Vaccines Need to Reach the Poor in Middle-income Countries Too

Monday, June 13, 2011

The world’s top aid donors met on Monday in London to replenish the Global Alliance for Vaccines and Immunisation (Gavi), netting a remarkable $4.3bn in the midst of a historic recession, to scale up immunisation programmes in the run-up to 2015 and the millennium development goal (MDG) timeline.

Gavi has increased vaccination coverage in the poorest countries of the world, known by the World Bank’s country classifications as the low-income countries (LICs, or those countries of annual income of about $1,000 or less per person), while receiving top marks for management and accountability.

Middle-income countries (MICs) are now home to the majority of the world’s unvaccinated children. Household survey data indicates that complete vaccination rates are substantially lower in MICs than LICs overall, and that the poor fare worse – a point hidden when one looks at average vaccinations data for a country.

China and India represent a chunk of the problem, with 33% of all unvaccinated children under one-year-old. Yet even excluding China and India, another 47% of unvaccinated children live in middle-income countries, with only 17% living in low-income countries. The sheer numbers of unvaccinated children might explain the frequency of outbreaks of vaccine-preventable diseases in MICs and the difficulties in eliminating polio. Without intervention, these differences may become more pronounced over time.

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