|© UNICEF HQ97-0767/Lemoyne|
Edward Jenner demonstrated the value of immunization against smallpox in 1792. Nearly 200 years later, in 1977, smallpox was eradicated from the world through the widespread and targeted use of the vaccine. In 1974, based on the emerging success of smallpox, the World Health Organization (WHO) established the Expanded Programme on Immunization (EPI). Through the 1980s, UNICEF worked with WHO to achieve Universal Childhood Immunization of the six EPI vaccines (BCG, OPV, diphtheria, tetanus, pertussis, and measles), with the aim of immunizing 80% of all children by 1990. Progress has continued since then: by 2011, 107 million children were vaccinated with three doses of diphtheria-tetanus-pertussis (DTP3) vaccine and global immunization rates were at 83%. Of the world’s 22.4 million children not immunized with DPT3, more than 70% live in 10 countries. Source: WHO/UNICEF.
The last 20 years have seen an explosion in the number of new vaccines. The GAVI Alliance has been instrumental in funding these new vaccines in the poorest countries. Vaccines against Hepatitis B and Haemophilus influenzae type b (Hib) have been widely introduced. An increasing number of countries are now offering pneumococcal conjugate vaccine (PCV) and rotavirus vaccine (RV) in their immunization programs, thus offering protection against some of the leading causes of child deaths: pneumonia and diarrhoea. Poliomyelitis is on the verge of eradication, measles deaths have been reduced by 71% between 2000 and 2011, and maternal and neonatal tetanus has almost been eliminated as a public health disease.
Delivering immunization also offers an opportunity to deliver other preventive services, for example vitamin A supplements, deworming medication and insecticide-treated mosquito nets Despite these successes, immunization is an unfinished agenda. An estimated 22.4 million children were not reached with three doses of DTP vaccine in 2011. Those who are not immunized – about every Fifth Child - are mostly among the poorest and the most vulnerable. Cold Chain and Logistics systems are aging and often insufficient to accommodate the new vaccines. Parents still do not view immunization as a right, and demand for immunization services is lacking in many communities. Financing for immunization often remains unpredictable.
UNICEF works with governments, partners and communities to increase demand for immunization establish better cold chain and logistic systems; design approaches to “Reach the Unreached”; and increase national ownership for immunization. In addition, UNICEF, which currently supplies vaccines reaching 36% of the world's children, works with partners and manufacturers to obtain vaccines at affordable prices while maintaining a healthy market.