What are biometrics and how can it be responsibly used to help tackle malaria?

For the first time in history, a biometric solution will be applied to track and trace the delivery of malaria vaccines, helping to save lives. How does it work and why is it important now?

Biometrics are the measurement of people’s unique characteristics. They are used to identify people. Physical characteristics may include the face, fingerprint, iris or palm. While commonly associated with border control or access gates at major sporting events, biometrics have recently started playing a role in more diverse settings, from election security to delivering aid in humanitarian crises.

In global health, however, biometrics have played a limited role to date. Identifying children using biometrics is complex since their developing features, such as growing fingerprints or facial characteristics, are challenging for matching algorithms. Moreover, there is a need to bring these biometric solutions to remote areas in global health contexts, often lacking connectivity and electricity. But this is starting to change.

Globally, one in four children go unregistered at birth. This lack of legal registration often leaves health workers in low-resource countries scrambling to link children to medical records. Demographic identifiers, such as names or dates of birth, frequently overlap. Since these details are manually recorded, the registration and identification process is prolonged and prone to errors, including duplicate records.

These problems are particularly acute for immunisation, which requires six to seven touch points over 18 months to deliver the various WHO-recommended vaccines. Consequently, generating timely vaccine coverage estimates can be extremely difficult.

In 2017, over 53% of Gavi-supported countries reported coverage estimates over 10 percentage points different from health survey data. This means we’re unsure if millions of children are receiving vaccines, or potentially falling through the cracks, leaving them vulnerable to deadly, preventable diseases.

Advances in image recognition and machine learning have created new opportunities to solve these challenges. In 2019, a unique collaboration between Simprints, a UK social enterprise; NEC, a Japanese technology company; and Gavi, the Vaccine Alliance, launched to develop the world’s first scalable child biometric system.

This multi-year study in clinical settings made significant advances in reducing the age at which biometrics could effectively be used. Field tests in Ghana and Bangladesh showed that biometrics were 240% faster in patient lookup, 100% accurate compared to 87.5% with paper systems, and significantly reduced the health worker's burden during high-volume periods at the clinics. Dr Alberta Adjebeng Biritwum-Nyarko from Ghana Health Service states: "We are very impressed with the results of the early deployment of Simprints in the Eastern region and look forward to scaling up to replicate the time and efficiency benefits in other regions. This will result in greater coverage and completion rates of the critical vaccinations that protect our population and save much-needed money and resources within our health system."

In Ghana, malaria is the leading cause of infant mortality. The newly introduced malaria vaccine is expected to lower severe cases and mortality significantly. However, the challenge is that the vaccine requires four doses. In the initial rollout, 29% of children were lost to follow-up before administering the fourth dose. This is a life-threatening coverage gap, with vaccine efficacy against severe malaria plummeting from 32.2% to 1.1% if only three doses are received.

To combat this challenge, Ghanaian officials are assembling a dedicated team to incorporate child biometrics to trace vaccine delivery in two malaria-prone regions. This endeavour will be financially supported by the Steele Foundation for Hope, ARM and the Gavi Matching Fund, aiming to deliver millions of vaccines over three years.

Like all sensitive data, using biometrics requires robust technical and legal protections. Privacy-by-design is baked in from the ground up through data siloing, encryption and strict consent protocols.

Legally, Ghana has one of the most advanced data protection frameworks in Africa, alongside a track record of using biometrics safely in elections and telecoms with high public acceptance. Initiatives such as this also open up the possibility of using immunisation to complete Civil Registration, provided that appropriate governance, legislation and protocols are in place. If these conditions are met, biometrics can become an excellent investment to deliver public services.

These technologies are only tools to solve problems. Used well, biometrics can provide the data needed to trace vaccine delivery, verify coverage and reduce dropouts. But data alone isn’t enough. It’s leveraging that data to ensure no child is left behind that ultimately saves lives in the battle against malaria.