No one likes being poked with a needle. Especially kids who may be having some shots for the first time. Like many National Society efforts around the world, the Red Crescent Society of the Republic of Kyrgyzstan (RCSK) tries its best to make taking a shot a little bit easier.Their approach often takes on a colorful, lively and even fun dimension as volunteers do their best to entertain potentially reluctant children. Given the potentially deadly consequences of being unvaccinated in the face of recent measles outbreaks, this approach is having a very serious and positive impact on increasing immunization rates.“When I heard about the hundreds of children getting sick with measles every week, as a mother of two young children, I knew I had to act”, says RCSK volunteer Kyzy Minagul.“When we were assigned by our branch to work at the local vaccination center to help with the crowd management, the centers were full of crying and screaming children who received their shots. I thought ‘it’s no wonder that parents are avoiding having their children to go to vaccination centers’.“I talked with other fellow volunteers about how we can make the vaccination experience less stressful. We dressed up as popular cartoon characters and greeted children and parents as they come to vaccination centers. While we can’t take away the shot in the arm part, we tried to make the environment more child friendly”.At the forefrontThe RCSK has been at the forefront of the national response to the measles epidemic in the country throughout the last year and this year. With the support of the IFRC’s Disaster Response Emergency Fund (IFRC-DREF), the National Society has been actively responding to the current epidemic between August 2023 and March 2024. In total, IFRC-DREF has allocated CHF 187,979 to bolster the RCSK’s efforts in curbing the outbreak, aiming to reach 120,000 people across the most affected regions and cities.Some 325 volunteers have been mobilized across the country tosupport the measles and rubella immunization campaign. RCSK places a strong focus on zero–dose and under-immunized children in these activities.One of those people reached is Nurgul, ayoung mother of three who lives in Kara-Balta town, a small town about a one-and-a-half hour drive from Bishkek, the capital city.Nurgul had chosen not to vaccinate any of her children. When she was approached by Red Crescent volunteers, she was skeptical about vaccination at first, having heard so many stories and rumours about the safety of vaccines.Volunteers met withNurgul and thoroughly discussed the benefits of vaccination, backing up their arguments with data on the safety and effectiveness of vaccines. After a series of conversations and her own research,Nurgul decided to go and vaccinate her children against measles.“Volunteers played an indispensable role in educating the parents about measles and rubella vaccination during this outbreak”, said Dr. Gulbara Ishenapysova, director of the Republican Center for Immunoprophylaxis, the main technical agency responsible for the national immunization programme under the Ministry of Health.“It takes organizations like the RCSK, which has a large network across the country, to swiftly mobilize such a large number of trained volunteers and increase the trust of communities in the vaccination campaigns organized by us, the health workers.”Despite the vaccination campaigns in main cities and most affected regions, the epidemic continues to this day and the RCSK plans to support the next measles immunization campaign planned for May 2024.

A mother of four and restaurant owner from Dabola, in central Guinea, Diaraye says she felt scared about vaccines. She didn’t think she had enough information and she’d heard rumours about harmful side effects.Several health workers came to visit her to try and convince her to vaccinate her newborn, Madiou, but she still felt uneasy.That was until she met Bérété, a Guinea Red Cross supervisor with theCommunity Epidemic and Pandemic Preparedness Programme (CP3).A mother herself, Bérété connected with Diaraye and patiently explained how vaccinating her own children has kept them safe from diseases. She responded sensitively to Diaraye’s concerns.Newly informed and confident, Diaraye agreed for Bérété to take baby Madiou for his first immunizations. Since then, Diaraye has become a champion for vaccination within her community.“My advice to mothers is to agree to their children getting vaccinated," says Diaraye. "Since the Red Cross came to help me vaccinate my baby, I’ve seen that it’s good for children. And I tell all mothers to go and get their children vaccinated at the health centre.”A global story, playing out locally, house-by-houseDiaraya’s story is far from unique. People around the world often don’t have access to life-saving vaccines, do not have all the facts about how they work, or don’t know who they can trust to give them accurate and unbiased information.This is why trusted community organizations, like Red Cross and Red Crescent Societies, are playing a critical role in reaching out at the local level, providing trustworthy information while enabling access to vaccines in places that are underserved by health services. In many cases, they are in the midst of ongoing emergencies.This year, World Immunization Week revolves around the theme of Humanly Possible, also the name of a global campaign to celebrate and build on the achievements made in protecting people from preventable diseases during the last 75 years.For its part, the IFRC is redoubling efforts to bring awareness and vaccines to people in vulnerable situations — conflict, outbreaks, forced migration, natural disaster — or who lack access to immunization services for whatever reason.The approach varies to meet the specific situation of each county. They also span the globe, from National Societies in Guinea, Afghanistan, Pakistan, andKyrgyzstan,and many others. Here