Last week, standing upon the tarmac at Asmara International Airport, Tedros Yehdego, EPI manager and a director at the Ministry of Health (MoH), proudly announced that a chartered flight bearing special cargo had just touched down. What made it so special? That it was a large shipment of childhood vaccines.
The recent arrival represents only the most recent in a longstanding biannual collaborative initiative that has been running since 2014. Twice every year, Eritrea, with the cooperation of some of its close partners, such as UNICEF, flies in a large consignment of childhood vaccines to help local efforts to achieve national immunization goals, reduce infant and child mortality, and promote child health.
The most recent shipment, the second this year, contains several million doses of more than a dozen vaccines. Over the following several months, these will be administered to hundreds of thousands of children nationwide, ultimately providing them with immunity for an array of vaccine-preventable diseases.
Reminder of high priority accorded to children
The shipment of childhood vaccines serves as a powerful reminder of the high priority accorded to children in Eritrea. Although the country is richly blessed with an abundance of natural resources and a long, unblemished coastline, the country’s people – and most especially its children – are regarded as its greatest resource and most precious asset. The first international convention ratified by the Eritrean government after the nation won its independence was the United Nations Convention on the Rights of the Child, a legally-binding international agreement setting out the civil, political, economic, social, and cultural rights of every child, regardless of their race, religion, or abilities, while it also acceded to the African Charter on the Rights and Welfare of the Child in December 1999, not long after the Charter entered into force – thus reflecting the very high priority accorded to promoting and protecting children’s health, well-being, and development.
Eritrea’s National Charter, adopted in February 1994 and which provides the guiding vision for the country, also clearly articulates the prioritization of children. It strongly declares that, “Eritrea should strive to minimize infant mortality and to care for its children. The children of martyrs, in the tens of thousands, who were, deprived of the love of their parents, as well as other orphans, must be provided with proper upbringing and care. In Eritrea, the rights of children to education, health, love, safety, play, and to human dignity must be respected” (PFDJ 1994).
Central role of vaccination
Since emerging as an independent nation in 1991, one of the main tools that Eritrea has relied on to promote the health and protect the lives of its children has been vaccination.
Human beings have benefited from vaccines for more than two centuries, while the history of inoculation can be traced back even further. Routine childhood vaccination is an important health intervention that helps prevent serious illness, disability, and death in children caused by a range of dangerous diseases, including diphtheria, tetanus, pertussis (whooping cough), influenza, measles, and pneumonia, among numerous others. Today, vaccination is widely recognized to be among the most simple, cost-effective, and successful ways to promote children’s general health and well-being.
Over the past three decades, Eritrea has made tremendous leaps in terms of national routine vaccine coverage. In 1991, there were only six vaccines available for children and the overall coverage rate stood at less than 10 percent. Across subsequent years, however, the national routine vaccination schedule has steadily grown and it has progressed to provide young children with an array of vaccines that help to protect against a variety of serious or potentially fatal diseases. This progress, led by the MoH and recognized and celebrated by a variety of regional and global organizations, has helped allow the country to significantly reduce child mortality and promote child health.
Notably, during a working visit to Eritrea in late 2021, Mohammed Malick Fall, UNICEF Regional Director for East and Southern Africa, explained that he was, “struck by the level of immunization [of children in Eritrea],” before going on to note that there, “are many advanced countries that have a hard time reaching [those coverage levels].” (Over the years, Eritrea has received a number of awards from GAVI [the Vaccine Alliance, which is a public-private global health partnership] and UNICEF, for its outstanding performance in improving child health and immunization.)
At present, Eritrea administers 14 vaccines (which protect against numerous diseases) to young children and routine coverage rates are nearly universal, hovering in the high 90s. Furthermore, the country’s average coverage across BCG, DTP1, DTP3, Polio3, MCV1, MCV2, HepB3, Hib3, Rota, and PCV3 is 94.3 percent, as compared to 66.5 percent in Sub-Saharan Africa and 73.4 percent worldwide. Through the MoH and the National Immunization Programme, 301 health facilities in the country (out of a total of 349) provide routine vaccination services six days per week. In addition, vaccination service is provided at 450 outreach sites nationwide, while nomadic groups and those residing in extremely remote or difficult to reach areas receive service through the “Reach Every District” approach, along with mobile health units and mass vaccination campaigns organized in close cooperation with community coordinators, volunteers, and local contacts.
Cooperation based on common principles, trust, and locally-defined priorities and needs
The fact that the latest shipment of vaccines was possible as a result of close cooperation between the Eritrean government and several partners, such as UNICEF, underscores another important, yet often overlooked, point about Eritrea more broadly. Eritrea’s approach to foreign assistance and development, perhaps somewhat unique or less common, has often been maligned and misjudged, with the country frequently (and incorrectly) being labeled as “isolationist”.
Instead, as the recent shipment of lifesaving vaccines exemplifies, a fundamental pillar of the country’s development agenda has been the establishment of cooperative frameworks and close partnerships with a range of international organizations, specialized agencies, and other partners. Many of these relationships are robust and longstanding, dating back to the earliest years of the country’s independence. Meaningful engagement and cooperation have been built upon a platform of common principles, transparency, and trust, with concerted efforts being based on complementarity and guided by locally-defined development priorities and needs.