Global immunization vision and strategy
By 2010: To ensure that every country reaches at least 90 per cent national vaccination coverage and at least 80 per cent vaccination coverage in every district or equivalent administrative unit; to reduce measles mortality globally by 90 per cent compared to the 2000 level. By 2015: To sustain vaccination coverage goal reached in 2010; to reduce morbidity and mortality due to vaccine-preventable diseases by at least two thirds compared to 2000 levels; to ensure that every person eligible for immunization has access to vaccines of assured quality; to ensure that the entire eligible population has access to new vaccines within five years of the introduction of these vaccines in national programmes; to ensure capacity for surveillance and monitoring; to strengthen national systems and to assure their sustainability.
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 2011 (2012 data revision). Polio is on the verge of eradication. Deaths from measles, a major killer, declined by 74 per cent worldwide and by 85 per cent in Africa between 2000 and 2010**. Immunization against tetanus has saved hundreds of thousands of mothers and newborns, and as of September 2012, 27 countries have eliminated maternal and neonatal tetanus, leaving 32 countries that still have not eliminated the disease.
Many new vaccines, such as those against pneumococcal disease, human papilloma virus and rotavirus, have been introduced in the recent years. 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 2011, 22.4 million children under one year of age worldwide went without all three recommended doses of the DTP vaccine; 20.1 million children in the same age group have not received a single dose of the measles 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.
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 Jun 9. [Epub ahead of print]
** 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. Published online April 24, 2012, DOI:10.1016/S0140-6736(12)60522-4.