are a few more examples of the ways Red Cross and Red Crescent Societies are taking on a wide range of very different immunization challenges.Philippine Red Cross takes on another measles outbreakThe Philippine Red Cross Society (PRCS) has been supporting the government of ThePhilippinesin responding to a measles outbreak by vaccinating more than 15,000 children ages 6 months to below 10 years old with measles vaccine.As of April 14, 2024, the Philippine Red Cross has vaccinated more than 15,500 children, mobilizing a total of 131 volunteers (35 vaccinators and 96 support volunteers) in 85 communities in four provinces.The PRCS’ measles outbreak response is being donein collaboration with the ICRC, which also has a long-time presence in theBangsamoro Autonomous Region in Muslim Mindanao, an area where people are impacted by internal conflict. Because of low immunization rates in the area, It's also one of the main places in the country where the measles outbreak is happening.The PRCShas been part of other polio and measles outbreak responses and plans to expand this current operation by deploying vaccination teams from other chapters, with the help ofresources from the IFRC and the United States Center for Disease Control.Using innovation to improve access to immunization in ThailandThe Thai Red Cross Society (TRCS), meanwhile, has been using technology in innovative ways tobring immunization services to people who would not otherwise have access to immunization services.In Thailand, many displaced people and undocumented residents are living without proper forms of identification required to access vaccination services. To address the health gap, TRCS partnered with the Department of Disease Control of the Ministry of Public Health and Thailand’s National Electronics and Computer Technology Center to develop the Thai Red Cross Biometric Authentication System.This system uses a biometric authentication system, using face and iris recognition technology — while still ensuring data privacy — to accurately identify and register vaccine recipients.This allows people without official documentation to still receive vaccines and it enables a way to keep a record of the vaccinations received.Using this technology, TRCS reached 20,000 adolescent girls (specifically ethnic minorities, migrants, and refugees) living in temporary shelters across the country with 40,000 doses of Human Papillomavirus (HPV) vaccine. This helped to significantly decrease their chances of getting HPV, a major, but vaccine-preventable cause of cervical cancer.If this can be expanded, more displaced persons and undocumented residents can be assured to have access to their next essential vaccine, such as a booster shot.Local presence, ready to prevent and respondOver the long term, immunization campaigns are only fully effective if they are of high quality and result in high rates of coverage. The challenge now is to improve and strengthen routine immunisation to better prevents future outbreaks, while also ensuring there is capacity in place to respond quickly and engage communities — if and when outbreaks occur.This is why the work of National Societies is so critical. As national organizations with widespread local presence, they are ideally suited to work with local and national health authorities and communities to build trust while delivering consistent access to immunization. The video below shows how the Pakistan Red Crescent brings immunization through local clinics.Back in Guinea, Red Cross volunteer Bérété continues to visit Diaraye to make sure her son Madiou is doing well, as part of her work engaging members of her community on how to protect themselves and their families.“We keep supporting her, because every time I send her child to hospital to be vaccinated, I never forget to follow up,”explains Bérété. “Every morning I come to see her to check on the child. Because you can’t just vaccinate a child and leave without following up. If she can see that you are there for her at all times, she will have the courage” to keep up with necessary immunizations in the future.

Muhammad Taher, a 40-year-old farmer and his family of eight children, is among the many families who have received life-saving immunization and medical care from Afghan Red Crescent Society mobile health teams.Getting any sort of healthcare in Muhammad Taher’s district, Nahr Seraj of Helmand province, has been a tremendous challenge for decades. Nahr Seraj is four-hour drive from the nearest city, Lashkar Gah, southwestern Afghanistan.For more than two decades now, public health care services in Afghanistan have relied on international financing while the last mile is delivered by various local humanitarian actors.As the IFRC marks World Immunization Week 2024, which this year has a theme of Humanly Possible, the Afghan Red Crescent’s efforts to bring healthcare and immunization to remote rural areas is a impressive example of what can be achieved through consistent, dedicated local presence.Following the historic events that took place in August 2021, a major strain was put on the public health system as donors reorganized their financing models. The transition stretched the system significantly, but a total collapse was prevented through solutions which have enabled continuation of primary and secondary health services.The Afghan Red Crescent Society is one of the local actors engaged in the delivery of primary and secondary health services in the country.The National Society’s network of more than 200 health facilities includes 97 mobile health teams, 46 fixed basic health clinics, 28 sub health clinics, one comprehensive health clinic, and a district hospital. There are also more than 40 health camps supporting routine immunization efforts in various provinces.Life-saving pre-natal care, medication and vaccinationThe ongoing economic hardship means that Taher, and countless others, are unable to pay medical bills or even reach the health facilities located in Afghan cities."My pregnant wife and three of my little girls fell ill recently and needed urgent healthcare but I couldn't afford to take them to the city hospital,” said Taher.