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Analytical summary - Immunization and vaccines development

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Four million unnecessary deaths occur annually from diseases for which vaccines are available. The root of this problem is distribution and supply systems on the one hand, and the difficulty of accessing hard-to-reach and mobile populations on the other. Despite much progress, goals are not yet reached and the absolute numbers of those not consistently immunized remain high. One mechanism adopted to readdress the situation is a strong focus on district-level immunization.

Approaches to improving routine immunization include:

  • prioritizing countries with the largest numbers of non-immunized or under-immunized children
  • using the district-level approach
  • improving data for programme monitoring
  • introducing new vaccines as appropriate
  • enhancing training of health staff
  • resource mobilization.

However, while governments are spending more on buying vaccines, expenditure on routine immunization implementation appears to have changed little over the past 10 years.

Percentage of neonates protected at birth against neonatal tetanus in the WHO African Region, 1990 and 2009
The drive to polio eradication continues, on the understanding that with stronger political and financial commitment, eradication is feasible. The majority of African countries have surveillance systems for measles in place, although large measles outbreaks have occurred in several countries owing to non-immunization of infants.

In general, weak national health systems and fluctuating availability of vaccines produce gaps in immunization coverage. Coupled with funding shortages, these problems continue to challenge successful delivery of immunization programmes in African countries. One review noted that:

  • vaccine stock-outs were affecting some countries;
  • health facilities were found to be inadequately equipped and staffed;
  • gaps were identified in the areas of immunization safety and waste management.

These issues need to be addressed if current initiatives to enhance research capacity at country level in respect of new vaccines development are to play their expected role in reducing vaccine-preventable disease.