Gavi’s next strategy must make sure to reach the 10 million children in fragile settings
This week, on 6-7 June 2024, the Board of Gavi, the Vaccine Alliance, is meeting in Geneva to approve and endorse the one-page framework for Gavi 6.0, which outlines its strategy for the five-year period from 2026-2030. Gavi, which is funded by public and private donors, was set up nearly 25 years ago to help governments of the world’s poorest countries vaccinate children against some of the world’s deadliest diseases. While Gavi has been pivotal in improving access to vaccines for millions of children, protecting over 1 billion children against vaccine-preventable diseases since 2000, far too many children in fragile and humanitarian settings are still missing out on their routine vaccinations, creating, a situation of inequity among Gavi end-beneficiaries.
Approximately 10 million (49%) of the world’s children who are ‘zero-dose’ (defined as children who haven’t received a single dose of diphtheria, tetanus and pertussis-containing vaccine) or under-vaccinated live in fragile or humanitarian settings, including in countries impacted by conflict. With nearly half (46%) of Gavi-supported countries currently classified as fragile or conflict-affected – a proportion that is set to increase as other countries transition away from Gavi support – Gavi needs to do much more if it wants to achieve its goal of leaving no one behind with immunisation by reaching zero-dose children. Specifically, the Gavi Board must ensure that Gavi 6.0 offers a concrete, effective approach for how to immunise children in fragile or humanitarian settings, especially if they are in areas that are excluded from government vaccination efforts. In addition, the Gavi Board must make sure that vaccine support for children up to age five becomes a permanent policy for all relevant vaccines, in order to catch up older children who have missed out on their vaccines.
Why is MSF concerned?
For over five decades, Doctors Without Borders/Médecins Sans Frontières (MSF) has been vaccinating children through routine and preventive vaccination campaigns, and in response to disease outbreaks in some of the world’s most challenging humanitarian contexts. Often, MSF and other organisations are the sole providers of vaccination for people who are not reached by government-led vaccination activities for various reasons, including security constraints and geographic challenges.
Lately, we have witnessed the reemergence of preventable and previously controlled diseases like diphtheria and measles – outbreaks which are often the result of chronic under-immunisation of people who are in hard-to-reach places.
An MoH staff, member of the CATI team preparing oral cholera vaccines in Jigjiga, Somali region, Ethiopia| Date taken: 05/02/2024 | Photographer: Mohamed Adan
In response to an increase in diphtheria cases in the Batha province of Chad, MSF teams, in collaboration with the Ministry of Health, have launched a diphtheria vaccination campaign in the center of the country. MSF has dispatched an emergency team to Batha to begin treating diphtheria cases since December 2023. The target of the campaign is to vaccinate 25,000 people in the two health districts and contain the spread of diphtheria in the region. | Date taken: 29/01/2024 | Photographer: Johnny Vianney BissakonouWhat is MSF calling for?
MSF is calling on Gavi and its Board to use the opportunity of Gavi 6.0 to adapt its current operating model to include alternative approaches to reach people outside of government vaccination activities, or who have little or no convenient access to vaccination, and to put organisations already involved in these activities at the centre of their design.
To show that Gavi will meaningfully engage in an approach to reach people outside of government vaccination activities, or who have little or no convenient access to vaccination, the Gavi Board should ensure that Gavi 6.0 contains a dedicated funding stream for this work, includes MSF’s recommendations gathered from decades of vaccinating people in hard-to-reach places, and makes vaccine support for children up to age five a permanent Gavi policy for all relevant vaccines, so that zero-dose and under-vaccinated children can be fully protected from vaccine-preventable diseases.
Nkosi Mahlangu
About Doctors Without Borders (MSF)
Doctors Without Borders (MSF) is a global network of principled medical and other professionals who specialise in medical humanitarian work, driven by our common humanity and guided by medical ethics. We strive to bring emergency medical care to people caught in conflicts, crises, and disasters in more than 70 countries worldwide.
In South Africa, the organisation is recognised as one of the pioneers of providing Antiretroviral Treatment (ART) in the public sector and started the first HIV programmes in South Africa in 1999. Until today, the focus of MSF’s interventions in the country has primarily been on developing new testing and treatment strategies for HIV/AIDS and TB in Eshowe (Kwa-Zulu Natal) and Khayelitsha (Western Cape).
In Tshwane, we run a migration project, and we offer medical and psychosocial care to migrants, refugees, and asylum seekers, who struggle to access public health services under South Africa’s increasingly restrictive.
Previously we offered free, high-quality, confidential medical care to survivors of SGBV in Rustenburg.
To learn more about our work in South Africa, please visit this page on our website (www.msf.org.za). To support MSF’s work:
- SMS “JOIN” to 42110 to donate R30 Once-off
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