Kate O'Brien, Director of the Department of Immunization, Vaccines and Biologicals at WHO
September marked a pivotal moment in the pursuit of health for all.
At the much-anticipated meeting of the Strategic Advisory Group of Experts on Immunization (SAGE), recommendations were issued for three new groundbreaking vaccines to combat malaria, dengue, and meningitis.
Nearly half the world's population remains at risk of malaria. In 2021 alone, there were an estimated 247 million cases of malaria, leading to 619,000 deaths. 95% of these cases and fatalities occurred in Africa, disproportionately claiming the lives of children under the age of 5. In response, SAGE and the Malaria Policy Advisory Group recommended R21/Matrix-M, a vaccine designed to safeguard vulnerable children from this infectious disease. This milestone follows the endorsement by the WHO of the first malaria vaccine, RTS, S, two years ago by the WHO, and brings us one step closer to our vision of a malaria-free world. Both vaccines are shown to be safe and effective in preventing malaria in children and, when implemented broadly, are expected to have a high public health impact.
The SAGE meeting also recommended a dengue vaccine named "Qdenga". Tailored for children aged 6 to 16 living in dengue hotspots, this vaccine has the potential to shield youth from a significant public health menace. A third recommendation concerned the new Men5CV vaccine against meningitis, and for all countries in the African meningitis belt to introduce the novel pentavalent meningococcal conjugate vaccine targeting serogroups A, C, Y, W and X (Men5CV) into their routine immunization programmes in a single-dose schedule at 9 to 18 months of age.
The meeting also issued a recommendation regarding COVID-19 vaccination, concluding that a single dose is sufficient for primary immunization, given that most people have had at least one prior infection.
UN General Assembly - three High-Level Meetings
The UN General Assembly convened three High-Level Meetings, each making strides in the global effort to strengthen immunization. The fight against tuberculosis (TB) took center stage with a focus on advancing science, finance, and innovation, culminating in United Nations Member States formally adopting a Political Declaration of unparalleled ambition, aiming to grant life-saving treatment to 45 million people between 2023 and 2027. The WHO Director-General officially launched the TB Vaccine Accelerator Council, which will facilitate the development, licensing, and use of new TB vaccines.
Universal Health Coverage (UHC) also emerged as a rallying cry, rekindling collective efforts to ensure health equity for all. It laid the groundwork for robust action, building upon the 2019 Political Declaration.
The global disparities exposed by the COVID-19 pandemic prompted the strengthening of pandemic prevention, preparedness, and response. A political declaration emerged, aiming to marshal national, regional, and international support. This wide-ranging document pledged to ensure timely, sustainable, and equitable access to pandemic-related essentials, such as vaccines, diagnostics, and therapeutics. WHO was entrusted with the critical task of orchestrating this effort in coordination with key partners.
Looking forward
We are supporting countries to further intensify and implement the "Big Catch-Up" operationalization in country programmes. Already 27 countries have plans in place for activities to catch-up, restore and strengthen immunization, and we have the power to make transformative strides towards the vision of strong primary health care services for vulnerable populations across the globe.
We must secure financing for immunization programs to help countries make the needed investments in health systems and workforce and better integrate wider primary care and health services. We must reach the generation of children who have been left exposed to preventable disease as vaccination programmes stalled during the pandemic years.
Looking ahead to the "The Summit of the Future" in 2024, we must take a long-term view of immunization. As a cornerstone of Universal Health Coverage (UHC), primary health care (PHC), and resilient health systems, it is key to ensuring future pandemic preparedness. Together, we can forge ahead, united in our commitment to advance health for all.
Finally, please join us in celebrating World Meningitis Day today, October 5, to raise awareness of the disease and the Global Road Map to Defeat Meningitis by 2030, approved by the World Health Assembly (WHA) in November 2020. The Road Map sets a comprehensive strategy "Towards a world free of meningitis", with three visionary goals, including the elimination of bacterial meningitis epidemics. While the road map to defeating meningitis addresses all meningitis regardless of the cause, it primarily focuses on the main causes of acute bacterial meningitis.
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As such, vaccines are central to its success. These include the already available Haemophilus influenzae type B (Hib), meningococcal A conjugate (MenA), and pneumococcal conjugate (PCV) vaccines, vaccines on the cusp of being deployed with the SAGE recommendation for Men5CV, and vaccines still in development, including group B streptococcus (GBS) vaccines. With collective global action, we can make "a world free of meningitis "our reality by 2030. Please join us to celebrate and take action on #DefeatMeningitis and #WorldMeningitisDay!
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