RESIST- Building a Resilient and Sustainable Immunization System in Tanzania

Immunization programs are very crucial in meeting most of the goals of the 2030 Agenda for Sustainable Development (SDG), particularly SDG 3 (ensuring healthy lives and promoting well-being at all ages). Specifically, effective immunization directly leads to the realization of SDG 3.2 (By 2030, end preventable deaths of newborns and children under 5 years of age), SDG 3.3 (By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases) and SDG 3.8 (Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all). the Global Vaccine Action Plan (GVAP) 2011-2020 aimed at reaching immunization coverage rates of 90% at national level and 80% at district level, but many parts of Africa, including Tanzania, are still way below this target. Despite the successes influenced by the SDG Agenda and GVAP, there still remain challenges as jointly reported in 2020 by the WHO and UNICEF. Tanzania has been implementing immunization programs since 1976. Despite the country having one of the largest average immunization coverage rates, coverage is still largely non-uniform across different demographics within the country and a large number of diseases still remain unabolished and/or at high prevalence. The 2015–16 Demographic and Health Survey (DHS) reported 1 in 4 children nationally was not fully vaccinated, and many regions fell short of the 90% coverage target set by the GVAP. 4 In addition, although vaccine stock outs have declined in the country over the past decade, significant stock outs are still prevalent. An effective supply chain of vaccines is at the center of all successful immunization programs. There is, therefore, a need to build a sustainable and robust supply chain model for vaccines and other immunization products. The model’s supply system must, at all times, be able to reach all demographic groups and must be flexible and resilient enough to respond to emergency and drastic changes such as the COVID19. More importantly, the model must be applicable in the local context. Furthermore, as we have witnessed during the COVID19 pandemic, vaccines supply programs should incorporate an important element of public education in order to combat vaccine hesitancy.