Immunization maintains strong performance made in last quarter century
Millions more could be saved with new vaccines, stronger health systems
4 OCTOBER 2005 | LYON, FRANCE
-- Immunization at the global level has progressed very well during the
past 25 years, but further increases in coverage would save the lives
of millions more who do not yet benefit from this protection, said a
group of immunization partners at the World Vaccine Congress in Lyon,
This conclusion was drawn after an analysis of the
latest immunization global data, published today. The World Health
Organization (WHO) and UNICEF, with financial support from the United
States Centers for Disease Control and Prevention, conduct world-wide
monitoring and work closely with Ministries of Health to produce
estimates of immunization coverage each year. The major findings are
summarized as follows:
- Global immunization coverage with three doses of
diphtheria-tetanus-pertussis (DTP3) vaccine has been sustained at 78%
for the year 2004.
- 102 countries have reached DTP3 coverage of 90%
or more and 80 countries are within the 50-89% range. Ten countries —
in Africa, Asia and Central America — have coverage levels below 50%.
- There has been dramatic expansion in the use of
hepatitis B and Haemophilus influenzae type b (Hib) vaccines. 153
countries now routinely vaccinate children with hepatitis B vaccine, up
from 12 countries in 1990. 92 countries include Hib vaccine in their
routine immunization systems, up from four countries in 1991.
- 27 million infants were not immunized with DTP3 in 2004, putting them at risk for life-threatening illnesses.
- Five countries—China, India, Indonesia, Nigeria
and Pakistan—each have more than 1 million unvaccinated children
accounting for 16.3 million (more than 60%) of the world's 27 million
"The spectacular gains made in immunization in the '80s
have been sustained. This is the result of strong commitment of
countries and partners, effective strategies and substantial financing.
But, we can and must do better. Vaccines must be brought to the
millions who are currently un-reached and all people must benefit from
new, life-saving vaccines. Our mission is to protect all people at risk
from vaccine-preventable diseases," said Dr Jean-Marie Okwo-Bele,
Director of the WHO Department of Immunization, Vaccines and
The estimated number of deaths in all age groups from
diseases preventable by vaccines currently recommended by WHO, such as
measles, hepatitis B, Hib, pertussis, tetanus and others, was 2.1
million in 2002, including 1.4 million children under age five.
Yet, in 2003 alone, immunization averted more than 2
million deaths from vaccine-preventable diseases. An additional 600 000
hepatitis B-related deaths that would have otherwise have occurred in
adulthood were also prevented. Historically, immunization is one of the
greatest public health success stories ever: smallpox was eradicated in
1980, the global incidence of polio has been reduced by 99% and in just
five years (1999-2003) global measles deaths have decreased by 39%,
with a 46% reduction in Africa.
Immunization is at an exciting turning point.
Unprecedented new resources for immunization are being made available
through the International Finance Facility for Immunization (IFFIm)
towards which a group of European countries committed nearly US $4
billion last month.
“IFFIm funding will enable us to scale up immunization
and introduce new vaccines to millions of the world’s poorest children.
Substantial funding to support health systems is needed if countries
are going to expand access to the traditional vaccines and manage and
deliver the new vaccines,” said Dr Julian Lob-Levyt, Executive
Secretary of the Global Alliance for Vaccines and Immunization (GAVI).
A revolution is expected in the next decade in the ways
that vaccines are designed, manufactured, financed, delivered and
administered. Major breakthroughs are occurring in vaccine development.
About 20 new or improved vaccines are anticipated within the next ten
“Dramatic progress has been made in the development of
several new vaccines for diseases that afflict children in developing
countries — new vaccines that are capable of protecting the lives of
even more children,” said Dr John Wecker, Director, Immunization
Solutions at PATH, an international nonprofit organization. “The
challenge we face is to ensure that all children who could benefit from
these vaccines will have access to them.”
WHO and UNICEF have produced a new Global Immunization
Vision and Strategy for 2006-2015 which aims to protect more people, of
all age groups, against more diseases and sets a number of immunization
1 WHO and UNICEF routinely monitor national infant
immunization coverage for protection against tuberculosis, diphtheria,
tetanus, pertussis, polio, measles, hepatitis, and Haemophilus
influenzae type b. DTP coverage is commonly used as the indicator
vaccine for immunization system performance. In 1980, global
immunization coverage with DTP3 was low at 20% and only about 30% of
countries had a formal infant immunization system, but dramatic gains
were made during the 1980s and these have been sustained until present,
despite an increasing world population. Of the 124.6 million infants
born in 2004 and surviving to their first year of life, more than 108
million received at least one vaccine and 95 million received BCG
vaccine against tuberculosis, DTP3, oral polio and measles vaccines.
192 countries now have an infant immunization system.
2 The ten countries are Central African Republic
(40%), Equatorial Guinea (33%), Gabon (38%), Haiti (43%), the Lao
People's Democratic Republic (45%), Liberia (31%), Nigeria (25%), Papua
New Guinea (46%), Somalia (30%), and Vanuatu (49%). In these ten
countries, 4.3 million children were unvaccinated in 2004.
3 The 27 million includes 11 million in South Asia, 9 million in sub-Saharan Africa and 3.9 million in East Asia and the Pacific.
4 India had 8.5 million, Nigeria 3.3 million,
Pakistan 1.8 million, China 1.6 million and Indonesia 1.3 million
unvaccinated children in 2004.
WHO is the United Nations specialized agency for
health. Its objective is the attainment by all people's of the highest
possible level of health. WHO has 192 Member States. More information
is available at http://www.who.int; for information on immunization,
please see: http://www.who.int/vaccines
The IFFIm and GAVI: The International Finance Facility
for Immunization (IFFIm) will be implemented through the Global
Alliance for Vaccines and Immunization (GAVI), an historic alliance of
all the major stakeholders in immunization. Alliance members include a
wide range of development partners: developing country and donor
governments, WHO, UNICEF, the World Bank, the vaccine industry (from
industrialized and developing countries), research and technical
agencies, NGOs, the Bill & Melinda Gates Foundation, and The
Vaccine Fund, the resource and financing arm of GAVI.
PATH, an international, nonprofit organization, creates
sustainable, culturally relevant solutions that enable communities
worldwide to break longstanding cycles of poor health. By collaborating
with diverse public- and private-sector partners, PATH helps provide
appropriate health technologies and vital strategies that change the
way people think and act. PATH’s work improves global health and
well-being. Visit www.path.org for more information about PATH.