24 November, 2009 - After three decades of aggressively promoting and achieving 95 percent immunisation coverage, Bhutan’s effort received international recognition on November 19, in Hanoi, Vietnam, when it received the best immunisation performance award.

For six different categories, the awards were given to 14 low-income group countries by the global alliance for vaccine and immunisation (GAVI) for their outstanding performance in child health and immunisation. The best immunisation performance award was also given to Bangladesh, Congo, Djibouti, Gambia and Eritrea.

“This is the result of our good policy and the dedication to primary health care by our health workers, both past and present,” said the health minister Lyonpo Zanglay Dukpa. “We are proud.”

“For us, our aim is to consistently maintain it above 90 percent. But, with the constraints we have, I think it’s very difficult to achieve 100 percent,” said the chief program officer for communicable diseases, department of public health, Tandin Dorji.

The award comes at a time when investigations are still ongoing over whether the recently introduced pentavalent vaccine had any bearing on the deaths of eight infants that received the vaccine. The vaccine has been suspended for the time being and the ministry is still waiting for WHO to identify an independent laboratory to send the random samples of the vaccines collected from across the country for quality testing.

Clarifying rumours that linked the suspension of the pentavalent vaccine to the award from GAVI, health officials said that GAVI is a link between the countries and the vaccine manufacturers. “GAVI has no role in manufacturing the vaccines,” said the health minister, Lyonpo Zanglay Dukpa.

“They’re called GAVI vaccines, but they just identify the pharmaceutical companies from which we can buy vaccines,” added Tandin Dorji. “They’re trying to help, pull money and negotiate with the vaccine manufacturer at a lower cost,” he said.

WHO was interested in the suspension of the vaccine because it would not only affect Bhutan but other countries as well, said health officials. “If we go ahead and say it’s because of the vaccine and the manufacturer tells us to prove it, then what?” said Tandin Dorji. “We withdrew it as a precautionary measure and not because it was due to the vaccine. With the introduction, we saw these four cases and, in the absence of any other cause, we withdrew the vaccine.

Although both the award and the suspension of the vaccine happened around the same time, health officials insist that there is no relationship between the two. “We received the award letter by July and the vaccine was introduced only in September,” said the ministry’s spokesperson Kado Zangpo.

Lyonpo Zanglay Drukpa added that the award is given on the basis of performance over the last five years. “They looked at the performance of consistence and it’s based on WHO’s report,” he said. “GAVI doesn’t decide unilaterally, so there is no relationship between the two.”

Lyonpo said that the decision to suspend the vaccine was good because it gave them time to look into the causes of the deaths. “Whether the children suffered because of the vaccines or because of meningo encephalitis, the ministry is concerned either way,” he said. “We’re waiting for the final report and we’re not leaving any stone unturned. We could easily say that it’s coincidental but we can’t say that. We have to make more than 100 percent sure that this vaccine is safe before we reintroduce it.”