“I approached my relatives and neighbours to lend me some money for [the trip], but none were able to help because they too were undergoing tremendous economic hardship.“Finally, one of my relatives mentioned that an Afghan Red Crescent Society mobile health team was operating in our village and suggested that I take my sick family members there.“Without wasting any time, I rushed back home and took my wife and children to where the teams were located. Thankfully my wife was able to get her prenatal checkup done by a midwife, my sick daughters were examined by a doctor and received free medication, and my other children got vaccinated,” he explained in relief.Vital support from partnersAfghan Red Crescent Society health facilities are supported by several partners, including the IFRC. For instance, in 2022 the IFRC provided funding for 47 mobile health teams which delivered primary healthcare and immunization services at least 500,000 people, among them women and children, in rural and remote areas of Afghanistan such as Taher’s district.The 47 mobile health teams have so far operated in many remote provinces including Nangarhar, Kunar, Nooristan, Kandahar, Helmand, Urozgan, Parwan, Sar-e Pol, Bamyan, Paktika, Wardak, Nimrooz, Herat, Badghis, and Jawzjan in the past years.Taher is certain that his family is now much safer after their visit to the Afghan Red Crescent mobile health unit.“My wife and my children are precious to me, and I can't imagine my life without them,” he said. “When they get sick, I get so worried since I have previously lost a close family member because we were unable to reach a doctor in time.“I can't express how grateful I am to the Afghan Red Crescent Society for sending a mobile health team to our village. They are providing life-saving help to people like us in remote rural areas where access to healthcare facilities is so constrained or totally non-existent."In 2023, the IFRC supported the Afghan Red Cresent in administering more than 390,000 doses of vaccines to children under 59 months of age.This included vaccinating more than 5,000 children in their second year of life (12 to 23 months of age) with measles vaccines as part of catch-up efforts, and giving some 46,000 oral polio vaccine doses to children aged between 24 to 59 months as part of intensive efforts to halt wild poliovirus transmission.IFRC’s support to the Afghan Red Crescent is part of its commitment, expressed in the IFRC Health and Care Framework 2023, to support National Societies in reaching “more than six million zero dose children globally and to reinforce both polio eradication efforts and routine immunization strengthening in multiple countries”.National Societies and the IFRC work together to expand routine immunizations to children through integrated service delivery and community engagement approaches. Trusted local healthcare volunteers work within at-risk communities to ensure children receive life-saving vaccinations for preventable diseases such as polio, measles and cholera.Words by Mir Abdul Tawab Razavy | Editing by Rachel Punitha

Humanly Possible. This is theme of World Immunization Week 2024. Humanly Possible is a testament to what can be achieve when humanity works together for a better future. Since the latter half of the 20th Century, coordinated, global immunization campaigns have saved millions of lives. Humanly Possible also reflects our continued commitment to ensure that every community has access to the vaccines and information they need for a healthy future, free from unnecessary illnesses and deaths.

Geneva/New York, 19 October 2022 - A strained global supply of cholera vaccines has obliged the International Coordinating Group (ICG)—the body which manages emergency supplies of vaccines—to temporarily suspend the standard two-dose vaccination regimen in cholera outbreak response campaigns, using instead a single-dose approach. The pivot in strategy will allow for the doses to be used in more countries, at a time of unprecedented rise in cholera outbreaks worldwide. Since January this year, 29 countries have reported cholera cases, including Haiti, Malawi and Syria which are facing large outbreaks. In comparison, in the previous 5 years, fewer than 20 countries on average reported outbreaks. The global trend is moving towards more numerous, more widespread and more severe outbreaks, due to floods, droughts, conflict, population movements and other factors that limit access to clean water and raise the risk of cholera outbreaks. The one-dose strategy has proven to be effective to respond to outbreaks, even though evidence on the exact duration of protection is limited, and protection appears to be much lower in children. With a two-dose regimen, when the second dose is administrated within 6 months of the first, immunity against infection lasts for 3 years. The benefit of supplying one dose still outweighs no doses: although the temporary interruption of the two-dose strategy will lead to a reduction and shortening of immunity, this decision will allow more people to be vaccinated and provide them protection in the near term, should the global cholera situation continue deteriorating. The current supply of cholera vaccines is extremely limited. Its use for emergency response is coordinated by the ICG which manages the global stockpile of oral cholera vaccines. Of the total 36 million doses forecast to be produced in 2022, 24 million have already been shipped for preventive (17%) and reactive (83%) campaigns and an additional 8 million doses were approved by the ICG for the second round for emergency vaccination in 4 countries, illustrating the dire shortage of the vaccine. As vaccine manufactures