Vaccines can solve global health challenges

Editorial Team

Editorial Team

January 31st, 2019

Editorial Team

‘The WHO has named the top 10 health issues for 2019. Vaccines play a major role in tackling most of them. ’

It’s a scary list with few surprises: climate change, air pollution, antimicrobial resistance and more. The World Health Organisation has set out the 10 most pressing global health challenges for the year ahead.

For the first time, ‘vaccine hesitancy’ makes the list. The reluctance to be immunised against vaccine-preventable diseases risks outbreaks of diseases like measles and jeopardises the global campaign to eradicate polio.

The WHO says the refusal to vaccinate despite the availability and effectiveness of vaccines is due to a combination of complacency, inconvenience in accessing vaccines, and lack of confidence (Note: It’s not all about so-called ‘anti-vaxxers’).

This is not news, unfortunately, yet it should still be shocking when you read the statistics. Vaccination currently prevents 2-3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved. 

‘Measles, for example, has seen a 30% increase in cases globally,’ says the WHO. ‘The reasons for this rise are complex, and not all of these cases are due to vaccine hesitancy. However, some countries that were close to eliminating the disease have seen a resurgence.’ (Europe, I think they are looking at you…)

Health workers remain an important source of information for people making decisions about vaccination. They should be supported to provide trusted, credible information on vaccines, the Organisation says.

This year, the WHO will step up its effots to eliminate cervical cancer worldwide by increasing coverage of the HPV vaccine, among other interventions. 2019 may also be the year when transmission of wild poliovirus is stopped in Afghanistan and Pakistan – if immunisation rates can be sustained.

Regular readers of this site know vaccines are essential to global health. What you might be surprised to know is that vaccines can also help to solve several of the other major challenges.

For example, the need to prepare for a global flu pandemic remains a concern. ‘The world will face another influenza pandemic,’ says the WHO. ‘The only thing we don’t know is when it will hit and how severe it will be.’ Disease surveillance and flu vaccination are vital to responding to any novel flu strain.

Several other communicable diseases make the list. Dengue, a mosquito-borne illness that can be lethal in up to 20% of those suffering severe forms of the disease, has been growing for decades.

‘An estimated 40% of the world is at risk of dengue fever, and there are around 390 million infections a year. WHO’s Dengue control strategy aims to reduce deaths by 50% by 2020.’ 

One dengue vaccine has already been approved and others are in the pipeline. A range of vector-control measures are crucial to containing the spread of the disease.

The panic and fear associated with HIV in the 1980s has faded, but the disease still kills nearly a million people a year. Access to pre-exposure prophylaxis (PrEP, which is when people at risk of HIV take antiretrovirals to prevent infection) has been a game-changer but the epidemic continues. Several HIV vaccines are also in various stages of clinical trials.

Ebola was the focus of serious concern in 2018 and continues to be a risk in parts of Africa. Last year, the Democratic Republic of the Congo saw two separate Ebola outbreaks, both of which spread to cities of more than 1 million people. One of the affected provinces  is also in an active conflict zone.

Vaccines have been a key element of a broad strategy to interrupt the spread of the disease. More than 60,000 people have been vaccinated. 

The ongoing challenge of antimicrobial resistance threatens to undermine some of the great successes of modern medicine – antibiotics, antivirals and antimalarials. ‘The inability to prevent infections could seriously compromise surgery and procedures such as chemotherapy,’ warns the WHO.

A range of actions is needed to reverse this trend, but vaccines are increasingly seen as part of the solution.

Finally, you might not see noncommunicable diseases as an area where vaccination plays a role. However, scientists are working on immunotherapies and vaccines for diabetes and other chronic conditions. This research may pay off in the long term.

But vaccines are also important today. For example, people with diabetes, COPD, heart disease and several other conditions are at increased risk of catching flu and of developing complications if they are infected.

The bottom line is that vaccines can – directly and indirectly – help us rise to the some of the biggest global health challenges of our time.