Conflict threatens global health security as children miss out on life-saving vaccines: report

As the world eagerly awaits a COVID-19 vaccine, a new report shows that children trapped in war zones are already missing out on life-saving vaccines.

Not Immune: Children in Conflict shines a spotlight on the harrowing impact war has on the immunisation of children and calls for urgent global action to protect children from preventable diseases.

Two thirds of the world’s unimmunised children are living in countries engulfed by conflict and each year millions more miss out on vital vaccinations.

Diseases like measles, polio, cholera, pneumonia, yellow fever and diphtheria, for which safe and effective vaccines exist, are gripping children in conflict as continued fighting undermines efforts to vaccinate them.

Long and enduring conflicts are winding back hard-fought vaccination progress for deadly illnesses, according to the report launched by Save the Children today.

COVID-19 has compounded the situation for children living in war zones, causing the suspension of immunisation programs in more than 60 countries.

As a result, 80 million more children under one are at increased risk of contracting vaccine-preventable diseases. In the four months to August alone, 50 million children missed out on polio vaccinations.

Save the Children Australia CEO Paul Ronalds said:

“As COVID-19 has shown, no country is immune from the spread of old or emerging diseases.

“While ensuring the health of children affected by conflict is their human right, it is also a critical part of protecting global health.

“We must not allow preventable diseases to take the lives of children because we couldn’t get vaccines to the 29 million or so babies born in conflict affected areas.

“While resources are being re-directed to fight COVID-19, we cannot allow other horrific diseases to re-emerge and spread across vulnerable populations, and in particular, among children.

“We have fought for too long and too hard to beat these diseases.”

Not Immune: Children in Conflict details deadly outbreaks of diseases from the past 10 years that could have been prevented with large-scale immunisations, including a polio outbreak in Boko-Haram controlled northeast Nigeria in 2016, and in Syria a year later.

Large-scale and severe cholera epidemics have occurred in conflict-affected countries including Iraq, Sierra Leone, Somalia, South Sudan and Yemen in the past 10 years. In Yemen over one million cholera cases and 2,500 deaths occurred between 2016 to 2018.

Vaccination rates have plummeted across many countries engulfed by war. In Syria, immunisation levels for diphtheria, tetanus and pertussis were above 80 percent before the war, but fell to 47 percent two years ago. In Ukraine the rate fell from 80 percent to 19 percent after four years of war.

Fear of contracting COVID-19 is also preventing families from accessing vaccinations, which is particularly concerning among vulnerable populations like refugees.

In Cox’s Bazar, Bangladesh, where more than 700,000 Rohingya fled to following deadly violence in Myanmar in 2017, Modina’s* one year old daughter had been receiving routine immunisations from birth at Save the Children’s health centre but stopped when news of coronavirus spread.

“My child started to become sick since the day we stopped the vaccinations. I did not go out of the house as I was afraid of coronavirus. And because of that (my daughter) became malnourished day by day.

“I became more afraid as she was becoming more sick. Then I realized how important the vaccinations are. The children will be safe from diseases like chicken pox, measles, and many others.”

Mr Ronalds said a range of measures were needed to reach children in conflict with vaccines, starting with a halt to fighting.

“We’re proud to see Australia pledge new funding to roll out a future COVID-19 vaccine in the Pacific and South East Asia, as well as make significant contributions to Gavi, the global vaccine alliance, and COVAX, the global facility for the equitable distribution of eventual COVID-19 vaccines. However, funding alone is not enough.

“Just months ago, the UN Secretary-General appealed for a global ceasefire to limit the spread of COVID-19 and allow aid – and immunisations – to reach the most vulnerable populations. The call was endorsed by 180 governments, yet the fighting continues.

“We cannot accept this. World leaders including Australia need to keep pushing for a global ceasefire. While war itself generates catastrophic health problems, health is a critical mechanism to help facilitate peace.”

The report calls for global vaccination efforts to sharpen their focus on reaching children affected by conflict, including refugee and internally displaced children.

It also calls for more support to be provided to conflict affected countries to increase immunisation coverage, including through “catch up” vaccines and with a focus on children with the lowest immunisation levels.

*Name changes to protect identity

/Public Release. View in full here.