Guest Blog: David Ferreira is the head of the GAVI Alliance's Washington Office and Managing Director of Innovative Finance.
I am a believer – a believer in immunization, in equity and in the vision that all countries can and should provide healthcare for their people.
I just returned from Ethiopia, which with GAVI support last month launched the rotavirus vaccine, soon after having conducted an October campaign against meningitis A and a May-June campaign against measles.
Let’s put this in context. Just a decade ago, Ethiopia’s immunisation coverage rate was as low as 28%, by measure of the World Health Organization/UNICEF, and no more than 51% by Ethiopia’s own estimate. Either way, millions of its children were not being vaccinated against deadly diseases.
Today, Ethiopia has a health system that is on its way to becoming a model for others, transformed through a decentralised, robust approach led by the country’s Ministry of Health. Under the plan, Ethiopia:
- Has hired 38,000 health extension workers to provide direct care for children and women, empowered to help make decisions about targets and budgets.
- Is recruiting a “Health Development Army” of 3 million female volunteers, each assigned to a handful of neighbourhood families, to encourage healthy behaviour (such as sleeping under mosquito bed nets) and immunization and to share their personal experiences.
- Has increased the number of local health centres to 3,200 from 949 a few years ago, and is now assigning to them Health Information Technicians trained in data capture, analysis and use to help make data collection more accurate and complete.
- Is upgrading the country’s supply chain system, building a 17-hub, direct route distribution network for pharmaceuticals, vaccines and medical supplies, with giant warehouses and cold storage facilities being constructed to accommodate proper stock levels nationwide.
The Ministry of Health is working to ensure that all children – whether urban or rural, privileged or disadvantaged – have equal access to vaccines. We were told that pentavalent coverage rates are now a key indicator reported by the Minister of Health to the Prime Minister, giving immunization the highest level of attention.
The result is that Ethiopia’s child mortality rate has plummeted from 204/1,000 a decade ago to 68/1,000 today, according to UN statistics. Remarkably, Ethiopia has met – almost three years early – UN Millennium Development Goal 4, reducing child mortality by two-thirds.
…with help from the GAVI Alliance
I am a believer in Ethiopia’s type of approach, which has provided protection against the most severe childhood diseases to the 3 million children born there each year, including one precious boy that I cradled briefly at the Meshuwalekiya Health Centre in Addis Ababa.
His name is Amen Desalegan. At age four months he was brought to Meshuwalekiya by his mom to receive three routine vaccines: pentavalent and pneumococcal vaccines, introduced with GAVI support in 2007 and 2011, respectively, and polio vaccine.
“Many bad things have happened in my life,” his mother explained through an interpreter. “Having him is a good thing. That is why we named him Amen.”
Amen now will have the chance also to receive rotavirus vaccine, as Ethiopia has become the 17th GAVI-funded country to introduce this new vaccine. Rotavirus – highly contagious – causes severe diarrhoea and takes the lives of more than 38,000 Ethiopian children every year, making it the second biggest killer of young children there. Ethiopia aims to immunise 2.8 million against the disease.
Rolling out any one vaccine is enormously difficult, particularly in a place as large (1.1 million square kilometres) and challenging (84 million people and a per capita GNI of US$ 410) as Ethiopia. Partners such as Lions Clubs International and LDS Charities have joined GAVI to help the Alliance with challenges such as these.
This is why I was accompanied on the trip to Addis Ababa by Lions Clubs International Foundation Chair Wayne Madden and LDS Charities major initiatives manager Jamie Glenn, while also meeting with key representatives from UNICEF, WHO and PATH. We all had come to see the remarkable transformation of Ethiopia’s health system and how it is reaching children with vaccines.
During this trip, it was my great honour to represent GAVI to His Excellency, President Mulatu Teshome, who kindly recognised the work of GAVI and its partners, including Lions Clubs. We were also privileged to meet and learn more about Ethiopia’s transformation from Minister of Health Dr Kesetebirhan Admasu, his Director of Maternal & Child Health Dr Tewodros Bekele Endailalu, immunisation manager Sintayehu Abebe, and Pharmaceutical Fund and Supply Agency Deputy Director General Wondwossen Ayele Halle.
GAVI has been a partner with Ethiopia for 11 years, and has disbursed around US$ 500 million to support its immunisation programmes. Ethiopia clearly has made transformative use of the funding provided to date.
GAVI is proud to have played a role in supporting Ethiopia’s public health system. When I see the faces of its children like Amen, I see the future of this inspiring and ancient land and appreciate the lasting difference that immunisation is making. I am a believer.