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
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
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.” #####  
As the COVID-19 pandemic begins to enter a new phase, UNICEF reminds the world that ‘the light at the end of the tunnel needs to shine for all’
 “COVID-19 is the first truly global crisis we have seen in our lifetimes. No matter where we live, the pandemic affects every one of us. Children have been seriously impacted. However, with more news about promising vaccines, and as we begin to imagine a day when COVID-19 is behind us, our guiding principle must be that the light at the end of the tunnel needs to shine for all. “This is why UNICEF has enthusiastically joined the Advance Market Commitment of the COVAX Facility to allow low- and lower-middle income countries access to COVID-19 vaccines. It is the best way to make sure that, as vaccines become available, no country is pushed to the back of the line. This would not only be fundamentally unfair, it would be unwise. The whole world will remain vulnerable to the virus until countries with the weakest health systems are protected from it as well. “In order for the COVAX Facility to work and guarantee equitable and affordable access to low- and lower-middle income countries, we need a global commitment to support and capitalize it, but also to finance the delivery of vaccines and associated supplies such as syringes and safety boxes. Governments must work together to ensure that COVID-19 vaccines are affordable and accessible to all countries. High-income countries should invest financially in the Advance Market Commitment and in UNICEF’s COVID-19 vaccine delivery efforts. All countries should take a strong stand against export controls on – and unnecessary stockpiling of – commodities for the COVID-19 response.  “UNICEF is also leveraging our unique strengths in community engagement and vaccine supply to make sure that countries participating in the COVAX Facility have safe, fast and equitable access to the vaccine. This is an enormous undertaking and many challenges still lay ahead.  As the largest vaccine buyer in the world,  procuring more than 2 billion doses  annually for routine immunization and outbreak response on behalf of nearly 100 countries, UNICEF is c oordinating and supporting  the procurement,  international freight , and in-country distribution of COVID-19 vaccines for the COVAX Facility. “Together with WHO, PAHO, GAVI and other partners at the global and regional levels, UNICEF is also working to support countries to ‘ready’ their immunization programmes for this historic roll-out. This includes assessing capacity and helping countries to strengthen their cold and supply chains so that they have adequate infrastructure to transport and store the vaccines for delivery to the frontlines. “However, the existence of a safe and effective COVID-19 vaccine alone will not end the pandemic. We need a diverse set of tools to help slow the spread of COVID-19, including diagnostics and treatments, as well as a continuance of preventive measures such as hand washing, physical distancing and mask wearing. UNICEF is providing governments with access to personal protective equipment, validated testing approaches, and proven treatments. In addition, UNICEF continues to work with multilateral partners to support governments with infection prevention control, water, sanitation and hygiene supplies, physical distancing, surveillance, contact tracing, case identification and community referral systems to stem the pandemic. “Lastly, we continue to help countries ensure the continuity of key essential services for women, children and young people – especially the most vulnerable. COVID-19 related disruptions have had a heavy impact on children: on their safety, their well-being, their future. Even as the fight against the disease enters into a hopeful new phase, we must not forget the work ahead of us to respond, recover and reimagine a better world for children.” ###
Leading airlines commit to helping UNICEF in its historic mission of transporting COVID-19 vaccines around the world
 UNICEF is today launching the Humanitarian Airfreight Initiative. Under this landmark initiative, over  10 leading airlines  are signing agreements with UNICEF to support the prioritization of delivery of COVID-19 vaccines, essential medicines, medical devices and other critical supplies to respond to the pandemic. The Initiative will also act as a global logistics preparedness mechanism for other humanitarian and health crises over the longer term.  “Delivery of these life-saving vaccines is a monumental and complex undertaking, considering the sheer volumes that need to be transported, the cold chain requirements, the number of expected deliveries and the diversity of routes” said Etleva Kadilli, Director of UNICEF Supply Division. “We are grateful to these airlines for joining forces with the UNICEF Humanitarian Airfreight Initiative to support the roll-out of COVID-19 vaccines.” The UNICEF Humanitarian Airfreight Initiative brings together the airlines covering routes to over 100 countries, in support of  the COVAX Facility  – the global effort aimed at equitable access to COVID-19 vaccines. Based on the COVAX Facility’s indicative distribution and first round allocation plan, 145 countries will receive doses to immunize around three per cent of their population, on average, starting in the first half of 2021, subject to all requirements being met and final allocation plans. In addition to prioritizing shipments of these life-saving supplies, the airlines will take measures such as temperature control and security, while also adding freight capacity to routes where needed. Their commitments are critical to the timely and secure delivery of vaccines and critical supplies.  Safe, timely and efficient transportation of life-saving supplies is critical to supporting access to essential services for children and families. COVAX deliveries and the subsequent vaccination of frontline workers will support health and social care systems to safely resume these critical services. Man next to a plane UNICEF/UNI319459/Rocio Ortega