Measles outbreak in Northern Ghana highlights vaccine shortage crisis

Dear Editor

I am writing to draw your attention to the recent outbreak of Measles in Ghana's Northern Region. Measles is a dangerous and extremely contagious disease caused by paramyxovirus (also known as the measles virus) that is easily passed from person to person or by close contact with an infected person's upper respiratory tract secretions [1]. It has been reported that measles vaccination coverage has decreased progressively over the world since the start of the epidemic, with a record-breaking number of roughly 40 million youngsters missing a shot in 2021. Last year, 14.7 million children missed their second dosage and 25 million children missed their first dose globally [1]. Thus, the World Health Organization and the US Centres for Disease Control and Prevention (CDC) have warned that the measles is now an “imminent threat” to spread over the whole world due to declining rates of vaccination and less monitoring during the COVID-19 epidemic [2]. According to the Ghana Health Service, 50 children have been affected by this vaccine-preventable disease, and this is just the tip of the iceberg [3]. Some reports have revealed that more than 100 cases have been recorded in one major facility alone [4]. This situation is a cause for concern, especially as the shortage of vaccines extends to other childhood diseases such as Rotavirus, Tuberculosis, and Pneumococcal vaccines. The ongoing outbreak of Measles in Northern Ghana is a result of several factors, including.

• 1.Vaccine shortages: The primary reason for the outbreak is the shortage of Measles vaccine in the region. Ghana has been struggling to obtain sufficient vaccine supplies, which has led to low vaccination rates and increased susceptibility to infectious diseases like Measles.
• 2.Weak healthcare infrastructure: Ghana's healthcare infrastructure in rural areas, where the outbreak occurred, is often under-resourced, understaffed, and underfunded. This has made it challenging to effectively respond to the outbreak and prevent further spread.
• 3.Limited public awareness: Many people in rural areas of Ghana may not be aware of the importance of vaccination or may hold misconceptions about vaccines. This lack of awareness has contributed to low vaccination rates and increased susceptibility to infectious diseases like Measles.
• 4.Inadequate surveillance and monitoring: There may have been a lack of proper surveillance and monitoring of the disease, which could have allowed the outbreak to spread undetected.
• 5.Insufficient funding: The government's funding for vaccination programs and healthcare infrastructure may be insufficient to meet the needs of the population, which has contributed to the vaccine shortage and weak healthcare infrastructure.
• 6.Delayed response: The government's response to the outbreak may have been slow or inadequate, leading to a larger outbreak.

The shortage of vaccines is not limited to the Northern Region alone. All regions are also reporting shortages of vaccines. This is a nationwide problem that needs urgent attention. Failure to address this issue can result in a further resurgence of vaccine-preventable diseases, which could lead to more deaths among children.

It is important to note that infectious diseases are a leading cause of mortality among children under the age of five [5]. Ghana has been making progress in reducing under-5 mortality (U5M) over the past seven years under the Sustainable Development Goals (SDGs). However, the current situation of vaccine shortage risks reversing the gains made so far. It is, therefore, essential that the government takes urgent action to address this issue.

The management of outbreaks requires resources such as surveillance, diagnosis, treatment, and community engagement. These resources must be made available to reverse the direction of the current situation. We cannot afford to lose the gains made over the years due to the shortage of vaccines.

Vaccination is the most effective way to prevent infectious diseases among children. It is, therefore, essential that vaccines are made available to children from birth to five years. Failure to do so will have severe consequences for the health of our children, which will, in turn, impact the economic growth of the country.

1. The way forward

The recent outbreak of Measles in Northern Ghana has highlighted the urgent need for action to address the shortage of vaccines in the country. The way forward requires a multi-faceted approach that includes the following:

Firstly, the government must prioritize the availability of vaccines to prevent further outbreaks of Measles and other vaccine-preventable diseases. This can be achieved through increased funding and collaboration with international organizations such as UNICEF and WHO.

Secondly, there needs to be a renewed focus on improving healthcare infrastructure and resources to effectively manage outbreaks. This includes strengthening surveillance and diagnostic capacity, providing treatment and care for affected individuals, and engaging with communities to raise awareness about the importance of vaccination.

Thirdly, there must be an emphasis on preventive measures such as routine immunization programs for children. The government can work with health workers, community leaders, and other stakeholders to increase vaccination coverage and ensure that all children receive the necessary vaccines.

Fourthly, there needs to be a concerted effort to address the root causes of vaccine shortages in Ghana. This includes improving supply chain management, addressing financing gaps, and building local manufacturing capacity for vaccines.

Finally, there is a need for increased advocacy and public awareness to raise the profile of vaccine shortages in Ghana and the importance of vaccination in preventing infectious diseases. This can be achieved through partnerships with media organizations, civil society groups, and other stakeholders.

In conclusion, Ghana requires a comprehensive approach that addresses the immediate crisis of the Measles outbreak while also addressing the underlying causes of vaccine shortages. This will require a sustained commitment from the government, international partners, and other stakeholders to ensure that all children have access to life-saving vaccines. Only then can we ensure that Ghana continues to make progress in reducing under-5 mortality and achieving sustainable development goals.

Declaration of competing interest

The authors declared that they had no competing interests.

Handling Editor: Patricia Schlagenhauf