Efforts to vaccinate “zero-dose” children in the Democratic Republic of the Congo (DRC) will be accelerated thanks to new funding from Gavi, the Vaccine Alliance’s Equity Accelerator Fund (EAF).
Over the course of the next two years, dedicated resources and tailored support will be channelled towards reaching children that have not received a single shot of a routine vaccine across 11 provinces. These provinces, which collectively account for 74% of the total number of zero-dose children in the country, are: Tshopo, Maniema, Kasai-Oriental, Mongala, Kasai, Haut Katanga, Sankuru, South Kivu, Tshuapa, Maindombe and South Ubangi.
To successfully reach these children and achieve an ambitious 2025 goal to reduce zero-dose children in the country by 35%, Gavi has begun disbursing funds from the nearly US$ 60 million approved for the country – the largest amount allocated from the EAF to any one country. With one of the highest numbers of children missing out on receiving routine vaccines as of 2021 (734,000) globally, and outbreaks of cholera, polio and measles, this boost comes at a critical time for the country.
“Too many children continue to miss out on life-saving vaccines leaving them vulnerable to some of the world’s deadliest diseases,” said Thabani Maphosa, Managing Director of Country Programmes Delivery at Gavi. “With innovation and targeted support, we can reach zero-dose children and ensure that the most marginalised communities are no longer left behind.”
Several high impact activities and innovations will be implemented through the EAF. This includes supporting local Civil Society Organisations (CSOs) and community health care workers to identify and monitor zero-dose children and tracking vaccinations using GPS and SMS. Additionally, investigating and addressing gender-related obstacles that impact demand for vaccines will be key to ensure there is equitable access and all targeted children are adequately protected.
Concerted efforts will also be made to reach communities living beyond a 5km radius from health facilities – including internally displaced people and refugee populations. Additionally, piloting the use of drones in areas with limited accessibility and integrating new battery and electricity-free cold chain carriers to ensure vaccines remain at optimum temperatures during transit will also be implemented in select provinces. Zero-dose children below 59 months living in areas not targeted by the EAF will be supported through the DRC’s immunisation catch up plan for 2023-2024.
“The Democratic Republic of the Congo, with support from its partners, is committed to improving the health of its population by reducing morbidity and mortality linked to vaccine-preventable diseases,” said Dr Sylvain Yuma Ramazani, Secretary General of the Ministry of Public Health, Hygiene and Prevention. “We are grateful to Gavi for its support towards strengthening our country’s health system. The Vaccine Equity Acceleration Fund is a perfect example of this support and will help reduce the number of zero-dose children in DRC.”
The DRC has made steady progress in achieving high immunisation coverage over the years. The Mashako 1.0 Plan, implemented in 2019 initially across nine targeted provinces (and later expanded to all the 26 country’s provinces,) to improve immunisation coverage yielded strong results: complete vaccination coverage improved by 27 percentage points across the nine Mashako provinces, as compared to other provinces, which improved by 15 percentage points.
However, progress slowed down in 2021 with the pandemic and a health care workers’ strike negatively impacting access to and uptake of vaccination. While there are signs of recovery, the 2022 coverage survey showed a 3.1 percentage point increase in full vaccination coverage and one percentage point increase in coverage for three doses of pentavalent vaccine, as compared to 2021. Current national coverage for full immunisation coverage remains at 45% – below the high levels reached in 2019.
In early 2022, the DRC launched the 2.0 version of the Mashako plan, which aims to consolidate the achievements of the previous plan by proritising key activities, including accessing funding at the decentralised level. Highlighting best practices and innovations that emerge from this vaccination push and implementing successful pilot activities across other relevant communities will be important to help the country improve coverage, especially when confronted with future outbreaks.
Approved by the Gavi board in 2020, The Equity Accelerator Fund is a time limited US$ 500 million funding lever for Gavi-implementing countries ,designed to help boost efforts to reach the most at-risk communities. US$ 400 million has been made available to eligible countries, while $100 million is being channelled to a consortia of partners to target children living outside of government reach in humanitarian settings. DRC is the largest recipient of core EAF funding receiving US$ 59.7 million out of the total of $400 million. The funding will be channelled through the Ministry of Health and the national CSO SANRU and UN Agencies (IOM, UNICEF, UNOPS, and WHO).
The EAF grant complements Gavi’s existing support to DRC, which aims to address immunisation inequity. This includes new vaccine introductions such as the second dose of the inactivated polio vaccine and the measles-containing-vaccines, implementing mass campaigns and outbreak responses, all of which place special emphasis on reaching non and under-vaccinated children.