Immunization remains the single most feasible and cost-effective way of ensuring that all children enjoy their rights to survival and good health. In the developing world, immunization saves the lives of 2.5 million children every year. Because of its recognized power and efficacy, renewed efforts are being made globally to mobilize more resources for another push to ensure that all children are protected by immunization and that new vaccines for other common killer diseases are developed.

A mixed performance

The series of immunizations known as DPT can prevent diphtheria, pertussis (whooping cough) and tetanus, but these three diseases still kill 600,000 children and afflict millions of others every year in developing countries. To be fully protected, children must receive three doses of the vaccine, administered at the ages of one month, one month and a half and three months. The percentage of children receiving the final dose (DPT3) is therefore a revealing and vital gauge of how well countries are providing immunization coverage for their children.

This league table shows progress, or lack of it, towards the lofty goal of immunizing 90% of children in all countries by the end of 2000. As the table indicates, 40 developing countries – and many industrialized countries – have done extremely well, attaining or exceeding the 90% coverage goal set at the 1990 World Summit for Children. The high performers are found primarily in the Americas, Central Asia, Europe and the Middle East and North Africa, but in sub-Saharan Africa, a region beset by economic hardship, armed conflict and AIDS, three countries – Gambia, Malawi and Mauritius – also attained 90% coverage or above. On average, however, only about half of the children in sub-Saharan Africa are protected. Countries in East Asia and the Pacific generally have high coverage, while South Asia, with a regional average of 70%, remains well below the goal.

The world average is now 77%, the result of a massive immunization campaign in many countries during the 1980s. That kind of push needs to be extended to provide coverage for all children. The new Global Alliance for Vaccines and Immunization (GAVI) has been created to renew this effort. It aims to help poor countries that meet specific criteria (see ‘Plans to save more children with Hib vaccine’) overcome the great gaps they face in immunizing their children. GAVI aims by the year 2005 to have assisted these countries in attaining at least 80% DPT3 and measles coverage in all districts.

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