Zambia in danger of reversing gains made in vaccine-preventable diseases

Zambia was among the countries in sub-Saharan Africa with the largest numbers of children who died from vaccine-preventable diseases, and that trend showed no sign of abating last year. The World Health Organization’s latest…

Zambia in danger of reversing gains made in vaccine-preventable diseases

Zambia was among the countries in sub-Saharan Africa with the largest numbers of children who died from vaccine-preventable diseases, and that trend showed no sign of abating last year.

The World Health Organization’s latest data on children under five in West and Central Africa found that in 2011 there were 95,878 new cases of severe acute malnutrition, which can mean a child in grave condition is dying of lack of nutrition. Zambia accounted for 27 percent of that total.

The greatest threat to infant survival is pneumonia, which claims lives in Zambia in droves. The numbers are horrendous. An average of one child in four dies of pneumonia every year, and in 2011 pneumonia ranked as the country’s second-leading cause of death among children under 5. One recent study showed that 91 percent of the country’s mothers suffer from acute maternal and infant pneumococcal diseases, a bacterial infection that can kill in hours.

But there have been some victories. In recent years, the number of cases of vaccine-preventable diseases has dwindled dramatically. For the decade before 2005, measles accounted for more than half of the country’s serious vaccine-preventable diseases. In 2009, the number declined to 2 percent, and by 2014, it stood at only 1 percent.

And pneumonia has dropped precipitously since the country launched its national vaccination program in 2004. In 2000, at the height of the national campaign, there were 103 deaths for every 100,000 children under 5, according to government statistics. A decade later, the rate had declined to 53 deaths per 100,000.

With massive anti-vaccination campaigns worldwide — backed by some of the world’s biggest vaccine makers and orchestrated by anti-science groups — the World Health Organization estimates that between 70 million and 90 million children are still missing out on vaccines they need. But the overall trend is reassuring.

Last year, because of the new vaccines, the country’s death rate from pneumonia dropped from 5.9 to 3.1 per 100,000 children, UNICEF estimates. The nation’s number of annual deaths dropped to 42,066 in 2014 from 103,585 in 2000.

At the height of the global campaign against measles in 2000, more than two of every 10 Zambian children under age 5 had been infected, although the number of vaccine-preventable diseases has dropped since then.

The new line of vaccines — especially the Hib vaccine for meningitis and pneumonia — has been a success story. But many parents still struggle to accept vaccinations. And Zambia’s history of vaccine scandals — the infamous Piroso scandal — has also cast a pall.

In one scheme that alarmed many in the country, Liberian dictator Robert B. Mugabe paid a notorious pharmaceutical mogul $64 million to produce vaccines in a country that, at the time, had no licensed facilities to do so. In the end, the medicine never reached the Zambian market. The Biotechnology and Agro-Industry Ministry, which oversaw the transaction, was suspended and its director and dozens of top officials were fired.

Jonathan Viljoen, the Zambian government’s senior advisor on immunization, said the Piroso scandal made it imperative to reach out to a population that was deeply suspicious of vaccinations.

He said he tries to calm those fears, saying Zambians must understand that the Hib vaccine was safe. The U.S. government imported it from the Americas to encourage people to accept the vaccine.

“We always say the political space isn’t always convenient to vaccinate,” he said. “But you have to work through those insecurities.”

He added that Zambians also often fear the rise of other diseases, such as polio and meningitis. The child mortality rates indicate that the country’s children have made great progress in recent years, and the efforts to fight child diseases are making progress. But his biggest frustration, he said, was that the recent decline in deaths from measles and other vaccine-preventable diseases had not translated into more vaccinated children.

But he said that wasn’t the fault of the WHO or the vaccination programs — it was the public’s.

“If people are skeptical about vaccines, it’s not necessarily because they don’t care,” he said. “I think it’s because there are other issues in their life that make them fearful of vaccination. So we have to educate them.”

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