Context and Issue

• Rwanda suffered a catastrophic genocide against the Tutsis in 1994
• This disaster and the ensuing war resulted in total disruption of the country’s health system including immunization service delivery.
• Following this incident, the national immunization coverage was very low (less than 30% in 1995) and incidence of vaccine preventable diseases (VPD) was high (e.g 28,000 measles cases in 1995);
• Only 6 traditional vaccines were provided in routine immunization programme in 1994.

WHO contribution

WHO  supported the  Government in the area of  advocacy for better domestic funding for immunization and introduction of new vaccines, mobilization of financial, human, logistic and technical resources to support immunization service delivery including routine, supplementary immunization activities (SIAs) and vaccine preventable diseases surveillance and joint strategic planning, implementation, supervision, monitoring and evaluation of EPI activities including joint field missions, sensitization of health workers on VPD surveillance, tracking vaccination defaulters, data quality improvement and operations research among other support
Support was also provided to implement the Reach Every Child (REC) approach and to strengthen leadership and management of the immunization programme.

These resulted in increased immunization coverage to more than 95% with gender and geographic equity, successful introduction  of 6 new vaccines  into  routine immunization programme and reduction in vaccine preventable diseases (last case of polio was reported in 1993 and neonatal tetanus was eliminated in 2004).
Achievements of Rwanda health sector and Immunization in particular are justified by commitment of high leadership, good partnership with development partners and grown home solutions to solve our population problems.  Rwanda has been the pioneer to introduce new life saving vaccines in last 7 years among them pneumococcal vaccine (Prevenar) introduced in 2009 (extracted from Rwanda Minister of Health speech during the visit of the delegation of pharmaceutical firm Pfizer).