Hurricane Matthew: Haiti Needs Vaccines to Stop Deadly Cholera Spreading
9,000 people died in Haiti’s last cholera outbreak. We must act fast in disaster-affected hotspots to help prevent history repeating itself.
9,000 people died in Haiti’s last cholera outbreak. We must act fast in disaster-affected hotspots to help prevent history repeating itself.
Health workers face suspicion and a lack of cold storage as they test the Ebola vaccine and also try to reach children who have missed inoculations against other diseases.
The earthquake that struck Haiti in January 2010 caused 1.5 million people to be displaced to temporary camps. The Haitian Ministry of Public Health and Population and global immunization partners developed a plan to deliver vaccines to those residing in these camps. A strategy was needed to determine whether the immunization targets set for the campaign were achieved. Following the vaccination campaign, staff from the Ministry of Public Health and Population interviewed convenience samples of households – in specific predetermined locations in each of the camps — regarding receipt of the emergency vaccinations.
Rapid monitoring was implemented in camps located in the Port-au-Prince metropolitan area. Camps that housed more than 5000 people were monitored first. By the end of March 2010, 72 (23%) of the 310 vaccinated camps had been monitored. Rapid monitoring was only marginally beneficial in achieving immunization targets in the temporary camps in Port-au-Prince.
Humanitarian emergencies result in a breakdown of critical health-care services and often make vulnerable communities dependent on external agencies for care. In resource-constrained settings, this may occur against a backdrop of extreme poverty, malnutrition, insecurity, low literacy and poor infrastructure. Under these circumstances, providing food, water and shelter and limiting communicable disease outbreaks become primary concerns. Where effective and safe vaccines are available to mitigate the risk of disease outbreaks, their potential deployment is a key consideration in meeting emergency health needs. Ethical considerations are crucial when deciding on vaccine deployment.
Allocation of vaccines in short supply, target groups, delivery strategies, surveillance and research during acute humanitarian emergencies all involve ethical considerations that often arise from the tension between individual and common good. The authors lay out the ethical issues that policy-makers need to bear in mind when considering the deployment of mass vaccination during humanitarian emergencies,
Global health and poverty reduction discourses have recognised immunisation as one of the most affordable and effective means of reducing child mortality and in a broader sense, as an essential contribution to poverty reduction efforts. While immunisation comes with countless benefits, it is potentially a complex and difficult health strategy to enforce. Decisions on broader health as well as immunisation goals are often made at a global level to be incorporated and adapted in to national health plans and budgets. Evidently for immunisation campaigns, the journey from the global to the local is a vulnerable and unpredictable one. Indeed ‘anti-vaccination rumours’ have been defined as a major threat to achieving vaccine coverage goals. This is demonstrated in this paper through a case study of responses to the Global Polio Eradication Campaign (GPEI) in northern Nigeria where Muslim leaders ordered the boycott of the Oral Polio Vaccine (OPV).