are producing at their maximum current capacity, there is no short-term solution to increase production. The temporary suspension of the two-dose strategy will allow the remaining doses to be redirected for any needs for the rest of the year. This is a short-term solution but to ease the problem in the longer term, urgent action is needed to increase global vaccine production. The ICG will continue to monitor the global epidemiological trends as well as the status of the cholera vaccine stockpile, and will review this decision regularly. About the ICG The ICG is an international group that manages and coordinates the provision of emergency vaccine supplies and antibiotics to countries during major disease outbreaks. It manages the global stockpile of the oral cholera vaccine. The group is composed of members of WHO, Médecins Sans Frontières, UNICEF and the International Federation of Red Cross and Red Crescent Societies. The ICG was established in 1997, following major outbreaks of meningitis in Africa, as a mechanism to manage and coordinate the provision of emergency vaccine supplies and antibiotics to countries during major outbreaks. Since the establishment of the cholera vaccine stockpile in 2013, 120 million doses of oral cholera vaccine doses have been shipped to 23 countries, of which 73 million (60%) has been approved for emergency response. Media contacts IFRC: Jenelle Eli +41 79 935 97 40 +1 202 603 6803 [email protected] MSF: Lukas Nef  +41792400790 +41443859457 [email protected] UNICEF: Tess Ingram +1 347 593 2593 [email protected] WHO: WHO Media inquiries Telephone: +41 22 791 2222 Email: [email protected]

Immunization is the foundation of healthy communities. And right now, in the continued fight against COVID-19, vaccines are one of many important tools we have to keep communities around the world safe and healthy. The International Red Cross and Red Crescent Movement is supporting COVID-19 vaccination efforts in 172 countries. And, together, our National Societies have supported more than 325 million people to access COVID-19 vaccination globally. Since the start of the pandemic, we’ve made special efforts to reach vulnerable, marginalized and hard-to-reach communities worldwide. To go what we call the ‘last mile’—because all people, no matter who or where they are, deserve access to health services, vaccines, testing and lifesaving treatment. And because we know that no one is safe until everyone is safe. So, what does this work actually look like? Scroll down to discover photos and examples from five different countries: Papua New Guinea, Libya, Zambia, Kyrgyzstan and Canada. And if you like what you read, sign up to the IFRC’s immunization newsletter for a monthly round-up of immunization activities in response to COVID-19 and other diseases. Papua New Guinea Papua New Guineahas one of the lowest vaccination coverage rates in the world. The Papua New Guinea Red Cross is working closely with provincial health authorities in the rollout of COVID-19 vaccines, and a crucial part of this work involves building public confidence in vaccination. Volunteers are providing accurate, reliable and trusted public health information about COVID-19 vaccination. In many cases, they work in partnership with local community groups—such as the Country Women Association in Madang province—to reach people in spaces they already feel comfortable in. By listening and responding to people’s concerns about the vaccines, they are dispelling people’s fears and encouraging more and more people to come forward for their jab. Libya The Libyan Red Crescent Society is partnering with the Libyan National Centre for Disease Control to support the rollout of COVID-19 vaccination—with a focus on community engagement and logistical support. More than 600 volunteers have been going out and about in their communities to engage with local people and answer their questions about vaccines. Volunteers have been helping with vaccine registration and data entry, so people can sign up for their jabs, and several Libyan Red Crescent health clinics in the south of the country are currently being used as vaccination centres. Zambia Zambia Red Cross Society volunteers are running a mobile COVID-19 vaccination campaign to take vaccines out to remote and hard-to-reach communities across the country. They’re working with trusted local community leaders, helping them to be advocates for COVID-19 vaccines so that their communities feel confident coming forward. Volunteers are also working hard to continue routine immunization activities across the country so that all Zambian children are fully immunized before the age of 5. Kyrgyzstan Hundreds of Kyrgyzstan Red Crescent Society volunteers across the country have dedicated their time to supporting the Ministry of Health and Social Development’s rollout of COVID-19 vaccines. They set up a special COVID-19 vaccination hotline to answer the public’s questions and address rumours and misinformation about vaccines. And they’ve been deployed to vaccination centres to lead vaccine registration and data entry so people can easily schedule their appointments. Canada In Canada, the Canadian Red Crosshas been supporting provincial, territorial and Indigenous health authorities in vaccination efforts among remote and Indigenous communities. For instance, in Northern Alberta, CRC’s Indigenous staff have been embedded into mobile vaccination teams to help understand and address the roots of vaccine hesitancy. They’ve been supported virtually by an Indigenous People’s Help Desk, set up to respond to the unique needs of Indigenous leadership during the pandemic. -- For more information, visit our immunization page or sign up to the IFRC's monthly immunization newsletter.

Working in some of the world’s most challenging environments, the IFRC supports our 191 National Societies to reach vulnerable and isolated communities with life-saving vaccines.

