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State of the World’s Vaccines: Childhood immunization at record high

© UNICEF/NYHQ2008-1508/Holtz
A young girl receives a vaccine against measles at a hospital in Bossangoa, in the Central African Republic.

By Elizabeth Kiem

NEW YORK, USA, 21 October 2009 – More children are being immunized against deadly diseases than ever before, yet without  better  funding and improved access, at least 24 million infants are left unprotected.

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A report released today by UNICEF, the World Bank and the World Health Organization finds that one in five children are not receiving routine vaccinations against preventable diseases like measles, tetanus and diphtheria.

The report, ‘State of the World’s Vaccines and Immunizations’ (SOWV), shows that recent declines in child mortality rates are a direct result of higher immunization rates.

“Worldwide, measles death fell by 74 per cent between 2000 and 2007, and vaccinations played an important part in that decline,” said UNICEF Executive Director Ann M. Veneman. “Such progress must inspire new efforts to immunize children around the globe against life-threatening diseases.”

Gains from expanded coverage

As many nations worldwide confront the challenge of rolling out new vaccines against the H1N1 virus, SOWV underscores the prominent role of vaccination in preventing a range of communicable diseases.

In the past three decades, immunization against diphtheria, tetanus, pertussis, polio, measles and tuberculosis has become increasingly routine, saving an estimated 2.5 million young lives every year.

But improved access and cold chain control (the system to store and transport vaccines safely from manufacturers to recipients) are necessary to make further gains.

“Even in countries with high levels of coverage we do find pockets, large pockets sometimes, of children who are just completely excluded. And that reflects also that there may be groups of children… which are also excluded from the health system as a whole,” says UNICEF Chief of Health and Associate Director of Programmes, Dr. Mickey Chopra.

© UNICEF/NYHQ2009-0111/Uddin
At a storage facility in Bangladesh, a health worker displays a vaccine against five common childhood illnesses.

Funding gap for new vaccines

Rapid advances in vaccine technology in the past decade have led to the development of several new vaccines. Most significantly, vaccines against pneumococcal disease and rotovirus directly address the two leading causes of all child deaths.

Dr. Chopra calls these vaccines “wonderful,” but warns that a funding gap makes it a challenge to incorporate the new vaccines into national immunization programs in the places that need it most.

“There is a danger that care givers and mothers will believe that their children are fully immunized against pneumonia and diarrhoea… and we believe these vaccines will only cover 20 to 30 per cent of the cases of pneumonia and diarrhoea,” said Dr. Chopra.

UNICEF advocates scaling-up sensitization to behavioural prevention like handwashing and exclusive breastfeeding as key interventions in the fight against diarrhoea and pneumonia.

Vaccination is a child’s right

The challenge for UNICEF, which regards the provision of childhood immunizations as a basic right, is to ensure that funding for these vaccines is sustained.

© UNICEF/NYHQ2007-0467/Nesbitt
A health worker prepares to mark a child's vaccination card at a fixed immunization post in Isawa Town in Nigeria.

An estimated $1 billion per year will be needed to deliver new and existing vaccines to every child in the 72 poorest countries.

The report recognizes the roles of financing partnerships like the GAVI Alliance, which includes WHO, UNICEF, the World Bank and the Bill & Melinda Gates Foundation in reversing a downward trend in immunization rates. But ensuring that recent progress is sustained requires as much advocacy work as donor resources.

“Making a big push and getting immunization entrenched into health systems and policies and making communities and mothers aware that this is something their child has a right to can make this a sustainable intervention even when global attention may shift to other issues and diseases,” said Dr. Chopra.

UNICEF’s leading role

UNICEF is the world’s largest procurer of vaccines, supplying necessary vaccines to more than half of the world’s children. In 2007 alone, the organization bought 3.2 billion doses. In 2008, UNICEF bought 2.6 billion doses.

Significantly, increased demand has meant that manufacturers in developing countries are increasingly the dominant providers, meeting 86 per cent of the global demand for traditional vaccines.

The expanding market for affordable vaccines, combined with the boom in research and development, bodes well for future immunization goals. The 2009 SOWV report cites the potential for new vaccines against malaria, tuberculosis and AIDS within the next decade.




UNICEF Chief of Health and Associate Director of Programmes Dr. Mickey Chopra discusses the findings of the latest State of the World’s Vaccines report.
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