Thursday, July 5, 2018

An Appeal from Uganda for Vaccination Funding - UPDATED

On Monday, July 2, 2018, 10:23:22 AM EDT, rose mary <rosemaryparker7771@gmail.com> wrote:



Good Morning , Mr. Douglas Cooper,

     Am truly honored to be writing to you and i thank you for giving me the chance to...This is Mary Parker one of your connections on Linkedin...with that been said i do not want to take any of your precious time and i also felt this email should not be a long one since this issue is not new to anyone again...well we took  a Trip to Uganda in East Africa and we discovered that the immunization of children over there is not up to date and the Government and other medical association need to do more about  the situation there..Young infants keeps dying by the day and nothing seems to be done over there... i took my time to write little about what we discovered over there and what needs to be done to savage the situation before it gets out of control..i guess am able to convince you to be of help to us in any little way you can and we would be so grateful to you for your help!!!

  
INTRODUCTION

     Childhood vaccination is a highly effective method for preventing vaccine preventable diseases.. Globally it is estimated that about 22.4 million children under one year of age were not vaccinated with a third dose of pentavalent vaccine (Diphtheria-Pertussis-Tetanus-Hepatitis B-Haemophilus type b influenza vaccine (DPT-HB-Hib)) in the year 2012, of whom 70% live in Africa, while 0.54%of the unvaccinated children were found in Tanzania. Children who miss vaccines or are partially vaccinated are said to be at high risk of vaccine preventable diseases that claim millions of lives each year.. It is also estimated that 10 million children under-five years die, one third of which is attributable to infectious diseases that would have been vaccine prevented... Immunization protects against a large number of childhood diseases considered dangerous. These include:Whooping cough (pertussis), measles, German measles (rubella), meningococcal C,pneumococcal disease, chickenpox (varicella), tetanus, mumps, polio, diphtheria, rotavirus and hepatitis.  Each of these diseases cause serious health problems and can sometimes prove fatal. Thankfully, through high immunization rates in the community, these diseases can be prevented and eventually stopped .A child is said to under utilize a vaccine if he or she misses out on one or more of the recommended vaccine dose.. In response to the under utilization of vaccines, World Health Organization (WHO) and United Nation for International Children and Education Funds (UNICEF) developed the Global Immunization Vision and Strategy (GIVS) in 2006 aimed to help countries to vaccinate more people, especially those who are hard to reach, Furthermore, GIVS emphasized on reaching every district strategy (RED), as it showed improvement in raising vaccination coverage in some countries where it was practiced... RED focuses on ensuring that each district achieves 90% coverage for all antigens by 2015, thus all major districts in Uganda should have 90% of its eligible children vaccinated. Unfortunately, only 50% of the districts in 2012 reported to have vaccination coverage above the required target (90%)..
Things to know about immunization:
=Immunization saves lives
=Vaccination is safe and effective.
=Immunization protects those you love
=Immunization can save you money
=Immunization gives future generations the chance to live disease free.


FINDINGS

 Once children are in Year 8 and Year 10, they will be offered recommended vaccines via a school-based program..It is important that you keep a record of your child’s vaccinations, and this can be done by taking your child’s Personal Health Record to appointments. Whilst there, you can also check your own immunization history. Adults can be immunized against a range of diseases too, and certain vaccines have an expiration date. For example, any adult spending time with a newborn is recommended to check with their GP to see if they are up to date with their whooping cough vaccine..We investigated the factors associated with childhood immunization status in Uganda. The finding that slightly over 50% of children were fully immunized is worrying in the face of very high infant and child mortality. This may probably be due to the ignorance of mothers or parents concerning the right dosage that a child is required to get. This is especially true for vaccines, like DPT and polio, that require three independent doses where some children may receive one dose or up to the second dose and do not complete the full course. Government effort and donors is urgently needed to increase coverage of immunization by educating the population on the right doses of each vaccine and importance of completing it. There is a discrepancy between the level of vaccination coverage between DPT (24%) and polio vaccine (52%). These vaccines are often administered at the same time and, hence, their coverage rates are expected to be similar. According to the UDHS report, differences in coverage between DPT and polio result, in part, from stock-outs of vaccines...We also found significant regional differences in the immunization coverage in Uganda... Therefore, there is a need for the government effort to reach the disadvantaged regions and locations. The Government of Uganda and sincere Donors should target rural areas by stocking the required vaccines in the community health centers or clinics. In addition, sensitization campaigns, especially targeting the uneducated, may go a long way in achieving this objective. In many of the cases, rural areas are disadvantaged due to poor road networks, especially during rainy seasons. Improving the transport facilities may also help solve the problem...Exposure to the media is significantly associated with childhood immunization. This can be attributed to the sensitization messages that parents receive through media to get their children immunized!!!!!


