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Global Immunization Challenges

One in four children is excluded

Despite the spectacular gains achieved by the WHO’s Expanded Programme for Immunization during the 1980s, one in four children did not receive routine immunization with the six basic vaccines against polio, diphtheria, whooping cough, tetanus, measles and tuberculosis in 1998, according to WHO figures. The proportion of children immunized each year against these six diseases is currently declining. Whereas the reported total was about 80 per cent in 1990 it fell to 74 per cent in 1998.

(Source: WHO Vaccine Preventable Diseases Monitoring System,
1999 Global Summary)

Global statistics from eight vaccine-preventable diseases

Annual cases (estimated)
Annual deaths (estimated)






5 000


45 million

346 000


30-40 million

888 000

Tetanus (including 215 000 neonatal)

Not available

410 000

Haemophilus influenzae b (Hib)

2-3 million

400 000

Hepatitis B

Not available

900 000

Yellow fever


30 000


2 979 720

*hepatitis B actual deaths based on projections of future mortality resulting from current annual infection rate

Global statistics from three diseases for which vaccines are not yet globally available

Disease Annual cases (estimated) Annual deaths (estimated)
Pneumococcal pneumonia Not available 1 million
Rotavirus 125 million 600,000
Meningitis AC 300,000 25,000 -30,000

The ’vaccine gap’ between rich and poor children is widening

Beyond the six basic vaccines, newer vaccines, such as those for hepatitis B, Haemophilus influenzae B (Hib), and yellow fever are now widely used in developed countries. While children in developing countries may have access to six or seven vaccines, their peers in industrialized countries can now expect to receive 11 or 12. Thus the gap between rich and poor children is widening.

(Source:The World Bank)

More vaccines are needed

As well as the challenges of increasing access to existing vaccines, there are additional challenges for research and development. For example, HIV, tuberculosis and malaria now cause a combined annual death toll of about 5 million yet, despite promising leads, no vaccines against HIV and malaria have yet been licensed and additional vaccines against TB are urgently needed.

Selected major killers not yet preventable by immunization


Estimated annual deaths (millions)









Source: WHO 1999


[More disease information]

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