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Afghanistan is a country under siege, but one threat doesn’t make the news. The toll is felt among the most vulnerable in an already fragile country. Every year, nearly 5,000 children under five die of rotavirus, a fast-moving and severe form of diarrhea. Afghanistan’s rotavirus death rate is among the highest of any country in Asia.  

Fortunately, Afghanistan is among the frontrunners in Asia to introduce rotavirus vaccine for children to prevent this life-threatening disease. The vaccine, which will be available for free in health facilities throughout the country, is the 10th vaccine to be introduced in the national immunization schedule.

As in many countries, diarrheal is exceedingly common in Afghanistan—a recent survey showed that over 1 in 4 children suffered from diarrhea in the preceding two weeks. Rotavirus accounts for at least one in two diarrheal hospitalizations in Afghanistan.

Nothing turns life upside down like a child in hospital. Severe diarrhea and vomiting put children at grave risk of death from dehydration. Rotavirus can further weaken young, already vulnerable children and set off a vicious cycle of malnutrition and illness. In a multi-country study, children who suffered a single episode of moderate to severe diarrhea had an eight-fold increased risk of dying in the following two months compared to children who did not suffer these illnesses.

Vaccine administered as oral drops

Rotavirus vaccines are critical because interventions that prevent other forms of diarrhea such as improvements in hygiene, sanitation and drinking water do not adequately prevent the spread of rotavirus.

The World Health Organization recommends that every country introduce rotavirus vaccine in their national immunization programs and over 90 countries have done so. The vaccine, which is given as oral drops to infants, has demonstrated rapid impact in every country where it has been introduced.

In Mexico, rotavirus vaccine reduced the number of deaths from diarrhea by half. In South Africa, it reduced the number of children hospitalized for diarrhea by one-third. New research from the UK has found that childhood vaccination against rotavirus has greatest benefit in the most deprived communities and could contribute to reducing health inequalities.

Over the next ten years, rotavirus vaccination in Afghanistan could prevent more than one million cases, approximately 50,000 hospital admissions, and 12,000 deaths. Vaccinating against common childhood infections is a critical way for Afghanistan to address key development challenges, including high rates of child mortality.

Parents must demand rotavirus vaccines

To achieve rapid reductions in the disease, parents must take their children to be immunized. In a country where vaccine coverage has plateaued below optimal rates, increased efforts are needed to ensure that parents demand the vaccine. The government and partners have planned communication efforts and started sensitizing religious leaders, teachers and front-line health workers to encourage high levels of vaccination. Community and political leaders must come out in support of the vaccine to encourage families to seek immunization on time.

Rotavirus vaccine can be given with other routine immunizations at regular pediatric check-ups. Thus, a successful rotavirus vaccine introduction may also improve coverage of other critical immunizations such as pneumococcal conjugate vaccine, also recently introduced in Afghanistan to protect against a severe form of pneumonia. Vaccines do more than just improve health. Childhood vaccination can increase educational attainment, which results in a more productive workforce. Prevention of outbreaks can bring stability to the country as a whole.

Afghanistan’s leaders are aware of the need to improve equity, especially for children. Rotavirus vaccine presents an opportunity to do that and the leaders of the country are poised to make this happen with a successful introduction and ongoing effort to ensure all children receive the vaccine.

View expressed in this article are of the author’s own and do not necessarily reflect Pajhwok’s editorial policy.

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The views expressed in this article do not necessarily reflect Pajhwok's editorial policy.

Author's brief introduction

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<p>Lois Privor-Dumm is Director, Policy, Advocacy & Communications, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Healthinfo-icon, USA</p>
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<p>Dr. Ghulam Dastagir Nazary is Afghanistaninfo-icon’s National EPI Manager, Ministry of Public Health</p>

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