In June 2020, a few months into the COVID-19 pandemic, the United Nations and the International Red Cross and Red Crescent Movement jointly called on governments, the private sector, international and civil society organizations to accelerate efforts to develop, test, and produce a safe and affordable “people’s vaccine” to protect everyone, everywhere and bring the crisis to an end. A people's vaccine should protect the affluent and the poor, the elderly as well as the young, forcibly displaced persons, migrants regardless of their immigration status, and other often neglected populations, both in urban areas and in rural communities. Fifteen months later, thanks to extraordinary scientific and technological advances, as well as global collaboration and mutual reliance in regulatory aspects, multiple safe and effective vaccines against COVID-19 are available and being administered in countries around the world. Yet, despite lofty rhetoric about global solidarity, the goal of a “people’s vaccine” is far from being reached. Equitable vaccine distribution is a political, moral, and economic priority which has so far been largely neglected. Profits and short-sighted vaccine nationalism continue to trump humanity when it comes to the equitable distribution of vaccines. Though more than 48 per cent of the world’s population has received at least one dose of the vaccine, that percentage drops to barely 3 per cent in low-income countries. The situation is particularly worrying in countries in humanitarian crisis which need almost 700 million more doses to reach the World Health Organization’s target of vaccinating 40 per cent of their populations by the end of the year. Over half of the countries with a humanitarian appeal do not have enough doses to vaccinate even 10 per cent of their population. Seven of the poorest in the world only have enough doses to reach less than 2 per cent of their population (Burundi, Cameroon, Chad, the Democratic Republic of the Congo, Haiti, South Sudan, and Yemen). Wealthy countries with access to large quantities of vaccines have generously pledged to donate their excess doses to low- and middle-income countries via COVAX. However, far too few of these donations have been received. Supply of doses to the most vulnerable continues to be constrained by export restrictions and an unwillingness of countries to give up their place in the production supply line to COVAX, even if they cannot use those doses immediately. The Humanitarian Buffer, part of the COVAX Facility, has been open for applications since June 2021. The Buffer is a measure of last resort to ensure the world’s displaced and other vulnerable populations are reached with COVID-19 vaccines. It is also part of the efforts to curb inequity, which would otherwise jeopardize social and economic recovery in humanitarian settings. We therefore need to urgently boost supply, share vaccines, and ensure that everyone has access. But having vaccine doses available is only part of the solution to this crisis. We must ensure that the vaccine makes it from the airport tarmac into the arms of the most vulnerable – including refugees, migrants, asylum seekers, marginalised groups, people who are stateless, and those living in areas controlled by armed groups and/or affected by armed conflict. There must be greater investment in local delivery mechanisms and capacity, not only to guarantee that vaccines are delivered quickly and fairly, but also to strengthen national health systems for more effective pandemic preparedness and response. All around the world, efforts to curb the pandemic are undermined by mistrust that leads to vaccine hesitancy. More than ever, it is important to work with and within communities, including through social media and community networks, to build trust and strengthen confidence on the efficacy and safety of vaccines. Activities that strengthen support for local actors and address misinformation are key to ensuring the successful delivery of vaccines to local communities, especially those most at-risk. The United Nations and the International Red Cross and Red Crescent Movement remain steadfast in their commitment to ensure equitable and effective access to COVID-19 vaccines across the globe. As the pandemic requires the international community to take extraordinary measures, today we unite our voices again to say it is time for actions to speak louder than words. --- It is a humanitarian imperative and our shared responsibility to ensure that lives everywhere are protected, not only in the few countries that have the means to buy protection. We call on governments, partners, donors, the private sector, and other stakeholders: to scale up COVID-19 vaccine supply and access to COVAX including through donations from high-income countries to donate vaccines to those countries and regions that remain inequitably served; to increase the funding and support to local actors to ensure that vaccines leave capital airports and reach everyone, including through investment both in the local health systems required for delivery and in community engagement to enhance acceptance and confidence in COVID-19 vaccines as well as vaccines in general; to strengthen the capacity for COVID-19 vaccine production and distribution worldwide, particularly in low- and middle-income countries; to accelerate the transfer of technology and know-how: investments made now will last well beyond this public health emergency and will strengthen the global capacity for response to future epidemics and pandemics; to request the lifting of all remaining barriers (by manufactures) to allow humanitarian agencies access COVID-19 doses, including through waiving the requirement for indemnification, particularly where the most vulnerable populations can only be reached by humanitarian agencies using the COVAX Humanitarian Buffer. For more information Tommaso Della Longa, IFRC,+41 79 708 43 67, [email protected] Crystal Ashley, ICRC, +41 79 642 80 56, [email protected] Anna Jefferys, UNOCHA, + 1 347 707 3734, [email protected]

