June 4, 2013 |

Equity in immunization

Health worker giving a child a vaccine, while the child leans against a woman.
Photo: PATH/Gabe Bienczycki.

Guest contributor Andy Seale was formerly director of advocacy and communication for the Vaccine Implementation Technical Assistance Consortium, part of our Vaccine Access and Delivery Global Program.

Woman in white lab coat places items on wooden table.
A health worker in Ethiopia sets up a vaccination site. Photo: PATH/Carib Nelson.

Ethiopia’s capital Addis Ababa is in the grip of a noisy, dusty, and unprecedented construction boom that’s rapidly transforming it into a modern metropolis, complete with high-rise skyline, new roads, and a metro transit system. Meanwhile, life has remained unchanged for millennia in the remote northeastern Afar region, where a largely nomadic population moves with their livestock in search of water and grazing.

As I traveled home recently after an inspiring visit, I was once again struck by the dynamic and diverse nature of this beautiful, historic country of extreme contrasts. It was my fourth visit to Ethiopia, where I work alongside PATH colleagues and local partners to strengthen delivery of childhood vaccines.

Differences within the same country manifest themselves in striking ways when it comes to health. Children born in Afar are more than twice as likely as children born in Addis Ababa to die before their fifth birthdays. In Afar, the percentages of children who have received recommended childhood vaccines are some of the lowest in Africa. According to recent studies, only 14 percent of children in Afar, compared to 94 percent in Addis Ababa, have immunization record cards.

Ambitious plans for equity

Despite these challenges, the Ethiopian government, supported by the GAVI Alliance, the World Health Organization, UNICEF, and civil society partners, is progressing with ambitious plans to address the challenges presented by inequities within the country. In Afar, local health extension workers are critical to these efforts, as are specially trained community champions who work closely with nomadic families to encourage them to vaccinate their children.

Like our partners in Ethiopia, PATH is driven by a vision of a world where innovation ensures that health is within reach for everyone. Recently, we  launched an online survey on behalf of the GAVI Alliance to help focus efforts on tackling inequities in immunization within low-income countries. I invite you to share your thoughts on immunization and equity by taking part. Our hope is that the survey, which will run through June 28, will serve as a way to consult with you—and help reinvigorate efforts to address inequities.

Health no matter where you are

Despite successes in improving access to immunization, 22 million children, mainly in the developing world, still aren’t vaccinated against common, life-threatening diseases. As we enter the final thousand days until the deadline to reach the Millennium Development Goals, equity has emerged as a critical theme for future global health efforts. Indeed, the Global Vaccine Action Plan endorsed by the World Health Assembly sets out to ensure that “the benefits of immunization are equitably extended to all people” regardless of geographic location, age, gender, disability, educational level, socioeconomic level, or ethnic group.

Ethiopia is home to some of the lowest and highest geographical points on the African continent. It includes both rural Abyssinian cultures that date back 3,000 years and a city that strives to be one of the most modern in Africa. We should continue to celebrate diversity like this within countries. We should also accelerate efforts to address other differences—such as access to health care—that are avoidable and unfair. Quite simply, children born in Addis and Afar should have the same chance at life.

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  • Andy Seale was formerly the director of advocacy and communication for the Vaccine Implementation Technical Assistance Consortium.