Decade of Vaccines — Global Vaccine Action Plan, 2011-2020
The Global Vaccine Action Plan (GVAP) # endorsed by the 194 Member States of the World Health Assembly in May 2012 to achieve the Decade of Vaccines vision by delivering universal access to immunization # is a framework to prevent millions of deaths by 2020 and beyond through more equitable access to the full benefits immunization to all people, regardless of where they are born, who they are or where they live.
The GVAP aims to strengthen routine immunization to meet vaccination coverage targets, accelerate control of vaccine-preventable diseases with polio eradication as the first milestone, introduce new and improved vaccines and spur research and development for the next generation of vaccines and technologies.
The GVAP builds on the Global Immunization Vision and Strategy 2006–2015, developed by UNICEF, WHO and partners to assist countries to protect more people against diseases by expanding the reach of immunization to every eligible person, including those in age groups beyond infancy, within a context in which immunization is high on national health agendas.
Progress on the GVAP will be reported annually to the World Health Assembly beginning in 2014.
Immunization, one of the most important and cost-effective public health interventions to-date, has saved millions of lives* and protected countless children from illness and disability. It is an affordable means of protecting whole communities and of reducing poverty.
Immunization coverage for the six major vaccine-preventable diseases – pertussis, childhood tuberculosis, tetanus, polio, measles and diphtheria – has risen significantly since the Expanded Programme on Immunization began in 1974. In 1980, DTP3 coverage was estimated at 20 per cent of the world's children immunized in the first year of life; it had increased to an estimated 83 per cent by the end of 2012 (2012 revision completed in July 2013). Polio is on the verge of eradication. Deaths from measles, a major killer, declined by 71 per cent worldwide and by 80 per cent in Sub-Saharan Africa between 2000 and 2011**. Immunization against tetanus has saved hundreds of thousands of mothers and newborns; according to WHO estimates, 59,000 newborns died from neonatal tetanus in 2011, a 93 per cent reduction from the situation in the late 1980s. As of July 2013, 31 of 59 priority countries have eliminated maternal and neonatal tetanus (meaning a reduction in rates to less than 1 case per 1,000 live births per district in a country), leaving 28 countries at high risk.
An increasing number of countries are now offering pneumococcal conjugate vaccine and rotavirus vaccine in their immunization programmes, thus offering protection against some of the leading causes of child deaths: pneumonia and diarrhoea. The world has also witnessed the expansion of under-utilized vaccines, such as the vaccines against yellow fever and Japanese encephalitis. UNICEF and WHO have expanded their monitoring process accordingly and include estimates of rotavirus, yellow fever and pneumococcal vaccine coverage.
Immunization coverage has still not realized its potential, however. As of the end of 2012, 22.6 million children under one year of age worldwide went without all three recommended doses of DTP containing vaccine; 21.2 million children in the same age group did not receive a single dose of measles containing vaccine. Vaccine security is fundamental to meeting immunization goals, and long-term funding remains a serious issue as neither developing country governments nor the international community have made firm commitments.
The GAVI Alliance (formerly The Global Alliance for Vaccines and Immunization) has developed financial sustainability plans for countries eligible for support. But mobilizing and securing adequate funding will also require stronger political will, better management and greater advocacy.
UNICEF and its partner organizations continue to respond to existing challenges to ensure that the hardest to reach children – most of them in Africa and Asia – are immunized with life-saving vaccines including new and underutilized vaccines.
* Levine OS, Bloom DE, Cherian T, de Quadros C, Sow S, Wecker J, Duclos P, Greenwood B. The future of immunisation policy, implementation, and financing. Lancet. 2011;378:439-48. doi:10.1016/S0140-6736(11)60406-6.
** Updated measles mortality estimates data through 2011obtained from Dr Robert Perry, World Health Organization, Geneva, Switzerland based on a model reported in Simons E, Ferrari M, Fricks J, Wannemuehler K, Anand A, Burton A, Strebel P. “Assessment of the 2010 global measles mortality reduction goal: results from a model of surveillance data.” Lancet. 2012;379:2173–78. doi:10.1016/S0140-6736(12)60522-4.