East Asia/Pacific was the only region in the world that, in terms of overall coverage, took a small step backwards between 1990 and 2003, with routine coverage against measles declining from 84 per cent to 82 per cent. Improvement is, therefore, required for the region to meet the 90 per cent immunization goal for measles by 2010. For some countries, moreover, the target seems very distant indeed, and major work will be required if it is to be attained.
Just over half the region's countries and territories have already achieved the goal, and all of these are likely to sustain their coverage. The fastest progress in recent years has been shown in the Cook Islands and Marshall Islands, which improved at average annual rates of 2.5 percentage points and 2.9 percentage points, respectively.
China's huge population clearly has a vast impact on the overall regional statistics. Measles immunization coverage is at 84 per cent (18). In 2004, in a welcome move, the government issued a new infectious disease law requiring basic immunization to be provided free for all citizens. China is one of the 14 countries in the region that funds immunization programmes entirely from its own budget.
Improvements will be required in 12 countries, four of which are cause for particular concern. In Papua New Guinea, significant new impetus is required: immunization against measles peaked here in 1995, at 75 per cent, but all forms of immunization have struggled to surpass 50 per cent in the succeeding years. Vanuatu has suffered an alarming fall in coverage from levels of around 90 per cent for most vaccines in 2001 to around 50 per cent in 2003. In Lao People's Democratic Republic, a boost in coverage to 73 per cent in 1994, following substantial donor support, has in the early 2000s fallen away to 42 per cent for measles. Nauru's coverage has varied but it clearly has the capacity to reach the target, having achieved measles immunization coverage of 99 per cent in 1997 and 95 per cent in 2001.
In Timor-Leste, immunization programmes are still in their relative infancy following the country's independence in 2002. However, between 2002 and 2003, measles immunization coverage rose by about a quarter to 60 per cent. So there is hope that progress will be rapid.