Gavi must do more to get vaccines to people excluded from vaccination

To reach people outside of government vaccination activities—or who have little or no convenient access to vaccination—MSF is calling on Gavi to incorporate the following recommendations into its upcoming five-year strategy:

• Make vaccine support for children up to age five a permanent Gavi policy for all relevant vaccines so that children up to age five who missed out on their routine vaccines due to immunization disruptions are eligible to receive “catch-up” vaccinations and be fully protected from vaccine-preventable diseases.
• Develop framework agreements with governments to guarantee that non-governmental organizations (NGOs) can quickly and efficiently engage in vaccination activities in hard-to-reach areas. Currently, access to fragile or emergency areas is negotiated on a case-by-case basis, making the rollout of vaccination activities slow and cumbersome.
• Enable the creation of in-country stocks of vaccine doses to which, as part of framework agreements with governments, NGOs have swift and unhindered access when undertaking vaccination activities, including for reactive outbreak campaigns and for people in hard-to-reach areas. Gavi should also ensure direct and rapid access to vaccine doses from Gavi/UNICEF to NGOs when necessary.
• Provide direct funding for staffing to support vaccination activities by NGOs and local civil society organizations (CSOs), to ensure independence from governments and prioritize safety and success in insecure regions. Gavi should also fast-track the disbursement of in-country funds to support the implementation of reactive outbreak campaigns, including those in fragile and humanitarian settings.

For more than five decades, MSF has been vaccinating children through routine vaccinations, including in response to outbreaks of disease in some of the world’s most challenging humanitarian contexts. In 2019, for example, MSF teams vaccinated a large group of children who had not received a single vaccine dose in two years against nine vaccine-preventable diseases in Mingala, a remote area in the Central African Republic. 

“We’re seeing people in humanitarian settings falling through the cracks because government-run immunization activities are sometimes unable to reach certain areas, even in cases where nationwide vaccination campaigns are underway,” said Alain Alsalhani, head of MSF’s vaccination working group. “Gavi must ensure agreements are in place with ministries of health so that NGOs can maintain the operational freedom to vaccinate children in hard-to-reach places and can have systematic and independent access to Gavi-funded vaccine doses instead of relying on the current ad hoc approaches for accessing vaccines. An approach structured in this way will allow for more children in fragile and humanitarian settings to be protected from killer diseases in a more timely manner.”