The International Red Cross and Red Crescent Movement is calling on states and pharmaceutical companies to move much faster toward a solution to the glaring inequity in access to COVID-19 vaccines around the world. We need to agree now on ways to increase COVID-19 vaccine production and distribution. The extraordinary times of a global pandemic demand extraordinary measures from the international community. We encourage States to consider all possible measures to boost production, distribution and equitable access to COVID-19 vaccines both between countries and within countries, to leave no one behind. This includes accelerating, under the World Trade Organization (WTO) umbrella, negotiations related to intellectual property and other barriers to a rapid scaling up of vaccine production all over the world. In addition, pharmaceutical companies must reach further to share the necessary technology and knowledge – and we call on states to provide them with the necessary incentives and support to do so. "In the middle of the worst pandemic in 100 years, the intellectual property waiver for COVID-19 vaccines is a necessary political commitment to address inequities in access at the scale and speed we need. Millions of lives depend on it and on the equally important transfer of technology and knowledge to increase manufacturing capacity worldwide" Francesco Rocca President of the International Federation of Red Cross and Red Crescent Societies (IFRC) We cannot afford to become bogged down in negotiations over the next 6 months. We also call for governments to accelerate the sharing of existing vaccine stocks to ensure a more equitable distribution, particularly in countries that are currently experiencing surges in COVID-19 cases. As of this month, the poorest 50 countries in the world account for 2% of the doses administered globally. And the richest 50 countries are being vaccinated at a rate that is 27 times higher than the rate of the 50 poorest countries. Africa accounts for 14% of the global population yet accounts for only 1% of administered doses*. This is not only morally wrong — it increases the risks of more contagious and deadly variants everywhere and puts unnecessary strains on the global economy. "Every option should be explored to overcome bottlenecks to equitable access. This includes a better distribution of existing vaccine doses globally, the transfer of technology and the ramping up of manufacturing capacity. There´s no silver bullet to equitable access. All possible means need to be considered" Peter Maurer President of the International Commmittee of the Red Cross (ICRC) Broader access to vaccines also requires community-level delivery and social mobilisation and connection to support community understanding and acceptance. This is important in every country of the world, as the challenges of this pandemic are felt worldwide, but it is even more important for populations who are always at the end of the line. People in low-income settings, in contexts affected by armed conflict and in areas outside of State control, refugees, migrants, detainees and other underserved populations should be included in national vaccination plans and not be forgotten. The International Red Cross Red Crescent Movement will continue in 192 countries to support governments' efforts to control the spread of the virus and deliver vaccinations. Our role is to reach the populations in the "last mile", and to continuously empower communities as the driving force for the humanitarian response to COVID-19. For more information, please contact: IFRC: Tommaso Della Longa, +41 79 708 43 67, [email protected] Teresa Goncalves, +44 7891 857 056, [email protected] ICRC: Ewan Watson, +41 79 244 64 70, [email protected] *The analysis of where vaccines have been administered; the relative reach of testing; and which countries carry out full, partial or no contact tracing is based on Oxford University's 'Our World in Data' (latest available data used) and the INFORM Severity Index – an inter-agency tool that measures the severity of humanitarian crises and disasters globally. For a full list of countries listed against crisis severity, visit INFORM Severity Index. All datasets have some gaps.

The moment the first coronavirus case was reported in Europe – on 24 January 2020, in Bordeaux, France– no one could have possibly imagined the monumental scale of the year of loss and struggle ahead. Nor could they have foreseen how Red Cross and Red Crescent National Societies stepped up their activities across Europe and Central Asia, enabling them to be at the heart of the response. Staff and volunteers from the movement have been running first aid tents, delivering critical supplies to the elderly, caring for the sick and dying, at the end of the phone for people unable to leave home. They’ve provided food, shelter, a kind word and a friendly face, supported those who fall through the cracks – the migrants, people on the move, people who are homeless. They’ve provided trusted information. The numbers are staggering. More than 12.5 million people across the region have received food and other material aid from Red Cross Red Crescent[1]. More than 2.8 million people have received direct cash or voucher assistance and 1.3 million more received psychosocial support to help them through the tough times. Red Cross Red Crescent ambulances carried more than 325,000 COVID-19 patients to hospitals. Accurate information was shared to help inform people about the virus and how to stay safe, and an estimated 60 million people in the region have been reached with this messaging. The breathtaking spread of the virus With Italy the centre of the first wave, and the first country to go into lockdown, it remained the hardest hit country in Europe for months. Italian Red Cross was the first National Society in Europe to deliver food and medicine to people in quarantine, and ramped up their ambulance service to cope with the escalating number of people infected. By March Europe was the epicentre of the COVID-19 pandemic, so much so that on 18 March more than 250 million people were in lockdown in Europe. And now, nearly 12 months after the first case, sadly by 19 January 2021, 30.8 million cases were confirmed and 674,00 people in the region had died. [2] The Red Cross Red Crescent response needed to be swift. On 30 January the World Health Organisation (WHO) declared the COVID-19 outbreak a public health emergency of international concern and the following day the International Federation of Red Cross Red Crescent Societies (IFRC) allocated funds for a Disaster Relief Emergency Fund (DREF) and a preliminary Emergency Appeal. With its long experience in health emergencies it anticipated COVID-19 could develop into a pandemic with a devastating humanitarian impact and sadly it has shaped up to be one of the world’s most challenging crises, affecting every corner of the region with everyone vulnerable to contracting this virus. In line with Red Cross Red Crescent’s unique role as auxiliary to government, and as a community-based and widely-trusted organization, in Europe region the Red Cross movement came up with innovative responses. The Austrian Red Cross