Nepal | March 26, 2019

Saving children: One vaccine at a time

Dr Mathuram Santosham & Dr Bikash Lamichhane

As a result of the Ministry of Health and Population’s concerted efforts to vaccinate every child against polio, the country achieved polio-free status in 2014. Maternal and neonatal tetanus was eliminated in 2005, largely thanks to vaccination efforts

Illustration: Ratna Sagar Shrestha/THT

When I was a young child, I lived with my family in Kathmandu. While at a busy marketplace, I saw other children, many of whom were visibly unwell.

Some looked skinny and under-nourished, others had skin infections. My mother took notice, and said to me: “Mathuram, you must one day become a doctor and help as many children as possible.”

Today, doctors like Dr Bikash Lamichhane and I share stories like this because thousands of children are still affected — and many lose their lives — to under-nutrition and disease around the world every year.

Fortunately, we have powerful tools to prevent these diseases in children — vaccines.

These are powerful interventions to protect children from serious diseases such as pneumonia, diarrhoea, measles and polio.

Vaccines have drastically reduced the number of children who die, fall sick or need to be hospitalised in Nepal and around the world.

Vaccination also provides indirect benefits to others in the community who aren’t vaccinated, such as those with compromised immune systems due to illnesses like cancer or HIV/AIDS, through a phenomenon called herd protection.

This happens when a sufficient number of people in a population are immunised against a disease, thereby reducing the probability that the disease will be transmitted to those who are sick or have not received the vaccine because they are too young or old.

But this can only be achieved by sustaining high levels of vaccine coverage.

Immunisation is a high priority for the Government of Nepal, which currently provides vaccines to protect against 11 diseases — tuberculosis, polio, Japanese encephalitis, diphtheria, tetanus, pertussis, hepatitis B, Hib, measles, rubella, and pneumococcal disease — through the country’s National Immunisation Programme (NIP).

As a result of the Ministry of Health and Population’s concerted efforts to vaccinate every child against polio, the country achieved polio-free status in 2014.

Maternal and neonatal tetanus was eliminated in 2005, largely thanks to vaccination efforts.

Nepal now has a plan to eliminate measles through vaccination by 2019.

The Government of Nepal believes that immunisation is a right of all Nepali children.

Making this a reality means guaranteeing that sufficient government funding for health and vaccination is always available.

To this end, Nepal has recognised vaccination as a protected budgetary investment signed into law. This establishes both a government fund and a private Sustainable Immunisation Financing Support Fund, a novel matching fund allowing domestic donors to contribute to the national immunisation programme.

In its campaign to save lives and prevent avoidable disease, in 2017, Nepal applied for Gavi co-financing support to introduce rotavirus vaccines into the National Immunisation Programme.

This support will allow Nepal to introduce a new vaccine targeting rotavirus, the most common cause of moderate-to-severe diarrhoea among young children.

Before the advent of rotavirus vaccines, nearly every child around the world was infected with rotavirus at least once before their fifth birthday.

Even today, rotavirus claims the lives of about 200,000 children and hospitalises hundreds of thousands more each year.

Those who survive the disease can experience some of the lasting effects of diarrhoea, and families can face catastrophic costs when a child is hospitalised with rotavirus diarrhoea.

But rotavirus vaccines now save lives and improve health in over 90 countries where they have been introduced.

For example, Rwanda, one of the first low-income countries to introduce rotavirus vaccine in 2012, has documented a 50 per cent reduction in hospital admissions for acute gastroenteritis.

Nepal will soon introduce rotavirus vaccine into the National Immunisation Programme, adding a critical tool to protect children from another serious and even deadly infectious disease.

Investing in interventions like rotavirus vaccines helps children grow to be strong and productive individuals who live happy lives and contribute meaningfully to a nation’s workforce.

As we are marking the World Immunisation Week (April 24-30), we should all reaffirm our commitments to ensuring the availability of vaccines to children everywhere.

Santosham is a professor of International Health and Paediatrics at the Johns Hopkins University and Chair of the ROTA Council, and Lamichhane is director of Child Health Division under the Department of Health Services, Ministry of Health and Population, Nepal


A version of this article appears in print on April 27, 2018 of The Himalayan Times.


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