CONCLUSIONS   

   Like any medication, vaccinations do come with some risk of side effects. Generally, these are mild reactions such as soreness at the injection site or a mild fever. Most effects are short-lived and cause very little discomfort. In fact, a mild fever or slight reaction can be a good thing, as it shows that the vaccine is having an effect on the immune system..Many schools and childcare facilities will ask that you provide a record of your child’s immunization when enrolling. As of January this year, new laws in NSW state that any childcare center can refuse to enroll a child who fails to provide an up-to-date immunization record. Should a childcare center fail to complete checks to ensure a child is vaccinated or exempt, they could face fines of up to $4,000...In the event of a disease outbreak, a child may be excluded should they not be vaccinated. This is designed to protect them from carrying the disease into the school grounds, putting other children at risk. 

  Funding the commitment of national governments for immunization is perhaps one of the most important challenges facing immunization program in the African Region today. The cost of vaccinating a child estimated at US$25-$45, baring other costs like training, supervision, communication among others. Several studies suggest that non-vaccine costs represent nearly half of the total cost per child . Between year 2016 and 2020, Africa will require a whooping US$17 billion for vaccines and vaccination services . Governments are expected to provide a third of this, which is US$6 billion leaving a gap of about US$5 billion. With increased competition for donor funding for developments and emergencies government commitment and funding of immunization becomes very crucial. Currently, most of the African countries depend of Gavi funds to support vaccine and immunization. Five countries reported fundin ..There is thus a dire need for a paradigm shift for governments to begin to take more responsibilities for immunization to ensure sustainable funding. Closely linked to this is the weak involvement of communities in immunization programs. The role of civil society and community-level work in advancing health, immunization inclusive, cannot be over emphasized. They have their roles in increasing demand for and uptake of available services through social and behavioral change interventions; ensuring government transparency and accountability; supporting resource mobilization; influencing national health policies; and supporting the monitoring and evaluation of effective program..
   
With all been said i do not want to take much of you time,i hope i have been able to convince you to have a rethink of the issue at hand sir even if you are not willing to invest in Africa just for the seek of the little kids and infants i plead with you just to  help out with little funds so we private group of Nurses can do our own little help down there is Uganda and some other parts of Africa...our mission should kick start at the end of the month and i will be expecting an honest and positive email back from you..thank you for taking your precious and limited time to read this email..thank you and may the good Lord continue to enrich your coast..Have a blessed day ahead..cheers!!!

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I don't know the truth of what has been sent me, nor the bona fides of the sender, and I have not contributed, but others may wish to.

An alternative opinion:

Thanks for sending this email request along to me ... but I have serious doubts regarding its legitimacy!  The “all caps” heading is reminiscent of various African scam emails that (thankfully) are filtered out of my Inbox, but it is particularly curious that this “Rose Mary Parker” is requesting funding to support a “private group of Nurses [which] can do our own little help down there is (sic) Uganda and some other parts of Africa.” There is no authorized “private group of nurses” in Uganda or anywhere else which can take external funds, and simply purchase vaccines to distribute as they see fit.  Everything is controlled through a national registry under the auspices of the Ministry of Health, and the World Health Organization, etc.

She mentions Gavi  and this prompted me to dig into that a bit more: https://www.gavi.org/about/partners/bmgf/ .  From their website, I was able to download their most recent (2016) financial report (attached).  If you take a quick look at page 22 in that report, I think Gavi – and hence Uganda/Africa – should be doing pretty well with a forecast of over 9.9 billion US$ in funding for the 2016-2020 period.  The statement provided under that funding/expenses table is pretty clear:  “After taking into account available resources, and assuming that the forecasted level of funding for 2017 to 2018 will be maintained through 2020, the Secretariat forecasts that Gavi will have sufficient resources to fund all its programmatic commitments through 2020.”

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