수단은 지속되는 분쟁으로 예방접종 안전망이 크게 훼손되었습니다. GAVI(세계백신면역연합)와 세이브더칠드런은 예방접종율을 향상 및 질병예방을 위해 백신 접종 지원활동을 진행하고 있습니다.

내전과 이동 생활로 예방접종을 받지 못한 어린이들이 많으며, 예방접종률도 2022년 93%에서 2023년 59%로 급감했습니다. 세이브더칠드런과 GAVI는 이동 예방접종팀을 지원하여 어려운 지역에 사는 어린이들에게 백신을 제공하고 있으며, 이를 통해 12만 명 이상의 어린이에게 예방접종을 실시했습니다. GAVI의 2023-2024년 수단 지원 예산은 총 7,740만 달러로, 백신 구매 등에 사용됩니다.

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AMID WAR, AND ON CAMELBACK: HOW SUDAN’S VACCINATORS ARE DELIVERING A DOSE OF HOPE

by Asrar Fadulelsied , RI manager, Save the Children in Sudan

▲△Vaccines reach a remote community located in a mountainous part of Aqiq, in Red Sea State, 2024. Credit: Asrar Fadulelsied.

A year of conflict has left Sudan’s immunisation safety net frayed. GAVI and Save the Children are helping vaccinators patch it back up.

Muhammad Saleh, the child of nomadic Beja pastoralists in eastern Sudan, was six months old and hadn't received a single vaccine. Born into a country at civil war, and into a family on the move in pursuit of pasture and water, Saleh had slipped through the fingers of the health system.

In that, he wasn't alone. 1.6 million children are born each year in Sudan – that's approximately 1.6 million children born, so far, into the year-old civil crisis that has seen an estimated 8 million people displaced from their homes.

The effect of the conflict on the reach of the country's immunisation services has been colossal. In November 2023, national figures for coverage with the third dose of the basic diphtheria, tetanus and pertussis-containing vaccine (DTP3) stood at 59%, an alarming drop from 93% in 2022.

"In Sudan, the country with the largest displacement crisis globally, immunisation remains the most cost-effective public health intervention preventing disease and reducing child mortality." – Bashir Kamal Eldin Hamid, Health and Nutrition Director at Save the Children International in Sudan

But vaccinators like Abdul Qader, a member of the State Ministry of Health vaccination team in Red Sea state, are working hard to win back lost ground. Operating out of the Aqiq Locality Primary Health Center – home to the last fridge on this particular branch of the Sudanese cold chain – Qader and his vaccine cooler box represent the forward frontier of Sudan's vaccine delivery effort.

VACCINE ODYSSEY

Qader's outreach journeys are often long and difficult. One mid-February day, for instance, he leaves the Aqiq PHC on a motorcycle, heading for the mountains. When the terrain becomes too rough to manage on two wheels, he swaps the bike for a camel, which carries him and his colleague Muhammad Hamed as far as Warhat village.

▲△ Infant Muhammad Saleh, whose family is nomadic, receives his first vaccination in a hard-to-reach part of Aqiq locality, Red Sea state, 2024. Credit: Asrar Fadulelsied.

Here, crouched on a thatched mat at the threshold of a Beja family's tent, Qader administers a first vaccine to the baby Muhammad Saleh.

It's a hard-won dose of safety amid pervasive danger.

"In Sudan, the country with the largest displacement crisis globally, immunisation remains the most cost-effective public health intervention preventing disease and reducing child mortality," says Bashir Kamal Eldin Hamid, Health and Nutrition Director at Save the Children International in Sudan. "On top of a fragile health system, the violent conflict [has] disturbed health service and the vaccination programme. Sudanese children are facing risks from conflict, malnutrition and outbreak of vaccine-preventable diseases."

Since December 2022, Save the Children and Gavi, the Vaccine Alliance have been working together to enable the efforts of health workers like Qader, and help bridge the gap between the populace and the health care system. Supporting monthly operations to reach children where they are has reduced the risk to public health that threatens at the change of seasons, when nomadic groups move higher into the hills, and further out of reach of fixed health centres.

In addition to supporting the deployment of mobile vaccination teams, Gavi and Save the Children support routine immunisation, health system strengthening and community resilience in the country – that is, amid some of the toughest conditions in the world today. Gavi's support budget for Sudan in 2023–2024 totals US$ 77.4 million, of which US$ 36 million is earmarked for the purchase of vaccines.

These efforts are making inroads.

"Supported by Gavi, Save the Children, in collaboration with the Ministry of Health, has reached more than 120,000 children in two states, including displaced children in more than 400 gathering points. [The partners are] committed to ensuring service continuity, improve vaccination coverage, and to overcome the current barriers in Sudan," reports Save the Children's Bashir Kamal Eldin Hamid.

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