Message by the Director of the Department of Immunization, Vaccines and Biologicals at WHO – October 2023 – World Health Organization

Kate O'Brien, Director of the Department of Immunization, Vaccines and Biologicals at WHO

In global healthcare, we are witnessing remarkable progress in the prevention of cervical cancer, a brighter future for malaria control, and a rallying call for more rapid progress on routine vaccinations.

Cervical cancer prevention soars to new heights

The fight against cervical cancer is scaling rapidly, thanks in large part to the growing momentum of HPV vaccination programs. In October, Nigeria, Bangladesh, and Cambodia joined the ranks of countries that include human papillomavirus (HPV) vaccine in the national schedule, following Indonesia's successful national rollout. These nations, home to substantial populations, shoulder a significant portion of the global cervical cancer burden.

Adding to the excitement is the upcoming introduction of HPV vaccination in India, and Pakistan's announcement of their intent to join the ranks of countries protecting women from cervical cancer. In a further boost to this cause, the Democratic Republic of the Congo's National Immunization Technical Advisory Group (NITAG), has recommended adding HPV vaccine to the national vaccination schedule. Collectively, these seven countries account for a third of the global cervical cancer burden, which will be significantly reduced in the future through HPV vaccination in the here and now.

Malaria control: a ray of hope

The battle against malaria is also witnessing a remarkable advance, thanks to the addition of malaria vaccine to the existing toolbox of malaria control interventions. With the completion of the pilot implementation of the RTS, S/AS01 malaria vaccine in Ghana, Kenya, and Malawi we are learning about the dimensions of vaccine impact. Recently presented data show a 13% reduction in all-cause mortality (excluding trauma) among children eligible for vaccination. Notably this impact was achieved at approximately 64-74% coverage, previewing the likelihood of even greater impact as the coverage scales up. Adding malaria vaccine to the portfolio of malaria interventions is about optimizing the mix of interventions, each of which are imperfect. Not only does this ease the health burden and suffering of children and their families, but also translates into substantial cost savings for healthcare systems.

The good news doesn't stop there. Nine additional countries, including Benin, Burkina Faso, Burundi, Cameroon, the Democratic Republic of the Congo, Liberia, Niger, Sierra Leone, and Uganda, are set to introduce the vaccine into their routine immunization programs beginning in early 2024. With a WHO policy recommendation for the second malaria vaccine, R21/Matrix-M, now in place, additional countries are also planning for introduction, given the expectation for sufficient supply, once the R21/Matrix-M vaccine achieves WHO prequalification. Having vaccines against malaria is a testament to the power of innovation and global collaboration in the fight against malaria.

Measles outbreaks and the importance of fully vaccinated children

The immunization community is anticipating the joint report by WHO and the Centers for Disease Control (CDC) on the 2022 measles case and mortality estimates, scheduled for release later today 16th November. Measles, one of the most highly infectious diseases, is making an unwanted comeback, with cases and deaths increasing globally. While Africa and South Asia have faced challenges with measles in the wake of the pandemic, other regions are also contending with outbreaks: from richer countries such as Austria and the UK, to middle-income ones like Russia, South Africa and Trkiye.

Measles is not the sole concern resulting from declining vaccination rates. As vaccine coverage decreases, measles tends to resurface first due to its high contagiousness. However, declining vaccination rates set the stage for other serious vaccine-preventable diseases to reemerge. Measles outbreaks serve as a warning sign for potential outbreaks of severe illnesses such as whooping cough, diphtheria, or polio.

In conclusion, under the banner of "The Big Catch-Up", it is crucial to support countries in reestablishing routine vaccination programs, improving their coverage and reaching the most left out, wherever they are found, in order to prevent large-scale global outbreaks of vaccine-preventable diseases.

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Message by the Director of the Department of Immunization, Vaccines and Biologicals at WHO - October 2023 - World Health Organization