Immunization – towards the ultimate goal of universal coverage
Vaccines have proven to be the most cost effective public health tool in the fight against infectious diseases. Globally, immunization is estimated to avert between two to three million deaths each year. In the last decade, great advances have been made in developing and introducing new vaccines and in expanding the reach of immunization programmes in the African Region. More people than ever before are being vaccinated, and access to vaccines by age groups other than infants is expanding.
Immunization against vaccine-preventable diseases is essential to reaching the Millennium Development Goal 4 on reducing under-five mortality by two thirds by 2015. Data from the African Health Observatory illustrates the progress achieved on this area.
The WHO battle over immunization started decades ago, with initiatives like the Expanded Programme on Immunization, which has now reached 40 years [video], and many others. In the African Region, the African Vaccination Week [video in English French or Portuguese] and other important initiatives have proved to be crucial in scaling up the immunization efforts.
All these efforts have resulted in significant improvements in the African Region:
There has been a significant decrease in the number of wild poliovirus cases (WPV) in the Region, which is close to attaining the ultimate goal of eradication. As of 31 December 2014, the number of confirmed polio cases due to WPV infection in the remaining endemic reservoir in the Region, Nigeria, declined by nearly 88% from 2013 to 2014. As at week 52, 2014 there were 17 WPV cases compared to 75 in the same period in 2013.
In 2013, a total of 87.8 million children received measles vaccination through supplementary immunization activities in 16 countries. Through these efforts, the African Region achieved 88% reduction in estimated measles deaths between 2000 and 2012.
The development and roll-out of the meningitis A conjugate vaccine in the ‘meningitis belt’ of Africa represents one of the great public health achievements in the Region. More than 217 million people in 15 countries in the Region have been vaccinated since its introduction in 2010, and no confirmed case of meningitis A has been identified among the vaccinated populations.
New and increasingly sophisticated vaccines, such as pneumococcal conjugate vaccines, rotavirus vaccines and human papilloma virus vaccines have become available in the last decade. Several countries in the Region are introducing these new vaccines into their routine immunization services. The collection, analysis and interpretation of surveillance data are vital to guide vaccination policies and programmes and make informed decisions. In recent years, considerable progress has been made in establishing systems to monitor coverage rates, trends and impact of vaccination on vaccine-preventable diseases. These efforts must continue, as more and more countries in the Region have introduced dedicated budgets for immunization and are developing multi-year national plans to sustain the gains achieved.
One of the significant developments in the field of immunization is the Global Vaccine Action Plan 2011–2020 (GVAP), endorsed by the World Health Assembly in 2012, which sets out a strategy for preventing childhood disease through vaccination. To foster its implementation in the African Region, the Sixty-fourth session of the Regional Committee for Africa endorsed, in resolution AFR/RC64/R4, the Regional Immunization Strategic Plan 2014–2020, which provides policy and programmatic guidance to Member States, in line with the GVAP.
Despite these and other success stories, many challenges remain to be addressed. Coverage gaps persist among countries, as well as within countries. Particular efforts are needed to reach the underserved, especially those in remote areas, deprived urban settings, fragile states and strife-torn regions.
Useful resources and links
25 diseases that can be prevented by vaccines (poster)
Global vaccine action plan 2011–2020 (available in English and French)
Immunization monthly update in the African Region
Progress report on the African Regional immunization strategic plan 2009–2013 (AFR/RC63/14)
TechNet-21, the technical network for strengthening immunization services
World Immunization Week poster toolbox: Immunize for a healthy future
African Vaccination Week website