PHM-Exch> [PHM NEWS] Setbacks in immunisation coverage reported to WHO: Strengthening comprehensive primary health care is critical

[Claudio Schuftan]

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From: <dlegge at phmovement.org>
Date: Fri, Jan 19, 2024 at 2:00 PM

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Setbacks in immunisation coverage reported to WHO
Strengthening comprehensive primary health care is critical

The latest report from WHO on immunisation coverage (EB154/9
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=a9742cb93a&e=5f3cea0f3e>,
to be considered at the WHO Executive Board from 22 January) describes a
very uneven recovery following the Covid pandemic.  Challenges persist in
meeting global coverage targets, in eliminating diseases like polio and
measles, and in preventing large outbreaks. Zero-dose children stands at
14.1 million and progress has stalled in low-income countries and in the
African region.

PHM appreciates the commitment of WHO officials and of the grassroots
immunisation teams but three major barriers remain: the flawed model of
‘universal health coverage’, economic constraints on health system
strengthening, and the role of corporate monopoly power in limiting access
and affordability.
Importance of primary health care

WHO’s Immunisation Agenda is rooted in the flawed concept of ‘universal
health coverage’ which aims to limit state involvement to funding a defined
package of basic services to be delivered through the private sector, and
opening new opportunities for private health insurance companies to compete
in the ‘beyond the package’ insurance market. This approach reduces primary
health care to an initial layer of private care, often acting as a
gatekeeper to specialized care.  This model has been promoted by USAID, the
World Bank, and the Rockefeller Foundation.

Robust public primary healthcare, centered on communities and territories,
is of pivotal importance. A high level of state capacity for planning and
collecting vaccination data, and monitoring delivery is also critical but
is hindered by both privatization and the erosion of public health systems.
Health workers form the backbone of the health system, especially in areas
where vaccination coverage is low, like non-urban and impoverished
communities. The report's lack of emphasis on health workers and their role
within the Immunization Agenda needs attention.
Pharmaceutical market: price transparency and pooled procurement

The latest report insufficiently addresses issues concerning corporate
power and vaccine affordability and availability. Over recent decades,
vaccine production has increasingly fallen under the control of major
pharmaceutical companies primarily based in Western Europe, the USA, Japan,
and more recently, China.  The monopolistic strategies employed by these
companies - utilizing intellectual property rights, including patents and
industrial secrecy, restricting access to biological samples, and
advocating for data exclusivity in clinical trials - result in high prices
and shortages. The Covid-19 pandemic underscored the limitations of this
model, revealing difficulties in scaling up production. The pandemic also
left clear that vaccine innovation is heavily funded by public resources.

PHM calls on Executive Board members to give full attention to matters of
affordability and access, including provision for compulsory licensing of
patents, transparency regarding innovation and manufacturing costs, and
technology transfer which is pivotal for access to vaccines. Strategies
like pooled procurement have proven effective in bolstering states’
bargaining power and their capacity to support national immunization
strategies.



The full PHM commentary on this item (here
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=21d664e5aa&e=5f3cea0f3e>)
provides more detail and references.See also Tracker links to previous
discussions of immunisation
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=df9373ae04&e=5f3cea0f3e>
.

The WHO Tracker and PHM item commentaries are produced as part of *WHO
Watch* which is a project of the People's Health Movement
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=112fedc1fb&e=5f3cea0f3e>
in association with Medicus Mundi International
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=9f618f776d&e=5f3cea0f3e>,
Third World Network
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=5a916fc660&e=5f3cea0f3e>
and a number of other civil society networks. WHO Watch contributes to
democratising global health governance, through new alliances, new
information flows and by broadening the policy discourse.

See the WHO Tracker page for this EB154 session (here
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=307b88daa6&e=5f3cea0f3e>).
See PHM’s integrated commentary
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=44cf8408a8&e=5f3cea0f3e>
on the full agenda of EB154 (or read the flipbook version
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=1b764bf77b&e=5f3cea0f3e>).
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