developed a contact tracing app. British Red Cross surveyed people on their loneliness and pivoted to provide extra support for those newly alone. The Czech Red Cross trained volunteers to work in hospitals that had become overwhelmed. The Turkish Red Crescent researched people’s knowledge and attitudes towards the virus and pivoted to fill the gaps they discovered. Swedish volunteers helped children with their homework. The Red Crosses of the countries of Italy, Slovenia and Croatia worked together to get supplies across their borders to people in an isolated part of Croatia. Extra support was given to people with HIV in Eastern Europe and Central Asia whose treatment was disrupted by the pandemic. With the rapid surge in prevention activity, while case numbers grew at an alarming rate, by the end of Spring the situation had improved somewhat. By summer as numbers plateaued government restrictions relaxed. The movement urged people to stay the course and maintain prevention measures in the face of pandemic fatigue and a sense the worst was behind us. Second wave Sadly conditions deteriorated, leading to a second wave. From late July case and death numbers steadily worsened again. By October, the Europe region accounted for the greatest proportion of reported new cases globally, with over 1.3 million new cases in the last week of October, a 33% leap in cases in a week. The national societies doubled down. Many had by now switched to remote and on-line support, however 23 National Societies continued to deliver COVID-safe clinical and paramedical services, including those in Germany, Italy, Israel, Spain and the UK. As well they ran quarantine and testing stations, triage facilities and outpatient fever clinics to support the public emergency medical service, and provided mobile care services. Some National Societies also supported experimental treatments by collecting plasma from patients who recovered from COVID-19 and had antibodies, and in turn provided this plasma to hospitals to treat very sick patients. Countless training and guidance sessions for staff and volunteers on COVID-19 were helped across the region, on the proper use of personal protective equipment and ambulances cleaning and disinfection. Vaccines – a potential game changer By the start of December, the future started to look brighter. Countries started to plan for the possible arrival of vaccines, but this was taking place against a background of a relentless resurgence in the number of people infected with COVID-19. In the WHO Europe region, there had been more than 4 million new cases in November alone, with the region accounting for 40 % of new global cases and 50% of new global deaths. [3] The vaccine results have come to be seen a large part of the solutions to containing the virus, but it has brought with it the challenge of countering misinformation and building trust in vaccines, as well as managing expectations that they will bring about a quick end to the pandemic. IFRC has supported local efforts to educate communities about their safety and efficacy. Those hardest hit In January more evidence came to light of the disproportionate impact the coronavirus was having on older people when the IFRC’s Europe office published the results of a survey[4] which found older people had become sicker, poorer and more alone as a result of the pandemic. It added to a growing body of evidence that coronavirus had harmed the poor and most vulnerable the most, pushing millions more into poverty. [5] Sadly, migrants were also identified in new IFRC research as those least protected and most affected by the pandemic. [6] And now, as we enter the start of the second year of the pandemic under ongoing harsh lockdowns, many countries are starting to see cases stabilise and even reduce. This emergency has had significant challenges, including global flows of misinformation and disinformation, response fatigue and system-wide impacts of multiple waves of cases. The Red Cross Red Crescent movement is well-placed to do its part in the regional response given its extensive history with disease outbreak. And planners in the movement acknowledge that vaccines will not be the silver bullet to end this pandemic alone. Red Cross will continue to work with communities to ensure they are informed about the virus, how it spreads and what to do to keep safe. It’s continuing to advocate for tracing and isolation of people who are ill as a central part of the response. To keep in the fight against COVID-19, the entire population must stick to the preventative measures which have been proven to help stop the spread of the virus – even as a vaccine becomes more widely available. [1] https://go.ifrc.org/emergencies/3972#actions [2] https://covid19.who.int/ [3] https://www.euro.who.int/en/about-us/regional-director/news/news/2020/12/whoeuropes-year-in-review-2020 [4] https://www.ifrc.org/press-release/new-study-finds-coronavirus-has-left-older-people-poorer-sicker-and-more-alone [5] https://blogs.worldbank.org/voices/2020-year-review-impact-covid-19-12-charts [6] https://www.ifrc.org/press-release/migrants-and-refugees-least-protected-most-affected-covid-crisis-warns-ifrc-president

After a brutal year dominated by the coronavirus, 2021 at last promises hope. When mass vaccination campaigns roll out, it will mark a critical turning point in the pandemic. However, vulnerable communities – especially migrants and refugees – run the risk of being left behind again. COVID-19 has exposed and magnified inequalities, destabilized communities, and reversed major development progress made over the past decade. For the 80 million people who remain forcibly displaced in 2020, the pandemic has exacerbated existing challenges and pushed them into more devastating, vulnerable and exploitative situations. About 66% of migrants and refugees have lost access to work due to COVID-19, with many losing the sole income they rely on. Many have experienced ballooning debts, which forces many to cut spending on essentials, including health, education or food to survive. People on the move too often fall through the cracks when it comes to accessing essential health services and we worry the same could happen for the vaccine. People in particularly fragile settings, like displacement camps, have access to fewer basic health care services. Many barriers exist, including direct exclusion, laws restricting access based on migration status, language barriers and lack of culturally-accessible and appropriate information about the vaccine. The health and socio-economic impacts of COVID-19 will have a lasting effect on millions of refugee