Regional Director’s remarks at the South-East Asia regional workshop to strengthen routine immunization capacities post COVID-19 pandemic

12 June 2023

Distinguished representatives of ministries of health, national immunization advisory groups and partner agencies, WHO colleagues,

I wish you a warm welcome and extend my sincere gratitude for your tremendous efforts throughout the COVID-19 crisis, which as you know, is no longer a global health emergency.

Since the beginning of the outbreak, you have been relentless in your commitment to maintain and restore routine immunization, acutely aware of what is at stake:

First, decades of progress in expanding routine immunization, which by 2019 covered more than 90% of all children in the Region;

Second, an array of disease eliminations: Regionally, polio and maternal and neonatal tetanus, but also in five countries measles, in two countries rubella, and in four countries control of hepatitis B;  

And third, the full implementation of our Regional Vaccine Action Plan 2022–2030 and the Immunization Agenda 2030.  

But more than just targets, goals, strategies and frameworks, the lives of tens of millions of people in our Region, children especially – the world’s largest birth cohort.  

My sincere commendations.

Today, I have noted: COVID-19 is no longer a global health emergency.

Though we have not yet exited the tunnel, we see light at its end.

And with that light, we remain acutely aware of persistent gaps and challenges, including for routine immunization.  

Between 2019 and 2020, DTP3 coverage in the Region has reduced from 91% to 85%.

In 2021, coverage fell to 82%, which was still higher than the global average, but well below the 2019 figure.

Alarmingly, the number of children in the Region who did not receive the first dose of DPT vaccine increased from 2 million in 2019 to 4.6 million in 2021.

However, across the Region, the picture is highly variable.

For example, we see several countries that have maintained high vaccination coverage, and which can now accelerate progress while sharing lessons learned.

Next, we see countries whose performance declined in 2020 but then stabilized in 2021 and 2022 and can now reach pre-pandemic levels.

And finally, we see countries with continued decline in vaccination coverage indicating chronic fragile capacity.

Need it be said: Each country’s needs will be highly specific, and over the course of this meeting it is our task to identify those needs to inform the upcoming 14th meeting of the Regional Immunization Technical Advisory Group (I-TAG), beginning 29 August.

I nevertheless take this opportunity to highlight several key points of focus, which I urge you to consider:

First, the need to accurately identify high-risk areas with high numbers of zero-dose children, and to then rapidly revise micro-plans to improve access to and uptake of routine immunization.

Second, the need to review implementation of catch-up immunization activities, including special campaigns, and where necessary, increase the age limit of target populations.

Third, the value of identifying opportunities to strengthen screening for vaccination status, such as at school entry, and during other health care visits.

Fourth, assessing behavioural and social drivers of immunization uptake to guide interventions that accelerate demand.

Fifth, reviewing and updating strategies for risk communication and community engagement, as well as outbreak communication, both nationally and sub-nationally.

Sixth, the importance of periodic mapping of at-risk populations vis-à-vis health care facilities and immunization and surveillance, and of developing actionable plans that address ongoing gaps.

And seventh, appropriately integrating digital immunization and supply chain management data from the COVID-19 response into routine immunization systems.

However, I also want to underscore the critical need for countries to not just expand coverage but also increase protection.

On this, I extend my highest commendations to Timor-Leste, which this year introduced pneumococcal vaccine as part of a wider catch-up campaign against polio, measles and rubella.

And I also extend my heartfelt congratulations to Nepal, which in 2022 became the fourth country globally to introduce typhoid conjugate vaccine.

More generally, I extend my sincere compliments to Bangladesh, which by June 2020 had restored immunization services to pre-COVID-19 levels;

My warmest felicitations to India, which in 2021 launched Intensified Mission Indradhanush 4.0, and at the district level has significantly strengthened accountability and engagement;

And my heartfelt gratitude to Indonesia for completing the readiness requirements for use of nOPV2 vaccine within a record time of two weeks from the notification of the outbreak of type 2 circulating vaccine-derived polio in November 2022.

I also express my deep admiration of Bhutan, DPR Korea, Maldives, Sri Lanka and Timor-Leste, who throughout the COVID-19 response maintained their measles elimination status.

And last but not least, I extend my sincere and abiding thanks to all our partners, donors and friends, who through their support, made these and other achievements possible.

Today, I have great confidence in your success – because throughout the COVID-19 response, you have shown what all is at stake:

Targets, goals, strategies and frameworks. But more importantly, millions of lives and our promise to leave no one behind.  

I wish you a productive and engaging workshop and look forward to the 14th I-TAG in August.   

Thank you.