Rwanda is among the few African countries that has registered a wide coverage in either routine immunization or the Covid-19 vaccination drive. The country has reached 96 percent coverage for routine immunization – mainly for children – while currently, over 65 per cent of the population is vaccinated against Covid-19, making Rwanda one of the highest covered countries in the world. But how did this come about? Vaccination and routine immunization services started to be accessible in Rwanda since the year 1980, according available information from the health ministry. But they kept upgrading overtime, just as the population kept increasing so as to heighten their access to all people, expand their use to all health facilities, train the keepers and acquire technological materials to store them. As of the year 2022, Rwanda has up to 13 types of vaccines in routine immunization notably, Tuberculosis, Diphtheria, Polio, Tetanus, Hepatitis B, Haemophilis influenza, polimococcus vaccine, the vaccine for diarrhea in children and measles rubella among others. Though a bigger portion is allocated to young people, there are other vaccines for adults like the one for yellow fever and the newly introduced Covid-19 vaccine among others. Each year, the country vaccinates more than 370,000 children (annual average birth cohort) against different diseases, and each of the children must be immunized six times a year, indicating Rwanda’s vaccination stock exceeds 2.2 million doses every year, according to Rwanda Biomedical Centre. This puts the country’s vaccination rate for children at 96 per cent, making it the highest in the East Africa region. When lifesaving vaccines were introduced in Rwanda, the types of vaccines were few, hence the government had to scale up the types of vaccines present in Rwanda so as to eradicate all the vaccine preventable diseases. Dr Hassan Sibomana the Director of Vaccination Program Unit Mat Rwanda Biomedical Centre, recalls; “In 2009, they introduced pneumococcal vaccine and HPV vaccine for cervical cancer as well as Rotavirus vaccine for diarrhea in children during the year in 2012, while measles rubella for children vaccine was introduced in 2013”. Doctor Hassan Sibomana, Director of Vaccination Program Unit at Rwanda Biomedical Center. Courtesy He opines that administration of these vaccines has significantly reduced the toll of vaccine preventable diseases, and he justifies the move by the fact that infant mortality has decreased as the vaccines toll heightened. He noted the vaccination and immunization drive started registering significant impact after 2010. “Diseases were taking more lives in hospitals and other health facilities. Children were mostly affected by diarrhea and pneumonia, in hospitals that were taking more childrens lives like pneumonia and diarrhea,” he said. “Prior to the vaccination roll out, we could have 30,000 cases of measles every year, but like last year, we only recorded 13 cases which means it is one case per one million people, and that scientifically implies we no longer have the measles outbreak in Rwanda, expect for some few sporadic cases.” Sibomana added that diseases like meningitis have completely been eradicated since early 2000, same to polio whose last case in the country was recorded in 1993. Also to mention, the introduction of the vaccine against diarrhea disease in 2019, its prevalence also fell by 90 percent. USD12 million budget He reiterates the wider coverage and vaccination present in the country is often speeded up by the political will of the national leadership which has allocated a budget of $12 million per year from the government and the partners aligned. According to Sibomana, traditional vaccines which include those against tetanus, BCG, polio, measles, diphtheria and others, are being procured by the government on the total basis, without the intervention of partners. Sustain achievements Having vaccines is one thing, and their maintenance, storage and distribution is another, says Habimana, calling for sustainability of the achievements registered, across board. Vaccines often require highly specialized equipment to store them or make sure they are distributed evenly before they expire, hence capacity and enough personnel to store them is another challenge that the lifesaving vaccines team has to deal with. “Over the previous years, we had to lease some warehouses of other institutions in our bid to maintain the optimum temperature, but we have been able to build our capacity and are able to store the vaccines in all our health facilities and all the medical personnel are trained on that,” he stated. For the vaccination milestones, he also attributes to even coverage reaching all groups of the population; from children to adults, prisoners, people with disabilities, refugees, and others. In addition, data and information management to record everyone who is vaccinated has been another key enabler. More to come Meanwhile, Rwanda has been nominated among a few African countries that will soon have vaccine manufacturing plants that will produce various vaccines to use on the continent. Sibomana says this is crucial for the continent because, only 1 percent of the vaccines used in Africa are manufactured on the continent that often records so many vaccine preventable diseases. He asserts it will reduce the cost that the government often spends on vaccines but also become part of that solution to sustain vaccine demand in Africa, courtesy to the lessons that many countries obtained from the Covid-19 pandemic. Some of the types of vaccines that are expected to be produced in Rwanda are those of TB, Covid-19 and malaria. After the vaccines, the government plans to embark on production of other medical products and devices, which the University of Rwanda has recently set up a faculty of supply chain management of vaccines and health commodities to produce the critical human resource for the budding industry.