and migrant families for years to come. We must address the many barriers to universal health coverage and ensure that migrants are fully included in national vaccination campaigns. The International Red Cross and Red Crescent Movement has been at the center of the pandemic, stepping up our support to migrants, refugees and asylum seekers, providing access to critical information, health services, psychosocial support as well as helping to mitigate COVID-19’s socio-economic impacts and strengthen the resilience of vulnerable groups. In Greece and Spain where there have been large number of people arriving, Red Cross has for several years been supporting individuals and families by providing food, water and other practical support so they’re treated with dignity and respect along their journeys. Through the Emergency Social Safety Net (ESSN), funded by the European Union and implemented by the Turkish Red Crescent and IFRC, 1.8 million refugees receive cash assistance every month to help cover their essential needs such as rent, transport, bills, food and medicine. Additional financial support was provided from June to July to help people cope through particularly tough months. All migrants, irrespective of status, should be protected from harm and have access to health care and the vaccine without fear of arrest, detention or deportation. This includes ensuring COVID-19 testing, tracing, treatment and the vaccine are available and accessible to everyone. The inequitable distribution of vaccines globally not only threatens to leave the most marginalised behind but also risks undermining our shared health if the virus is left to continue among unprotected communities. The vaccination roll-out must work in parallel with access to critical public health preventative measures. We ask governments, the private sector, international organisations and civil society to unite towards “a people’s vaccine.” A people’s vaccine should equally protect the affluent and the poor, those in cities and in rural communities, older people in care homes and those living in refugee camps. A global social contract for a people’s vaccine against COVID-19 is a moral imperative that brings us all together in our shared humanity. We must take concrete action to prevent the exclusion of groups at significantly higher risk of severe disease or death, such as refugees, migrants, internally displaced persons, asylum seekers or those affected by humanitarian emergencies. Migrants and refugees must not be left behind while the rest of the world recovers: none of us are safe until all of us are safe. *This opinion piece was originally published on Thomson Reuters Foundationon December 24, 2020. This article covers humanitarian aid activities implemented with the financial assistance of the European Union. The views expressed herein should not be taken, in any way, to reflect the official opinion of the European Union, and the European Commission is not responsible for any use that may be made of the information it contains.

Budapest, 5 March 2019 – Ukrainian Red Cross Society volunteers are being deployed to help contain a measles outbreak that has affected more than 75,000 people, making it the largest outbreak in Europe since 2015. This includes 54,000 measles cases reported in 2018, and more than 21,000 cases registered thus far in 2019. Poor immunization coverage has contributed to the measles outbreak in Ukraine. In 2018, the measles vaccination rate for newborn babies was only 54 per cent, which is amongst the lowest in the world. This is well below the target of 95 per cent recommended by the World Health Organization. A rate of 95 per cent would protect even those members of the community who cannot be vaccinated for medical reasons. Professor Mykola Polishchuk, Acting President of Ukrainian Red Cross Society, said: “Ukraine has one of the lowest vaccination rates against measles in the world and this is a very worrying trend. We are deploying 100 Red Cross volunteers to raise awareness about vaccination and conduct education campaigns to stop the spread of this disease.” The International Federation of Red Cross and Red Crescent Societies (IFRC) has released 109,000 Swiss francs from its Disaster Relief Emergency Fund to help the Ukrainian Red Cross Society tackle the outbreak. Officials say the low coverage rate and widespread transmission of the virus is due to many factors, including transport costs for those in rural areas, a high number of people with weakened immune systems, such people living with HIV and tuberculosis - and vaccine refusal. The funds will allow Ukrainian Red Cross Society to assist 90,000 people, including the most at-risk – children under six years of age, people with weakened immune systems, and people who have never been vaccinated against the disease. The emergency funds will also allow volunteers to help health authorities raise awareness about vaccination, to conduct education campaigns in kindergartens, schools, hospitals and aged care facilities, and to provide protective equipment for Red Cross volunteers. IFRC Europe Regional Director, Simon Missiri, said vaccine refusal is an increasingly worrying trend worldwide. “It is hard to believe that children are dying of measles in Europe in 2019,” he said. “This disease is almost completely preventable. Red Cross workers have an important role in helping communities understand the importance of vaccines, and in answering concerns that are increasingly prevalent in many countries.” The measles operation will run for four months in five regions across the country. Recent global declines in vaccination rates resulted in more than 110,000 measles deaths worldwide in 2017. The Ukraine outbreak coincides with other measles outbreaks across Europe and in the Philippines where measles cases are up more than 547 per cent in 2018 compared to 2017.

More than 8,440 cases of measles – including 136 deaths from the disease - have been recorded in several regions of the Philippines, including the capital city Manila. In response, the authorities are working with the Philippine Red Cross and the World Health Organization to ramp up public information campaigns and vaccination activities in Metro Manila, Central Luzon, and Mindoro, Marinduque, Romblon and Palawan. The Red Cross is also employing interventions to increase vaccine coverage and care and support for people currently in hospitals. Although cases of measles have been on the increase in the Philippines in recent years, there was a 547 per cent spike from 4,000 cases in 2017 to 21,818 cases in 2018. More than 200 people died, most of them children.