A funeral was held last week for Alicia, a beautiful five year old girl who was in the Nursery Class at eduKenya’s Kwa Watoto School. In the midst of heartbreaking grief, the eduKenya/Kwa Watoto School staff and parents came together to support Alicia’s family and each other as all mourn her loss.Alicia’s death was likely caused by rotavirus, a virus that causes gastroenteritis and is the leading cause of severe diarrhea in infants and young children worldwide. According to the World Health Organization, rotavirus causes more than half a million deaths globally each year in children who are five years old and younger, and hospitalizes millions more. 95% of rotavirus deaths occur in developing countries, where access to rotavirus vaccines and treatment is limited or unavailable.

Rotavirus is highly communicable and effectively prevented by vaccines administered during the first year of life. Without vaccination, children will near definitely contract rotavirus. Without access to medical care, including oral rehydration therapy to treat dehydration caused by severe diarrhea, many unvaccinated young children like Alicia tragically die.Research across multiple countries and diverse settings shows that rotavirus vaccines are highly effective in reducing rotavirus-related deaths and hospitalizations, and significantly lowering health care costs. Kenya planned to introduce a two-dose rotavirus vaccination series into the routine vaccination schedule this year, though will reportedly delay its introduction until 2014 due to supply/financing constraints.Financing for Kenya’s Division of Vaccines and Immunization, which is tasked with reducing morbidity and mortality due to vaccine preventable diseases, comes from the Government of Kenya (56%) and the Global Alliance for Vaccines and Immunizations (44%). Kenyan spending on health (of which immunization is a small part) accounts for just 4.5% of total GDP. Clearly there is insufficient financing for public healthcare and immunization in Kenya.In recent years, there has been a downward trend in immunization financing due to several key donors pulling funding as a result of political unrest in Kenya. Political stability as well as political will to prioritize immunization for all Kenyan children are essential not only for adding a rotavirus vaccine to the routine vaccination schedule, but also for improving the overall vaccine delivery system.

So what can we do, in memory of beloved Alicia, to prevent other young children from dying as a result of rotavirus? Advocacy, in the form of your voice and your spending, is essential to ensuring that Kenyan children have access to lifesaving immunizations and adequate primary care:

• Advocate for increased government spending on preventative and curative public health in Kenya, and specifically for the swift introduction of a rotavirus vaccine into the routine vaccination schedule.
• Support the education of girls and mothers in Kenya, as children of educated mothers are much more likely to be vaccinated. The higher the level of education completed by the mother, the higher the incidence of complete vaccine coverage for her children.
• Support economic empowerment programs that increase the income-generating skills and opportunities for mothers, as research has demonstrated that when mothers increase their income or assets, the money is more likely to be spent on medicine, nutrition and housing for their children.
• Pray for the children of Mathare – for health, education and the opportunity to rise out of poverty – and support Alicia's classmates in having the opportunity to receive a quality education and break the cycle of poverty.

References:CDC rotavirus site: http://www.cdc.gov/rotavirusGAVI Alliance: http://www.gavialliance.orgMinistry of Public Health & Sanitation Division of Vaccines and Immunization Multi Year Plan 2011 – 2015: http://www.gavialliance.org/country/kenya/documentsPATH Rotavirus Advocacy and Communications Toolkit: http://sites.path.org/rotavirusvaccine/rotavirus-advocacy-and-communications-toolkitPATH RotaFlash, October 2, 2013: http://vad.createsend1.com/t/ViewEmail/r/AA3ECC32B8EA780C2540EF23F30FEDED/7B9A9AABC20F96627F4E5A579FEBB2E9Rotavirus Disease Burden and Impact and Cost-Effectiveness of a Rotavirus Vaccination Program in Kenya: http://jid.oxfordjournals.org/content/200/Supplement_1/S76.full.pdf+htmlWorld Health Organization on rotavirus: http://www.who.int/nuvi/rotavirus/en