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Refreshing commitments to immunization in the DRC

September 11, 2019 by Guy Bokongo

DRC President Tshisekedi Tshilombo at the National Forum on Immunization and Polio Eradication

DRC President Tshisekedi Tshilombo has committed to making concerted efforts to increase immunization rates throughout the country, especially among high-risk rural populations. Photo: Bill & Melinda Gates Foundation/Diana Zeynab Alhindawi.

Against the backdrop of an ongoing Ebola outbreak, promising news from the DRC—top leaders commit to increasing immunization efforts and working to eradicate polio. PATH Advocacy and Policy Manager Guy Bokongo shares his personal reflections.

At the invitation of President Félix-Antoine Tshisekedi Tshilombo, governors and leaders from each of the Democratic Republic of the Congo’s (DRC) 26 provinces traveled to Kinshasa to discuss joint efforts to strengthen the country’s immunization system and advance progress toward polio eradication. This type of gathering—the largest of its kind ever held in the DRC—and the resulting co-financing commitment are truly remarkable for a president's first year in office.

Robust health policies, adequate financial resources, and delivering on commitments will improve the accessibility and availability of high-quality, lifesaving immunization services, thereby creating a brighter future for the DRC’s women, newborns, and ch

Robust health policies, adequate financial resources, and delivering on commitments will improve the accessibility and availability of high-quality, lifesaving immunization services. Photo: Gavi/Evelyn Hockstein.

Coming together around a shared goal

Vaccines save lives and prevent unnecessary suffering from disease. Despite this lifesaving potential, 1.8 million children miss out on a full course of vaccines every year in the DRC, contributing to one of the highest rates of child mortality in the world. The country has experienced major outbreaks of measles, polio, and yellow fever—all vaccine-preventable diseases—in recent years. It was with this context that President Tshisekedi Tshilombo convened the National Forum on Immunization and Polio Eradication from July 22-23, 2019, which PATH was pleased to help organize.

“ PATH was pleased to help organize and be part of the National Forum on Immunization and Polio Eradication...We look forward to continuing to support the president in realizing his vision of improving the health and general well-being of the Congolese people. ”
— Trad Hatton, DRC country director, PATH

Addressing the provincial leaders in attendance, President Tshisekedi Tshilombo publicly affirmed his commitment to immunization as a pillar of universal health coverage. Urging the leaders in attendance to join him in committing to increase immunization rates throughout the country, he decried the fact that one out of every seven children in the DRC still dies of vaccine-preventable diseases before the age of five, and called on participants to propose new and innovative approaches for strengthening immunization systems at both the national and provincial level.

“ This forum will broaden thinking at the technical and political level to pave the way for strengthening the implementation of priority strategies for the relaunch of [the national vaccination program], and to promote the political commitment and accountability of health and political administrative authorities nationally and provincially. ”
— Félix-Antoine Tshisekedi Tshilombo, President, Democratic Republic of the Congo
High level attendees at the DRC Forum on Immunization and Polio Eradication

The forum was attended by governors from each of the DRC’s 26 provinces as well as civil society leaders and high-level representatives from the global immunization space. Photo: Gavi, the Vaccine Alliance.

The World Health Organization (WHO) Regional Director for Africa Dr. Matshidiso Moeti, who was also in attendance, reaffirmed WHO’s continued support for the implementation of priority strategies for increased immunization rates through DRC’s Expanded Program on Immunization.

Strengthening immunization in the DRC context

In the DRC’s decentralized health system, both national and provincial leaders have a role to play in fostering a strong immunization system throughout the country, addressing gaps in routine immunization coverage, and overcoming barriers to access and utilization of immunization services. Progress has been made in recent years, but key gaps persist, and the poorest children continue to be left behind. Ensuring that the promise of immunization is realized by all Congolese requires commitment and increasing financial support at all levels of the government.

The forum culminated in a tremendous display of commitment from the country’s new leadership when provincial governors committed to take concrete action to improve immunization systems—providing oversight, accountability, and resources—by signing on to the Kinshasa Declaration on Immunization and Polio Eradication.

The day after President Tshisekedi Tshilombo spoke at the forum, the DRC Ministry of Finance announced a disbursement of US$3 million in co-financing for the purchase of new vaccines through Gavi, the Vaccine Alliance. At the heart of Gavi’s funding model, co-financing requires countries to meet part of the cost of Gavi-supported vaccines themselves. This enhances country ownership of immunization financing and helps strengthen financially sustainable immunization programs in preparation for Gavi to phase out support for these vaccines.

In addition to Dr. Moeti, the forum was also attended by high-level representatives from the Bill & Melinda Gates Foundation, UNICEF, Rotary International, The World Bank Group, the US Agency for International Development, and Gavi, the Vaccine Alliance, among others.

DRC governor signing the Kinshasa Declaration

The forum culminated in the signing of the Kinshasa Declaration on Immunization and Polio Eradication by Congolese leadership including each of the country's 26 provincial governors. Photo: PATH.

Continuing the momentum

President Tshisekedi Tshilombo’s remarkable commitment builds on progress made by the Congolese government in recent years that clearly demonstrates commitment to improving immunization coverage in the country. In 2017, the DRC government joined African Heads of State in endorsing the Addis Declaration on Immunization (ADI), vowing to achieve 90% national immunization coverage by 2020. To translate this commitment to action, the government led stakeholders to develop the DRC ADI Roadmap in 2018, focusing on approaches that will be critical to strengthening the immunization system.

The same year, the government launched the Emergency Plan for the Revitalization of Routine Immunization—also known as the Mashako Plan—aimed at raising immunization coverage nationally by 15% over 18 months by targeting the eight most vulnerable provinces.

There was a feeling of optimism in the air—a realization of the need to act now, and to do more—at the National Forum on Immunization and Polio Eradication. The clear goals and strong leadership that emerged out of the forum are a strong sign of the Congolese leaders’ appetite for strengthening immunization systems and ridding the country of polio once and for all.