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OP-ED: Vaccinating the forgotten children

  • Published at 12:19 pm June 21st, 2020
Photo: AFP

We cannot forget the role immunization plays

Health authorities in Bangladesh have recently been focused on testing and treating the increasing number of coronavirus cases; unfortunately, this has left childhood vaccination off the priority list.

Failure to implement the childhood vaccination programs could result in the death or serious illness of a large number of children. 

Public health in Bangladesh in the 1980s and 1990s was defined by the strides made in the area of vaccination. This achievement is hardly discussed, but there is no doubt that it has saved the lives of tens of thousands of children.

A historic vulnerability to infectious diseases resulted in vaccination campaigns against illnesses such as TB, popularly known as jokkha. Many of us remember the slogan “Jokkha hole rokkha nai.”

We often forget the role of immunization programs, but the truth is that the scenario was very different just a few decades ago.

A crucial challenge to the global south post-1970 was characterized by the lack of access to basic health measures such as immunization. Bangladesh was among a handful of newly independent nations which championed this global awakening through multilateral initiatives, including Smallpox Zero.

By 1975, the program eradicated smallpox, an amazing achievement for a country which had been afflicted by the war in 1971 and famine in 1974. This was made possible by targeted programs executed by government agencies in collaboration with NGOs.

By improving vaccination coverage for just six diseases (diphtheria, whooping cough, tetanus, polio, measles, and tuberculosis), Bangladesh reduced its child mortality rate to a fraction of what it was before.

Figures show that as recently as 1985, only about 2% of children between the ages of 12 and 23 months were vaccinated against these illnesses.

Subsequently, WHO undertook a massive intervention called the expanded program on immunization (EPI). The program focused on the six mentioned diseases in Bangladesh, and by 1993, approximately 74% of children were immunized.

This was achieved through collaboration between local and international organizations and public health experts. The establishment of icddr,b, the rural networks of Gonoshathya Kendra, the social mobilization schemes of BRAC and ASA, and the state funding for community health clinics were all significant.

For the past three decades, the country has attained global recognition for being able to mobilize public-private partnerships across its health networks. However, this coordinated effort has been upset by the onset of Covid-19.

While we agree that the coronavirus crisis requires immediate attention, we should not forget about the possibility of outbreaks of other serious diseases. Two months of the country’s resources being diverted for facilitating Covid testing signifies two whole months where thousands have not received vaccination.

Experts have considered this an essential challenge for the health authorities. Dr Senjuti Saha, who is currently working as a scientist at the Child Health Research Foundation (CHRF) in Dhaka, expressed her worries about leaving such a big gap in the arena of child health.

Their work in finding diseases that evade standard diagnostics have helped to understand both the direct and indirect benefits of vaccines. Decades of thorough vaccination have reduced the incidence of many serious diseases; this progress may be lost if children are not immunized during the current pandemic.

CHRF has closely worked with the Bill and Melinda Gates Foundation and Gavi -- the Vaccine Alliance, both of which have been instrumental in shaping the immunization infrastructure of the nation.

Dr Saha was recently on the news as she, along with her team at CHRF, became the first to sequence the genome of the novel coronavirus (SARS-CoV-2) in Bangladesh. Additionally, their facilities have been used as Covid testing sites.

When such concerns are raised by experts who have worked with the Covid-19 response and child health directly, it behooves us to take a step back and analyze our priorities.

Whether a complete lockdown is brought back or not, health workers will primarily continue to work for Covid response. We are aware of the fact that resources are limited.

However, it is time for authorities to sit down with health experts to allocate resources to prevent the childhood disease outbreaks that are waiting to happen. 

Tahmid Hasib Khan is an MPH student at Columbia University, New York. He specializes in Epidemiology and Health Communication.

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