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

Modina* (24) and her daughters Humaida* (1) and Sifatara* (3) access medical services at Save the Children's health centre in Cox's Bazar, Bangladesh.

Save the Children calls on world leaders to deliver global ceasefire to help fight spread of COVID-19.

As the world awaits a COVID-19 vaccine, a new report by Save the Children shows that millions of children trapped in war zones are already missing out on life-saving vaccinations.

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

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

Diseases such as 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-won progress on vaccination against deadly illnesses, according to the report launched by Save the Children today.

Vaccination rates have plummeted across many countries engulfed by war, the report outlines. In Syria for example, immunisation levels for diphtheria, tetanus and whooping cough (also known as pertussis) were above 80 percent before the war, but fell to 47 percent two years ago. In Ukraine the national rate fell from 80 percent to 19 percent after four years of war.

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’s Global Medical Director Dr Zaeem Haq said:

“COVID-19 has made it painfully clear that no country is immune from the spread of old or emerging diseases.

“Ensuring the health of children in conflicts not only upholds one of their most basic human rights, it is also a critical part of protecting global health.

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

While resources are being re-directed to fight COVID-19, the world cannot allow other horrific diseases to re-emerge and spread across vulnerable populations, particularly children, Dr Haq continued.

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

Mazen*, three months old, receiving an oral vaccine in a tent in North West Idlib, Syria.

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, Somalia, South Sudan and Yemen in the past ten years. In Yemen more than one million cholera cases and 2,500 deaths occurred between 2016 to 2018.

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.”

While the funding of Gavi, the global vaccine alliance, and COVAX, the global facility for the fair distribution of eventual COVID-19 vaccines across the globe, is extremely important, more needs to happen, Save the Children emphasized.

Dr. Haq continued: “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 children and their families. But the fighting continues. That is unacceptable.  World leaders need to keep pushing for a global ceasefire, as that is a condition to reach the most vulnerable children.”

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” vaccinations and with a focus on children with the lowest immunisation levels.

*Name changed to protect identity