ensuring their children are vaccinated by following physical distancing recommendations in line with national guidance. Finally, we call on countries and local leaders to implement effective communication strategies to engage communities, ensure supply and demand for vaccination remains strong, and help assure a healthy life for every child especially in this challenging time.” #####
UNICEF to lead procurement and supply of COVID-19 vaccines in world’s largest and fastest ever operation of its kind
– UNICEF is leading efforts to procure and supply COVID-19 vaccines in what could possibly be the world’s largest and fastest ever procurement and supply of vaccines, as part of the global vaccine plan of the COVID-19 Vaccine Global Access Facility (COVAX Facility) led by Gavi, the Vaccine Alliance. With several vaccine candidates showing promise, UNICEF, in collaboration with the PAHO Revolving Fund , will lead efforts to procure and supply doses of COVID-19 vaccines on behalf of the COVAX Facility for 92 low- and lower middle-income countries whose vaccine purchases will be supported by the mechanism through the Gavi COVAX AMC as well as a buffer stockpile for humanitarian emergencies. In addition, UNICEF will also serve as procurement coordinator to support procurement by 80 higher-income economies , which have expressed their intent to participate in the COVAX Facility and would finance the vaccines from their own public finance budgets. UNICEF will undertake these efforts in close collaboration with WHO, Gavi, CEPI, PAHO, World Bank, the Bill and Melinda Gates Foundation and other partners. The COVAX Facility is open to all countries to ensure that no country is left without access to a future COVID-19 vaccine. “This is an all-hands on deck partnership between governments, manufacturers and multilateral partners to continue the high-stakes fight against the COVID-19 pandemic,” said Henrietta Fore, UNICEF Executive Director. “In our collective pursuit of a vaccine, UNICEF is leveraging its unique strengths in vaccine supply to make sure that all countries have safe, fast and equitable access to the initial doses when they are available.” UNICEF is the largest single vaccine buyer in the world, procuring more than 2 billion doses of vaccines annually for routine immunization and outbreak response on behalf of nearly 100 countries. It is the main procurement partner of Gavi, the Vaccine Alliance, which over the last 20 years has reached more than 760 million children with life-saving vaccines, preventing more than 13 million deaths. UNICEF will use its market shaping and procurement expertise to coordinate the procurement and supply of COVID-19 vaccines for the COVAX Facility. This could potentially double the agency’s overall vaccine procurement throughput volume in 2021 alone. In response to an expression of interest that UNICEF issued in June on behalf of the COVAX Facility, 28 manufacturers with production facilities in 10 countries shared their annual production plans for COVID-19 vaccines through 2023. According to the timelines the manufacturers indicated, the span from development to production could be one of the fastest scientific and manufacturing leaps in history. A UNICEF market assessment , developed by compiling information submitted by vaccine manufacturers along with publicly available data, revealed that manufacturers are willing to collectively produce unprecedented quantities of vaccines over the coming 1-2 years. However, manufacturers signaled that investments to support such large-scale production of doses would be highly dependent on, among other things, whether clinical trials are successful, advance purchase agreements are put in place, funding is confirmed, and regulatory and registration pathways are streamlined. This assessment also illustrates, among other things, manufacturers’ responsiveness to the COVAX Facility’s design and objectives—a key pillar of the ACT-Accelerator initiative , which is a new, groundbreaking global collaboration to accelerate the development and equitable distribution of vaccines, diagnostics and therapeutics to address the COVID-19 pandemic across countries of all income levels. A key next step will be ensuring self-financing economies sign up for the COVAX Facility by 18 September, which will allow COVAX to support early, at-risk investments in increasing manufacturing capacity on a broad scale, through advance purchase agreements. Currently under development by WHO, the COVAX allocation framework will guide how and where UNICEF, PAHO and other procurers working on behalf of participating countries supply COVID-19 vaccines that are secured by the Facility. Initial dose allocations are expected to be scaled to enable countries to vaccinate health and social workers, followed by subsequent tranches of vaccine doses that would enable participating countries to vaccinate populations at higher risk of critical COVID-19 disease. “UNICEF has been critical partner in the Alliance’s success over the last two decades – helping us reach more than half the world’s population with life-saving vaccines,” said Dr. Seth Berkley, CEO of Gavi. “This expertise and experience will be important in ensuring that COVAX – as a global effort to procure and deliver safe and effective COVID-19 vaccines, on an accelerated timeframe, and at an unprecedented scale – can protect the most at-risk, wherever they may be in the world. Together we can work to end the acute stage of this pandemic, including its devastating impact on individuals, communities, and economies.” UNICEF, Gavi, WHO, and PAHO have started critical preparatory work for country vaccine readiness in collaboration with partners and national governments including: Working with device manufacturers to plan availability of safe injection equipment and cold chain requirements for the vaccine; Developing guidance with WHO and trainings to support vaccination policies and appropriate handling, store and distribution of the vaccines; Working with manufacturers on freight and logistics solutions to get vaccine doses to countries as quickly and safely as possible once they are allocated; Supporting countries in planning for vaccine delivery, including targeting those most at risk and transport and storage at point of service delivery; Ramping up efforts with civil society and other local partners to ensure that people are well-informed about the COVID-19 vaccination process and putting measures in place to enhance trust and tackle misinformation about COVID-19 vaccines. 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