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On behalf of the World Health Organization (WHO), Dr. Jean-Bosco Ndihokubwayo, WHO Representative in Chad, presented the official certificate of merit to Chad's Minister of Public Health, Mahamet Aziz Saleh, this month in recognition of the important efforts made by the country in recent years to improve routine immunization, which resulted in the elimination of MNT.
A very high proportion of tetanus cases worldwide occur in mothers and their newborns. WHO estimates that in 2017 (the latest year for which estimates are available), 30,848 newborns died from neonatal tetanus. Mothers and infants die in excruciating pain within days of delivery, but this infectious disease is surprisingly easy to prevent through immunization and hygienic birth practices. A series of three shots provides lifetime immunity to a woman and all her future children.
In 2010, Kiwanis International and UNICEF joined forces to create The Eliminate Project, a historic initiative aimed at eliminating MNT worldwide. The support of partners such as Kiwanis International, BD and LDS Charities has helped to increase equitable access to lifesaving immunizations for some of the most vulnerable mothers and children in the world. With their partnership, UNICEF has been able to vaccinate millions of women of reproductive age against tetanus.
Tetanus is acquired by exposure to the spores of the bacteria Clostridium tetani, commonly found in dirt. Cases of tetanus are rare in the United States and other parts of the developed world. The majority of mothers and newborns dying of tetanus live in areas of Africa, South Asia and East Asia where women are poor, have little access to health care and have little information about safe delivery practices.
Mothers who give birth outside of professional health facilities and who have not been vaccinated are most likely to become infected, usually through unhygienic childbirth and umbilical cord care practices. Once the disease is contracted, the fatality rate can be as high as 100 percent without hospital care and between 10 percent and 60 percent with hospital care. The true extent of the tetanus death toll is not known because many newborns and mothers die at home and neither the birth nor the death is reported.
The only way to eliminate MNT is to immunize women between 15 and 49 years old. The tetanus vaccine is free to all in Chad.
The World Health Assembly first called for the elimination of neonatal tetanus in 1989. In 1999, the goal was expanded to include elimination of maternal tetanus. At that time, there were 57 countries that had still not eliminated MNT. Timor Leste was added to the list in 2002 and South Sudan in 2011.
Between 1999 and March 2019, more than 154 million women have been immunized with two or more doses of the vaccine that prevents MNT. The number of newborns who die of tetanus every year has dropped 85 percent since 2000.
As of March 2019, 46 countries have eliminated MNT, leaving just 13 countries still at risk: Afghanistan, Angola, the Central African Republic (CAR), the Democratic Republic of the Congo (DRC), Guinea, Mali, Nigeria, Pakistan, Papua New Guinea, Somalia, Sudan, South Sudan and Yemen.
UNICEF and partners like Kiwanis International and LDS Charities will continue to meet the health and vaccination needs of mothers and children around the world so that no child dies a needless, preventable death.
For more than 70 years, UNICEF has been putting children first, working to protect their rights and provide the assistance and services they need to survive and thrive. With a presence in 190 countries and territories, UNICEF has helped save more children's lives than any other humanitarian organization in the world.
The MNT Elimination Initiative is an international private-public partnership that includes National Governments, UNICEF, WHO, UNFPA, GAVI, USAID/Immunization Basics, CDC, UNICEF National Committees, the Government of Canada, the Government of Japan, Save the Children, PATH, RMHC, The Bill & Melinda Gates Foundation, Kiwanis International, Pampers, a brand by Procter & Gamble, BD and LDS Charities.
Top photo: Mothers and children wait to receive lifesaving vaccinations at the UNICEF-supported health center in Ambatta, a suburb of Ndjamena, the capital of Chad, in 2019. © UNICEF/UN0291197/Frank Dejongh