This is a guest blog by Dr. John Wecker, the director of Vaccine Access and Delivery at PATH.
Resourceful, brave, committed — and perhaps a little addicted — that’s the kind of person it takes to ensure that vaccines reach children in the poorest countries of the world. People like Amani Abdelmoniem Mustafa, the manager of the Expanded Programme on Immunization (EPI) for one of the largest countries in Africa — Sudan.
Each country in the world has an EPI. It is through this system that vaccines reach their final destination. Amani is responsible for making sure that each year the roughly 1 million children born across Sudan — a geographically diverse country with mountains, deserts, and flat plains divided by the Nile river—are vaccinated against a variety of deadly diseases. And her workload just got heavier.
In June, politicians and philanthropists from around the world committed US $4.3 billion to the GAVI Alliance over the next five years to pay for live-saving vaccines. In another milestone, GAVI has received a record number of requests to support the introduction of vaccines — 74 applications for new and underused vaccines from the governments of 50 of the world’s poorest countries.
With demand from countries at an all-time high and the money pledged, there remains one more significant challenge: successfully delivering these vaccines to the people who need them most. That job is up to the EPI teams. In Sudan, Amani and her team are working hard to roll out a vaccine against rotavirus, the single largest cause of diarrheal deaths in children under five, with a launch date of July 17 — this Sunday.
A confident woman, Amani talks passionately about her commitment to the children of Sudan, waving the henna-dyed tips of her fingers for emphasis. When her headscarf, called a tarha, slips back while she is making a particularly animated point, she reflexively tugs it back up to her hairline.
The pride that she has for the “big EPI family” that is spread across the 15 states of Sudan is palpable. She laughs as she tells the story of how one of her EPI managers corralled a group of camels to pull their tractor out of the mud during the rainy season. She grows more serious when she talks about the risks the team takes, from potential kidnapping to automobile accidents. All of this for the equivalent of US $4 per day in wages.
Particularly challenging is delivering vaccines to Sudan’s “hot spots,” areas with tightly controlled government access. The EPI staff are allowed to do their work because “they are known and trusted,” Amani says.
Amani is quick to add that no one complains about the hardships they endure carrying vaccines across mountains and deserts to reach the remotest villages. Still, there are many personal sacrifices.
She talks about the time not spent with her husband and her two children, the ten years she has worked without a vacation, the ever-growing workload as more and more vaccines are added to the EPI. She feels sometimes that she has reached the limit of her endurance and longs for a better balance in her life.
But still, she keeps working. When asked how she finds the energy, she gets a puzzled look on her face and replies, “EPI is an addiction. We love it. We are proud to see that the diseases are disappearing. It is for the children!”
Sudan will be the first country in Africa to introduce a vaccine against rotavirus with GAVI support. The delivery of rotavirus vaccine to the first child in Sudan will be marked by a ceremony in Khartoum. Local dignitaries and governmental officials will participate, as will Amani. It will be a day for her to celebrate, filled with pride for her team and love for the children of Sudan. The next day, the vaccine delivery heroes will be back to work.