Eastern/Southern Africa immunizes 71 per cent of its children against measles through routine services; coverage has increased at an average annual rate of 0.7 percentage points between 1990 and 2003. A long distance remains if the goal of 90 per cent coverage is to be met. The average rate of increase will need to rise by 2.6 percentage points each year until 2010.
Higher rates of immunization are desperately needed. With 156 child deaths per 1,000 live births, Eastern/Southern Africa has a higher rate of under-five mortality than any world region except West/Central Africa.
In coverage against measles, the best performing countries in the region are Seychelles, which immunizes 99 per cent of its children, and the United Republic of Tanzania, which immunizes 97 per cent.
Eritrea and Uganda have not yet reached the goal but are considered likely to do so by 2010. Eritrea deserves particular credit since, as recently as 1992, measles immunization had reached only 18 per cent of children. Yet in the ensuing decade, coverage increased at a phenomenal average rate of 6 percentage points per year - by far the most rapid improvement in the world over that period. Closer attention shows that Eritrea achieved similar impressive growth in coverage for all major vaccines by 1999 but that coverage has diminished slightly since.
The other 14 countries in the region will need to improve their average annual rate of increase if they are to reach the goal of 90 per cent measles immunization coverage. In four countries - Angola, Ethiopia, Madagascar and Somalia - improvement will have to be substantial: an average 4 percentage points or more per year. Somalia, which has farthest to go, would need an even more dramatic transformation than Eritrea to achieve 90 per cent coverage; routine coverage was at 40 per cent in 2003.