Two observations made by World Health Organisation (WHO) Director-General Dr Tedros Adhanom Ghebreyesus in his opening remarks at a series of meetings at the World Health Assembly’s (WHA) 76 Strategic Roundtable last week need to be acted upon by governments on a priority basis. WHA is the decision making body of the WHO. The first point was about the importance of restoring essential immunisation. As the WHO chief pointed out, in the past two years we have witnessed the fastest and largest vaccination rollout in history, which has been critical to ending Covid-19 as a global health emergency.
We have also taken huge steps towards a new tuberculosis vaccine after decades of stalled progress. And, on World Malaria Day, we celebrated the nearly 1.5mn children in Ghana, Kenya and Malawi who are protected by the new malaria vaccine as part of a pilot study led by WHO. But while we recognise our collective achievements, we also need to remain clear-sighted about the consequences of Covid-19 and its impact on protecting children with life-saving immunisations. It is estimated that 67mn children missed out on essential vaccines during the pandemic, leaving them at risk of preventable disease. The consequences of this are already being seen and felt across the world, with reports of dozens of outbreaks of measles, cholera and diphtheria.
The effects of missed vaccinations for other vaccine-preventable diseases, like HPV, will take years to be seen and will affect people in the prime of their lives. This sharp decline in essential immunisation coverage follows almost a decade of stalled progress, including millions of children who have never received a vaccination at all.
To galvanise global action, WHO and its partners in the Immunisation Agenda 2030 launched ‘The Big Catch-up’ – a year-long effort to get immunisation back on track. The WHO is working with countries to support health workers and communities to catch-up the children who have missed out on life-saving vaccines. Countries are also being supported to strengthen primary healthcare systems so they can deliver essential immunisations, even in times of crisis. Many countries have made remarkable progress, but more remains to be done. Much of the success is due to the hard work of community health workers in getting vaccines to those who need them.
The second point highlighted by Dr Ghebreyesus is with regard to ending tuberculosis (TB) by 2030 through universal access to care, multisector collaboration, and innovations to accelerate progress and combat antimicrobial resistance. He pointed out that over the past 20 years, there has been significant progress in the fight against tuberculosis. As many as 74mn more people are now able to access TB services. But major disruptions from the Covid-19 pandemic and other global crises have reversed progress in many countries. A total of 10.6mn people fell ill with TB in 2021, and nearly half a million people fell ill with drug resistant TB, while the number of people able to access diagnosis and treatment fell.
The WHO chief pointed out that there are new and powerful tools to combat TB, including rapid molecular tests, which reduce testing times from three days to less than two hours. The new all-oral treatment regimens for drug-resistant TB reduce treatment times from eighteen months to six months. These are game changers for diagnosis and treatment, and both are now becoming widely available in more than 100 countries. WHO has called on leaders to commit to concrete targets, including licensing at least one new TB vaccine. The WHO chief also stressed the need to address the drivers of TB: poverty, malnutrition, diabetes, HIV, tobacco and alcohol use, poor living and working conditions, stigma and discrimination, and more. Urgent action is required, it goes without saying.