POST 00793E : OTHER INTERVENTIONS WITH VACCINATION
Follow-up on Posts 00789E and 00791E
27 May 2005
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Robert Steinglass (mailto:[email protected]) from
ImmunizationBasics makes some comments on Bob Davis and Juan Ortiz'
presentation. You will have noticed that this presentation was not in Post
00790E as I had written, but the previous one 00789E. The second
contribution is from Jim Ricca (mailto:[email protected]) from the
American red Cross, who explains briefly Red Cross efforts to integrate
with routine EPI.
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Hi, Bob.
Thank you for these slides and for your dissemination efforts. Better use
of the routine immunization platform can assist other programs to achieve
their own objectives and thereby raise the value of immunization programs
across the many programs and interventions.
The Lancet series (quoted in your slides) did a great job in late 2003 of
alerting the world to the continuing magnitude of preventable child
mortality. However, in my opinion, the series also undervalued the
importance of vaccination. The Lancet articles estimated that in the 42
countries with 90% of child mortality, only 100,000 deaths were due to
measles each year. Yet at the same time, WHO (WER article in February 2004)
estimated more than 600,000 deaths annually due to measles. Furthermore,
even though pertussis is estimated to kill more children each year than
neonatal tetanus, pertussis did not receive attention as a continuing major
cause of mortality.
This is more than just an academic discussion. It is my understanding that
the models used to generate the figures for The Lancet series back in 2003
are still being used to identify burden of mortality in some of the broader
child health partnership work being done in Africa and elsewhere.
Then, of course, there is the issue that past reductions in
vaccine-preventable disease mortality cannot be taken for granted and
assumed to continue automatically. Past drops in vaccine-preventable
disease mortality still must be sustained, even as we look for the current
causes of mortality.
Thanks again for the interesting articles.
Robert
Robert Steinglass
Technical Director
IMMUNIZATION Basics
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I'm sure that there is ample experience with coupling EPI service delivery
to other MCH services that others will want to recount in response to this
request. I just wanted to make people aware of the fact that the Red Cross
is currently involved in such work and is looking to expand its experience.
For instance, as a follow-up to the December 2004 Togo Measles/Malaria
Campiagn, there is an ongoing multi-year Red Cross/Togo MoH effort to link
ITN distribution to routine EPI as a way to maintain high rates of ITN use
after the "initial country-wide priming" that occurred through the
campaign. The Red Cross has been looking for other countries in which to
implement this model of a national scale "quantum leap" in ITN usage rates
through a national Measles/Malaria Campaign and then maintaining the high
rates of ITN use afterwards by linking ITN distribution to routine EPI
services. In any case, I have also copied a number of people at Red Cross
Washington, Ottawa, and Geneva who have been directly involved with this
effort, so perhaps they will want to contribute more information than I am
able.........
Jim Ricca, MD, MPH
Senior Health Advisor
American Red Cross
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