Last week, the US reported its first case of polio after 11 years. Health officials in New York State said a patient tested positive for the dreaded disease that had been all but eradicated around the world following decades of hard work. Though it is not certain if the case originated in the US, the news came days after the UN issued a stern warning about the risk of the return of a number of diseases previously curbed or eliminated from many nations as a result of interrupted vaccination programs due to the COVID-19 pandemic. Medical experts and those working with children have expressed fears that tens of millions of children face missing out on crucial vaccinations, that have gone a long way in preventing deadly diseases such as polio, measles or diphtheria, since early 2020. Those warnings intensified throughout the pandemic, as such programs were hindered due to lockdowns and other curbs meant to stop the spread. Last week, a report by the UN confirmed the worst fears of health experts and pediatricians, especially in developing nations. The report, by the World Health Organization and UNICEF, said that over 25 million children worldwide had failed to receive routine jabs that protect against life-threatening diseases last year, 2 million more than in 2020, and 6 million more than in 2019. The UN says that the data, collected from 177 countries, represents the biggest sustained fall in children’s immunization in over a generation, and that the consequences will be measured in lives. Indeed, the worst aspect of the report is that the drop in vaccinations continued well into 2021, a surprise given that many experts had already factored in the number of children who missed their vaccines in 2020 due to COVID-19. The UN has warned that unless serious steps are taken to reverse the fall, the world could see many more outbreaks of diseases thought vanquished, leading to more sick children and greater pressure on already overstretched health systems. The UN says that vaccination rates dropped in every part of the world, looking at take-up of the three-dose diphtheria, tetanus and pertussis jab. It says that its data includes both children who get no jabs at all and those who miss out on any of the three doses necessary for protection. Globally, DTP3 coverage fell from 86 percent to 81 percent last year, far below the 90 percent mark needed to ensure effective coverage. The historic fall in vaccine coverage of children has come just as rates of severe malnutrition rise. Ranvir S. Nayar More seriously, the number of children who had missed out on all three doses rose by 37 percent between 2019 and 2021 — 13 million to 18 million — most of whom live in low and middle-income countries. Little wonder, then, that cases of vaccine-preventable diseases have been rising. A 400 percent rise in measles cases has been recorded in Africa, on the back of news that, in 2021, 24.7 million children missed their first dose of the measles vaccine, and a further 14.7 million did not get the essential second dose. The UN says that coverage was 81 percent, the lowest since 2008. Pakistan and Afghanistan, meanwhile, have reported fresh polio outbreaks, with the former registering as many as 12 cases. There are three main reasons behind the drop in vaccinations since 2020. One is that governments around the world have redirected significant health resources to fighting COVID-19, leaving children’s immunization programs by the wayside. Another is the lack of financial resources left in the wake of COVID-19, with the third reason being the disruption of supply chains due to the pandemic reducing the availability of vaccines, certainly in remote areas. To make matters worse, the historic fall in vaccine coverage of children has come just as rates of severe malnutrition have risen. Experts say malnourished children tend to have weaker immune systems, and infections like measles can often prove even more deadly to them. While supply chain issues can be resolved fairly easily, the situation is far more critical for poor countries and those with poor healthcare systems, such as war-torn Afghanistan or Syria. These countries need help — not just financial, but also in terms of human resources — in order to get vital jabs into children’s arms. The onus, naturally, falls on richer countries to support poorer ones. It would be important for those more fortunate states to remember that even their own children will not be safe until every last child has been vaccinated. The doubting Thomases, or those cynical about the risk of these “poor-country” diseases reaching the shores of the developed world, may just want to read the news of the polio outbreak in New York. • Ranvir S. Nayar is managing editor of Media India Group.