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Pacific island countries are falling back on vaccination targets, especially those for diseases transmitted by mother-to-child transmission, according to WHO officials.
Po Lin Chan, doctor in the WHO regional office, explains to SciDev.Net that “vaccination has helped reduce the prevalence to 1% in the Pacific Islands, but achieving 0.1% prevalence in children requires additional interventions based on maternal, newborn and child health programs, including screening prenatal pregnancy for hepatitis B alongside that of HIV and syphilis “.
The response of the WHO Regional Office for the Western Pacific to this problem has been to add hepatitis B to an existing immunization program to eliminate mother-to-child transmission of HIV and syphilis with the aim of achieving 0.1% prevalence by 2030.
The WHO recommendation is based on the example of China. “Since 2010, China has offered universal testing for every pregnant woman, for HIV, syphilis and hepatitis B, and modeling suggests that China will meet the elimination target by 2029,” Chan said.
For the Pacific Islands, according to epidemiologist Caroline Van Gemert of the Burnet Institute in Melbourne, who participates in Vanuatu’s health program, elimination will not be achieved even by 2030, unless things change dramatically on field. The team presented their work at the World Epidemiology Congress, which was held from September 3-6.
“To achieve elimination of mother-to-child transmission infections, a country must be able to prove that elimination goals are being met – but data is not collected, there are huge gaps that must be addressed to monitor elimination, ”said Van Germert. SciDev.Net.
Only Guam, which is administered by the United States, reports data, says Van Germert. “I know other countries are testing pregnant women, but the data is not published,” she says. In addition, screening is not systematic. “In Vanuatu, it depends on the clinic and the availability of tests. The tests are more available in hospitals than in community health facilities, ”she said.
WHO guidelines recommend that medicines such as tenofovir be given to infected pregnant women to prevent transmission to their babies.
“Treatment is not available on all islands. Whether nationally or at health facility level, I was unable to collect data,” Van Germert said.
According to Van Germert, Pacific countries could complete a WHO monitoring form with several indicators. “This is already what WHO is doing with UNAIDS for HIV surveillance. Each year, countries file global AIDS surveillance data, ”she adds.
Vaccination campaigns must also be improved. While some islands have had a universal childhood immunization program for decades, full coverage is difficult to achieve due to logistics between each country’s main islands and the outer islands.
“It is expensive to reach some islands because access is only by boat. It is also difficult to maintain the cold chain necessary to keep the vaccine doses viable,” says Chan. If the deployment of COVAX – the multilateral mechanism for the distribution of COVID-19 vaccines – is successful, there will be lessons to be learned for the delivery of other vaccines, including hepatitis B.
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