Immunisation up but situation remains “grim”, says WHO

Although average figures for routine childhood vaccination in the DRC rose slightly in 1999-2000, overall the picture is “grim”, according to the World Health Organisation (WHO) DRC country update for July. The increase is attributed to intensive efforts in NGO-supported health zones and improvements in the cold chain due the expansion of the polio programme. However, fewer than one-third of children are routinely vaccinated and averages for some antigens fall as low as 18 percent while in Orientale province, rates run at zero to 10 percent. NGO and WHO efforts to improve the cold chain and training of staff are continuing, but as one logistician explained, “If you have the fridge, you don’t have the kerosene to run it. When you have the kerosene, you don’t have the vaccine. Then the fridge breaks down because of poor maintenance. There always seems to be something.” On top of this, NGOs are reporting frequent reluctance among health workers to give childhood vaccination, or indeed provide any preventative care, free of charge because their pay is mostly derived from fees for service. Both short-term solutions and long-term thinking are required, according to WHO, and a five-year strategic plan for the development of expanded immunisation activities was recently completed by DRC health authorities, with the technical and financial support of the US-funded group Basic Support for Institutionalising Child Survival (BASICS) and WHO.