In 1990 about 12 million children under five were dying each year around the world, about half of them (5.1 million) from vaccine-preventable diseases.
In the three decades since there’s been a modest decrease in the number of children who die from other causes, but the number of child deaths caused by diseases for which there are vaccines fell to 1.8 million: a two-thirds decrease. Yet two of the leading causes of child mortality, pneumococcal pneumonia and rotavirus diarrhoea, are preventable by vaccines and measles – one of the world’s most contagious diseases – still kills 140 000 people annually, mainly children under five.
So what are vaccines? They act like a training course for the immune system, helping prepare the body to fight off disease-causing microbes, like bacteria and viruses, and teaching it to recognise and destroy these invaders before they can do significant harm. The benefits of vaccination accrue across a lifetime:
- Fully-immunised children have better cognitive development, physical strength and educational outcomes, and their healthcare costs are lower (in terms of hospital treatment and ambulance costs, and the time saved for health workers).
- The families of immunised children tend to be smaller because those families lose fewer children to preventable disease and have more time for their children, and the mothers in such families are healthier: partly because they have fewer children, and because going for vaccination brings women themselves in contact with health services.
- Vaccines keep healthy people healthy, removing a major obstacle to development.
- In the long term, higher vaccination rates mean a healthier, more productive workforce and stronger economy, families and communities being lifted out of poverty, and a healthier population because there are fewer outbreaks and epidemics.
Put simply, vaccines are one of the most successful and cost-effective health investments in history.
In September 2015, Australia and all other United Nations member states endorsed the Sustainable Development Goals (SDGs), a set of 17 interlinked targets that serve as a blueprint for a more sustainable global future. Goal 3, Good Health and Well-Being, includes a target to end the preventable deaths of newborns and children under five by the year 2030, with all countries to reduce neonatal mortality to 12 per 1000 live births (or lower) and under-five mortality to 25 per 1000 live births (or lower). Increasing immunisation is one important way to help achieve this goal.
“It’s really hard to see a child struggling to breathe … It was hard to make eye contact with their mothers, who were looking on and stroking their children’s foreheads… Being in that room reinforced for me what a miracle vaccines can be. Pneumonia is such a terrible disease, but there is a new tool that can prevent many cases of it — and prevent them rather easily.”
– Melinda Gates
Results impact on child immunisation & polio
Given the enormous ill health and loss of life caused by vaccine-preventable diseases, promoting the survival and development of children has been one of Results’ priority issues since we started in Australia in 1986. In fact, the World Summit for Children in 1990 – a landmark event focused on agreeing goals that would improve the lives of the children, and for which RESULTS and its international partners advocated strongly – was the predecessor of the Millennium Development Goals, agreed in 2000, and their replacement, the SDGs (mentioned above).
One of the childhood illnesses on which Results has long had a special focus is polio. Until vaccines were introduced in the mid-20th century polio, which paralysed hundreds of thousands of children around the world every year, had been endemic in Australia.
Since 1988, when the Global Polio Eradication Initiative (GPEI) began as a concerted effort to eradicate polio, global incidence of the disease has been reduced by more than 99%, and the number of countries with endemic polio from 125 to two. In September 2020, the African continent was declared free of wild polio virus. These successes have been achieved primarily due to vaccination.
Results also works with national and international partners to promote action to reduce the toll from other vaccine-preventable infectious diseases, primarily by promoting affordable and sustainable access to vaccines for the world’s poorest countries through Gavi, the Vaccine Alliance (Gavi).
As well as vaccinating children, the work of both GPEI and Gavi strengthens health care systems, in part by building domestic political support for immunisation. This helps to ensure that vaccines are available where they are most needed, stored and transported correctly, delivered by trained health workers and that children have up-to-date records of the immunisations they have received.
2019 and 2020 were important years for child immunisation and polio. Within the space of about six months, both GPEI and Gavi held ‘replenishment’ conferences, where investing and implementing countries come together and pledge funds for the work of these organisations over the ensuing several years.
Both replenishment campaigns featured the same three strands of work common to all of Results’ campaigns:
- Parliamentary engagement: advocacy is at the heart of what Results does, and we do it primarily with Australia’s federal parliamentarians. Our grassroots advocates across the country met with their MPs and Senators to speak to them about the importance of immunisation for child health – especially against the backdrop of COVID-19.
- Media engagement: working with high-profile champions of our issues to help them speak in the media and writing letters to the editor is another way we generate political and public attention.
Public engagement: we take advantage of opportunities to hold events that draw attention to our issues.
The GPEI Replenishment campaign
In 2019, GPEI sought a total of US$4.2b for its work over the following five years, during which time it hopes to eradicate polio entirely. These investments were earmarked to prevent new cases of polio in the two remaining countries (Afghanistan and Pakistan) where the disease still exists, and to prevent re-emergence of polio in countries where it has been eliminated. Eradicating polio will free up resources to address other diseases, and the eradication campaign has demonstrated improvements to health delivery which will have benefits elsewhere in health systems.
In the lead-up to the polio pledging event in Abu Dhabi, Results undertook a number of activities in support of a generous Australian investment in GPEI:
- WPD event at Parliament House, together with partners from Global Citizen, Polio Australia, Rotary and UNICEF, together with Australian parliamentary One Last Push champions for polio eradication. RESULTS brought a speaker from PNG (who had worked on a polio outbreak there in 2018). Minister Hunt spoke, event supported Australia being represented in Abu Dhabi and announcing a further financial contribution to GPEI.
GPEI had sought $25m from Australia, and we contributed $15m. In light of increased health need as a result of COVID-19, Results is currently calling on Australia to increase its support for polio eradication via an additional investment in GPEI.
The Gavi replenishment campaign
Gavi, the Vaccine Alliance was founded in 2000 and, over the last 20 years, has supported the immunisation of more than 600 million children, as a result of which more than 8 million lives have been saved. Australia has been investing in Gavi since 2006. In 2020, domestic civil society organisations called on the federal government to contribute $300m to Gavi’s work over the next five years.
Results’ campaign for Gavi, the Vaccine Alliance began before COVID-19 hit. Once the pandemic arrived, and with many implementing countries diverting part of their Gavi resources to COVID response (and with other health-related activities being postponed or interrupted), there was huge global focus on the importance of vaccines and on the health systems that GPEI and Gavi had played such an important role in helping to build.
Across our five-month campaign, Results advocates contacted 129 federal parliamentarians (57% of the total) and met with 33 of them to discuss Gavi’s work. As a result, 10 cross-party MPs and Senators sent letters of support to the Prime Minister and to the Ministers for Foreign Affairs, Defence and Trade, and International Development and the Pacific. Our advocates had several letters to the editor about Gavi published in newspapers around the country, and Results also co-hosted a public webinar with Global Citizen about Gavi, immunisation and how Australians could show their support for the replenishment. Held during World Immunisation Week in April, the webinar attracted nearly 100 attendees.
At its replenishment conference, the Global Vaccine Summit, in June, Gavi raised US$8.8b, far exceeding its US$7.4b target. Australia made a $300m investment, a 20% increase on its commitment in 2016, as well as contributing $80m to the Gavi-led COVAX facility, which will make a COVID-19 vaccine available in an affordable and timely manner to all countries (not just the wealthiest). Results’ advocacy colleagues in the international ACTION Partnership also worked on the replenishment in their own countries, making a huge contribution to this unprecedented outcome.