Vaccines were developed at an unprecedented speed in response to the COVID-19 pandemic. High-income countries, including Japan, recorded high vaccination rates in 2021. However, many low-income countries still recorded low vaccination rates, highlighting a global vaccine disparity.

  The COVID-19 Vaccines Global Access Facility (COVAX Facility) is a global risk-sharing framework established to ensure the equitable distribution of COVID-19 vaccines. This paper explains the mechanism of the COVAX Facility and discusses the following aspects: (1) issues related to vaccine supply through the COVAX Facility, and vaccine donation or provision as a means of bilateral assistance; (2) case studies of vaccine supply and the number of vaccines administered in the Pacific Islands; and (3) the state of vaccine support in terms of the island nations’ vulnerability to COVID-19.

  COVAX Facility was established in May 2020 and started to supply vaccines to low-income countries in February 2021. The framework also played a significant role as a means of vaccine donation from developed countries having had surplus COVID-19 vaccines to low-income countries when COVAX Facility experienced a shortage of vaccines. However, despite these efforts, COVAX Facility was unable to achieve “equal access” to COVID-19 vaccines.

  For instance, vaccine disparities persist among the 14 Pacific Island countries, which continue to face challenges pertaining to land dispersal, narrowness, and remoteness from global markets. On some of these islands, received bilateral assistance and vaccine donations through COVAX Facility have provided the necessary and sufficient vaccines and achieved high vaccination rates. However, in some island countries such as Kiribati, Solomon Islands, and Vanuatu, the vaccine supply is sufficient, but it does not translate into vaccinations being administered actively. Such places are particularly susceptible to vaccine wastage. Furthermore, in Papua New Guinea, a country with low basic health care standards, improving vaccination coverage may be a challenge even if large-scale support of the health care system for COVID-19 would be provided in the short term.

  It has been over two years since the detected outbreak of COVID-19. To improve vaccination rates globally, it is necessary to not only provide support in terms of vaccine supply but also to offer mid- to long-term assistance, including support for the establishment of vaccination systems and basic health care services.

Introduction

  The number of Japanese working in developing countries is increasing, and it is critical to understand more clearly their perceived travel risks and ensuing behaviors. Therefore, the purpose of this study was to investigate health risk perception, health behavior, and disease prevention among Japanese overseas workers who had lived in low and middle-income countries.

Methods

  A qualitative descriptive design was used. A purposive sample of Japanese (N = 8; [3 men; 5 women]) experienced in sponsored overseas volunteer work were interviewed.

Results

  Three categories emerged from the content analysis of health risk perceptions: pre-overseas travel concerns, increased awareness of travel-related risks, and desire to avoid injury or illness. The related health behaviors and disease preventions were: pre-departure preparatory steps for preventive actions, preventive efforts against injury and illness using available resources, finding a safe hospital, and treatment of health problems. Their health behaviors reflected the extent of activities they had to undertake to protect health when they had limited knowledge of and access to the country’s resources. In the absence of continuous health advice from reliable sources, past experience became important.

Conclusions

  The health risk perceptions of the overseas worker were informed by their past experience and from pre-departure advice, which in turn influenced their pre-departure preparation. Pre-departure and in-country advice could be very important to support the efforts of overseas workers to avoid injury or illness.

Objective

  To explore and extract the elements of educational intervention from sustainable trachoma prevention programs in developing countries particularly in Africa.

Methods

  Literature review was conducted with the search engine, PubMed, with extracting keywords as “Trachoma, intervention, education, SAFE, hygiene, WASH, sustainable, sustainability, and elimination”. After carefully reading the extracted literature and assessing the sustainability of the interventions conducted in Sub-Saharan Africa, using analytical standpoint determined by the JICA evaluation items on sustainability, the elements of educational interventions were categorized.

Result

  Twenty-two articles were extracted and 10 articles that specifically state effectiveness and contents of intervention were selected for analysis. Five categories with elements of educational intervention were classified as follows: [Education in school age and community], [Intangible and tangible support], [Guidance of constructing latrines], [Guidance on how to use equipment and resources], and [Continuation of knowledge and skill transfer activities].

Discussion

  The results of this study suggested the significance of conducting educational intervention, not only the construction but also the management and maintenance of latrines, and the effectiveness of habituation of hygiene behavior to school children by implementing hygiene education at schools which behavior may also diffuse at home. Challenges remained in trachoma prevention effort who are left out of the support, such as unenrolled children who are unable to receive school hygiene education, and/or those who are inaccessible to clean water.

Conclusion

  Elements for educational intervention in sustainable trachoma prevention were examined in this study. It was shown that continuous holistic efforts should be made for the educational interventions as well as for the improvement of accessibility of clean water and hygiene without leaving people and the least developed countries behind.