The final day of the Health and Humanitarian Logistics conference, HHL, this year began with a keynote speech by Ms. Anuradha Gupta, the deputy chief executive officer of GAVI. GAVI is a global vaccine alliance that aims to reduce preventable child mortality in developing countries through vaccinations. It primarily targets ultra-poor households in Sub-Saharan Africa and Southeastern Asia and the results are impressive. Since the alliance was formed in 2000, there has been a 44% decrease in child mortality in the 70 GAVI supported countries. And even more encouraging is the 71% decline in vaccine-preventable deaths over GAVIs 20-year existence. 

Ms. Gupta focused her keynote speech on zero dose children. These are the children who have not received a single vaccine dose in their life. They are usually very difficult to reach, their mothers regularly face barriers when accessing healthcare services and sanitation. According to Ms. Gupta’s estimates, 2 out of 3 zero dose children live in households surviving on less than 1.90$ per day. And nearly 50% of children dying of vaccine preventable deaths are zero dose. Ms. Gupta emphasized that the current Covid-19 pandemic has pushed many additional households into deep poverty, expectant and new mothers have been deprived of essential health services and many more children might become zero-dose. Based on the speaker’s estimates, 1 Million more children could die within 6 months as a result of the pandemic. 

To combat this issue, Ms. Gupta said, we must first identify where these children are. GAVI’s analysis suggests that 42% of zero-dose children are in just 5 fragile countries – Nigeria, Democratic Republic Congo, Afghanistan, Somalia and Chad. But further analysis requires sub-national real-time data so that high-risk areas within each country can be targeted and prioritized. In addition, Ms. Gupta pointed out that “we must develop differentiated and well-suited strategies for each fragile area”. To illustrate, for 1 province in Chad called Batha where people live a nomadic lifestyle, the president of Chad disproved the need to apply a generalized vaccination strategy. Instead, he suggested that it would be much more beneficial if livestock and child immunization were brought together in the region because the people care very much about their livestock and so livestock vaccination might be the best time to remind them about the immunization of their children as well. Flexible policies are also vital when dealing with humanitarian crises. GAVI usually targets children under 1-year of age, but in case of refugee camps, they sometimes vaccinate children up to 5 years or even 10 years of age, because these children have not received their vaccination in time. It is crucial to vaccinate them to prevent disease outbreaks in refugee camps.

Finally, Ms. Gupta emphasized the value of multisectoral collaboration. In the last 2-3 years, GAVI has broadened their partnerships with non-traditional set of actors, including the International Organization for Migration, Crown Agents international development company or Health Pooled Fund in South Sudan. These partnerships have enabled GAVI to offer a more holistic package of services to difficult-to-reach communities, rather than only immunization. They currently provide nutrition services, antenatal care, deworming or child growth monitoring. Ms. Gupta ended her speech on this point by saying that in order to leave no child behind, interventions must bring together the humanitarian, health and development perspectives.