Good news, bad news. Since 2000, over 500 million children have been vaccinated with support from the global alliance for vaccines known as
GAVI. GAVI estimates that during that period vaccinations prevented seven million deaths. Less good: a fifth of children in the world's poorest countries are not vaccinated and some
1.5 million children each year die from vaccine-preventable diseases. On the "good" ledger, just weeks ago, in budget slashing times, world governments at a conference in Berlin pledged over $7.5 billion for GAVI supported immunization campaigns. Meanwhile, however, headlines in the United States suggest that a raging debate calls vaccination itself into question. And in parts of the world (notably northern Nigeria and Pakistan) vaccination has taken on horrendous political connotations with murders of vaccinators occasionally wrapped up in religious rhetoric.
Notwithstanding bad news, the global vaccine story deserves to be celebrated as a remarkable bright spot on today's rather gloomy international scene. It shows what can be done with clear, strong partnerships among different actors, and science well allied with conscience. But the next stages, to reach the fifth of children who are not yet vaccinated, calls for new, wise, and creative efforts.
In that spirit, GAVI leaders met with a diverse group of faith-inspired organizations on February 1 in Washington, to explore what a deliberate mobilization of faith leaders and communities might involve.
Engaging the many faith-linked actors on immunization is certainly not a new idea. Leaving aside religiously linked qualms about or outright objections to vaccination (which involves quite small minorities), faith communities have long been at the forefront of health and thus immunization. Leaders are strong advocates and organizations are critical both for basic health care and thus routine vaccination and for special campaigns, for example in war-torn areas. Georgetown University's Berkley Center and the World Faiths Development Dialogue explored the topic several years ago and identified promising paths to more purposeful partnerships. GAVI has worked with several organizations, including Latter Day Saints Charities, World Vision, the Catholic Church, and Muslim Aid, on specific programs. But clearly the potential of this huge array of organizations and their moral voice have barely been scratched.
Dagfinn Høybråten, GAVI's Norwegian board chair, is a passionate advocate and leader. Immunization, he argues, is among the most basic and fundamental human rights. He sees immunization as an issue that can unite people of all faiths and of no faith. He stressed the spirit of community as the driver. Dugnad, a Norwegian term for voluntary work done together, offers an inspiration. Significantly, a dugnad culture does not thrive where there are unresolved controversies about goals, paths, and tools. Here he looks to faith communities both for to articulate and convey a common vision, to address knotty and difficult obstacles, and to focus on what truly matters - the lives of children.
So what more is needed and what is feasible?
GAVI relies on governments to translate broad goals into reality. The hope is that faith-inspired organizations will help to bolster government commitment, both among those that provide financial support, and those at the implementing end.
Immunization relies on people's trust. Faith institutions can help dispel mistrust and foster confidence in many situations.
Faith communities are often directly involved, running health facilities, organizing campaigns, mobilizing volunteers, and serving as examples by publicly having their children vaccinated.
Perhaps most important, faith leaders can help reach the most difficult to serve communities and children that are the focus of the next stages of the global campaign. That includes outlier groups and people in tumultuous countries like the Democratic Republic of the Congo, Sierra Leone, and Syria.
Immunization does not happen in a vacuum. The Ebola crisis in West Africa has brought home forcefully how tightly linked health and poverty can be. Fear of Ebola has stymied immunization as well as pre-natal care. Faith communities rarely miss these linkages and can help "connect the dots" among different public health and welfare efforts.
It is heartening that GAVI's leaders are looking to religious actors as important partners. The challenge ahead, however, is complex. Religious institutions are far from monolithic and many sensitivities are involved. Simplistic, one size fits all approaches can backfire, undercutting health campaigns but also adding fuel to flames of distrust and religious and ethnic tensions. Looking to several priority countries to identify what is missing in partnerships and to explore practical partnerships could show the way to the kind of global partnership that GAVI hopes to encourage. It is time to move ahead.
