Advancing immunization coverage and combating epidemics in the DRC

Under the patronage of the President of the Democratic Republic of the Congo, Félix-Antoine Tshisekedi Tshilombo, the DRC officially held the third National Forum on Vaccination and Polio Eradication in Kinshasa on June 2023. This event reflects the collaboration between the Presidency, the Ministry of Public Health, Hygiene and Prevention, National and International Technical and Financial Partners, and the High Authorities of the country's Provinces.

The organization of this high-level Forum is part of the national strategy to enable everyone to live in good health, to promote well-being at all ages, and to improve physical and financial accessibility to quality health care and services. It follows the announcement of the introduction of Universal Health Coverage in 2021.

It also aims to maintain the national commitment to implementing the Kinshasa Declaration and the Mashako Plan, announced in 2019, of the January 2017 Addis Ababa Declaration on Immunization, aimed at advancing immunization coverage in the DRC and combating epidemics, particularly polio - by maintaining the commitment of National and International Partners as well as that of the country's Provinces.

Reducing the number of "zero-dose children"

Developed by the Ministry of Health, the primary aim of the Mashako Plan in 2019 was to reduce the number of "zero-dose children" (children who have not received any vaccine scheduled in the vaccination calendar) by 35% by the end of 2025, and to increase vaccine coverage with a first phase of campaigns in the 9 Provinces most affected (Haut Katanga, Haut Lomami, Ituri, Kasai, Kinshasa, Kwilu, Mongala, Tanganyika, Tshuapa) by measles and polio epidemics, and where half of all Congolese "zero-dose children" lived. To date, the Mashako Plan has been gradually expanded between 2020 and 2022 to cover all the country's Provinces, generating a 50% increase in the number of vaccination sessions compared with 2018, resulting in full vaccination coverage rising from 35% to 50% between 2018 and 2020. Plan Mashako II in 2021, aimed at amplifying the positive momentum initiated by the initial plan.

However, between the 2020 and 2021 surveys, full vaccination coverage at national level fell from 50% to 41% due to the impact of the Covid-19 pandemic and its effects on demand as well as the supply of immunization services.

On a positive note, vaccination coverage increased from 41% to 45% in the 2023 survey, confirming the resumption of services. Despite this significant progress in the DRC, the results of the latest immunization coverage survey established by the Mashako Plan show that there are still one and a half million under-immunized children in the country, with over 750,000 so-called "zero-dose" children. In addition, the DRC, which had been declared free of wild polio cases in November 2015, has been facing variant polio outbreaks since 2017.

Strong political commitments to expand immunization coverage to several million additional children

It is expected this Forum will propose concrete actions set out in the improvement schemes resulting from the successive Mashako Plans, and a renewal of strong commitments by the Government, the Governors of the Country's Provinces and all the Technical and Financial Partners, in favor of immunization in the DRC. On this Forum, His Excellency President Félix-Antoine Tshisekedi declared: "In four years, we were able to expand immunization coverage to several million additional children, despite the many challenges we face. I am aware that we still have some way to go to achieve the goals we have set ourselves. I am confident that, together, we can achieve these goals. I will personally follow up every six months with the Governors of the Provinces to ensure their involvement in all immunization-related activities and ask them to set up catch-up campaigns wherever necessary. I will be holding quarterly meetings with the Ministers of my Government to monitor the activities for which they are responsible, such as funding and technical support for the Mashako Plan.”

For his part, the Minister of Public Health, Hygiene and Prevention, Dr Roger Kamba, added: "Thanks to the implementation of the Mashako Plan, our country succeeded in increasing vaccination coverage. This is a testament to the dedication of our health workers. We continue to immunize all children wherever they are and actively monitor outbreaks to respond quickly. Nevertheless, we must redouble our efforts to reach the goal of vaccinating 75% of children by 2027 as set by our President. I reaffirm that I, and all Ministry of Health staff are fully committed to work with our partners so that every health center has the means to vaccinate all children for whom they are responsible. I would also like to warmly thank the mobilization of diplomatic missions, partners of the United Nations System, Technical and Financial Partners and the private sector for their involvement and effective participation in this effort, which involves us all."

Defeating polio in the DRC, a global health priority

"The progress made by the DRC on immunization is essential to defeating polio in the DRC and on the African continent. On behalf of the Global Polio Eradication Initiative, we are here to reaffirm the commitment of all International Partners to end polio and increase immunization coverage in the DRC," said Dr. Chris Elias, Chairman of the Polio Oversight Board.

“Over the past five years, there has been significant progress ensuring more Congolese children and adults alike have access to life-saving vaccines, including against polio, pneumonia, rotavirus and cholera. Gavi is committed to support the DRC in increasing access and availability of vaccines, and introducing new vaccines against such as those typhoid, human papilloma viruses and malaria, so no one dies from vaccine-preventable diseases,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance.

The Mashako Plan is available on the website of the Ministry of Health, Hygiene and Prevention: https://www.pevrdcongo.cd/, https://www.engagementvaccination