‘Vaccines, nutrition combo could beat COVID-19, future pandemics’

Delivering immunisation and nutrition programmes together is necessary to maximise results and minimise the costs of these critical health services, enabling more people to be reached, especially in vulnerable communities. This is the conclusion of a new policy brief launched last week and co-authored by Gavi, the Vaccine Alliance, and the Scaling Up Nutrition (SUN) Movement – global leaders in immunisation and nutrition respectively.

The policy brief, ‘Equity from birth: an integrated approach to immunisation and nutrition, highlights that malnutrition and infectious diseases together cause millions of preventable child deaths every year and contribute to a vicious cycle of poor health, stunted growth, poverty and exclusion; while malnutrition – both undernourished and overweight – can severely decrease our COVID-19 survival rate.

Ahead of the December 7-8 Nutrition for Growth Summit (N4G), to be held in Tokyo, Gavi and SUN are calling on global leaders and key decision-makers in all countries to take action and prioritise this two-pronged vaccine-nutrition approach, through clear commitment.

They are also calling on relevant international health partners to take action to advance the integration of immunisation and nutrition and to develop clear recommendations governments can use to roll out this urgently needed approach.

United Nations Assistant Secretary-General and SUN Movement Coordinator, Gerda Verburg, said: “Delivering immunisation and nutrition services together will ensure that more people can be reached, especially the vulnerable, women, and children – and contribute to building communities that are resilient to COVID-19 and future pandemics. Countries must be enabled to advance smart joint packages of support on the ground, where it matters the most.”

The policy brief highlights that by 2022 alone, the COVID-19 pandemic could result in an additional 2.6 million children suffering from stunting and 9.3 million suffering from wasting. In 2020, the COVID-19 pandemic and associated disruptions on health systems resulted in 22.7 million children missing out on vaccinations – 3.7 million more than in 2019 and the highest number since 2009.

Deputy Chief Executive Officer, Gavi, Anuradha Gupta, said: “By integrating immunisation and nutrition efforts, and allowing vaccines and good nutrition to be delivered together we can ensure we reach the most vulnerable populations – effectively and efficiently, to help enhance equity across the world.”

The policy brief also recommends that national governments and international health partners are proactive about combining immunisation and nutrition interventions and other essential health services, including through sharing infrastructure and value chains.

Group CEO, Amref Health Africa, Dr. Githinji Gitahi, said: “It takes a great deal of effort for health workers to reach the most vulnerable children during immunisation campaigns. If they could use the opportunity to also screen for malnutrition or provide vitamin A supplementation or therapeutic foods for example, they could make a big difference in children’s lives.”

The N4G Summit comes at a critical time, midway through the United Nations (UN) Decade of Action on Nutrition, with only five years left to achieve the World Health Assembly (WHA) targets on maternal, infant and young child nutrition, and with just ten years left to achieve the Sustainable Development Goals (SDGs). Given this, and the serious disruptions caused by the COVID-19 pandemic, the policy brief underscores now is the time to invest better and smarter, as countries gradually find ways to restore, maintain and strengthen immunisation, nutrition, and other essential services.

Until now, routine immunisation and improved nutrition have played a critical role in reducing child under-five mortality by 67 per cent over the last 30 years.

Malnutrition remains an underlying cause for 50 per cent of the 3.1 million child deaths each year. Immunisation prevents two three million deaths each year from diseases including diphtheria, tetanus, pertussis, influenza and measles.

At least 1.5 million people still die from vaccine-preventable diseases each year. One dollar invested in nutrition provides a US$ 16 rate of return. One dollar invested in immunisation in Gavi-supported countries provides a US$ 21 rate of return. Nearly 20 million infants have insufficient access to vaccines each year.

Undernutrition rates among children remain unacceptably high – with 149.2 million children under five years suffering from stunting and 45.4 million children suffering from wasting.

By 2022 alone, the COVID-19 pandemic could result in an additional 2.6 million children suffering from stunting and 9.3 million suffering from wasting. In 2020, the COVID-19 pandemic and associated disruptions on health systems resulted in 22.7 million children missing out on vaccinations – 3.7 million more than in 2019 and the highest number since 2009. In 2020, the number of children who have received no routine vaccines, “zero-dose” children increased from 13.6 million to 17.1 million.

Malnutrition and infectious diseases are mutually negatively reinforcing. Acutely malnourished children are 2.5 to 15 times more likely to die from pneumonia, and up to eight times more likely to die of diarrhoea – with repeated bouts of diarrhoea associated with up to 43 per cent of child stunting cases. Influenza vaccines for mothers led to a 15 per cent reduction in low birth weight.

Gavi, the Vaccine Alliance is a public-private partnership that helps to vaccinate half the world’s children against some of the world’s deadliest diseases. Since its inception in 2000, Gavi has helped to immunise a whole generation – over 888 million children – and prevented more than 15 million future deaths, helping to halve child mortality in 73 lower-income countries. Gavi also plays a key role in improving global health security by supporting health systems as well as funding global stockpiles for Ebola, cholera, meningitis and yellow fever vaccines. After two decades of progress, Gavi is now focused on protecting the next generation and reaching the unvaccinated children still being left behind, employing innovative finance and the latest technology – from drones to biometrics – to save millions of more lives, prevent outbreaks before they can spread and help countries on the road to self-sufficiency.

Gavi is a co-convener of COVAX, the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator, together with the Coalition for Epidemic Preparedness Innovations (CEPI) and the World Health Organisation (WHO). In its role Gavi is focused on procurement and delivery for COVAX: coordinating the design, implementation and administration of the COVAX Facility and the Gavi COVAX AMC and working with its Alliance partners United Nations Children Fund (UNICEF) and WHO, along with governments, on country readiness and delivery.

The Vaccine Alliance brings together developing country and donor governments, the WHO, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Bill & Melinda Gates Foundation and other private sector partners. View the full list of donor governments and other leading organizations that fund Gavi’s work here.

Since 2010, the SUN Movement has inspired a new way of working collaboratively to end malnutrition, in all its forms. With the governments of SUN Countries in the lead, it unites people—from civil society, the United Nations, donors, businesses and researchers—in a collective effort to improve nutrition.