WHO and UNICEF give hope
The World Health Organization (WHO) estimates that 2 million child deaths were prevented by vaccinations in 2003. Nonetheless, more deaths can be prevented through optimal use of currently existing vaccines. It is against this background that WHO and UNICEF have launched the strategy to be implemented during 2006-2015.
In 2005, WHO and UNICEF worked with partners to create a Global Immunization Vision and Strategy (GIVS) for 2006-2015.This strategy, which seeks to expand the reach of vaccination to every eligible person, is intended to be used as the basis for developing national comprehensive multiyear plans. GIVS articulates the WHO and UNICEF visions for global immunization in 2015 and is composed of four strategic areas: 1) protecting more persons in a changing world by improving routine immunization coverage, ensuring at least four immunization contacts per child, and expanding immunization programs to all ages; 2) introducing new vaccines and technologies; 3) integrating immunization, other linked health interventions, and surveillance in the health systems context; and 4) creating global partnerships to support and finance immunizations. GIVS calls for raising global immunization coverage for these common diseases to at least 90 per cent in every country over the next five years.
Each year these diseases kill more than a million children worldwide. Immunization is a cost-effective intervention which can put an end to these needless deaths. GIVS is the first ever strategic framework for immunization designed to respond to the challenges of a rapidly changing and increasingly interdependent world. It presents a wide range of initiatives which countries can choose from to address their own specific needs. UNICEF and the WHO say the objectives outlined in the strategy must be addressed if the world is to achieve the Millennium Development Goal of a two thirds reduction in mortality among children under five by 2015.
GIVS places special emphasis on the poorest and most underserved areas, where the majority of child deaths occur. GIVS, which addresses the time period 2006-2015, was discussed and officially endorsed at the World Health Assembly in Geneva, in May 2005.
Vaccine-preventable diseases kill more than 2 million people every year, two-thirds of whom are young children. GIVS will work to support and improve child health and survival through the delivery of a package of key health interventions, such as nutrition and insecticide-treated nets (ITNs) against malaria, at the point of immunisation, especially for hard-to-reach populations. "One in four children is still deprived of lifesaving vaccines that should be within reach," said UNICEF Executive Director Ann M. Veneman.
The GIVS strategic framework on immunisation presents a range of strategies (24 in total; divided into 4 thematic areas) from which countries are invited to select those most suited to their needs. Key themes underriding these strategies are global partnership and the power of information and communication technologies (ICTs) and the mass media to spread vaccine-related information and correct misconceptions.
"The strategic approaches are: protecting more people in a changing world; introducing new vaccines and technologies; integrating immunization, other health interventions and surveillance in the health systems' context; and immunizing in the context of global interdependence. Immunization and the other linked interventions described will contribute significantly to the achievement of the Millennium Development Goals, the immunization-related goals set by the United Nations General Assembly special session on children in 2002, and the goals set by the Global Alliance for Vaccines and Immunization and its financing arm the Vaccine Fund.
They will also help Member States, as urged in resolution WHA56.19, to increase vaccination coverage against influenza of all people at high risk. In today's increasingly interdependent world, acting together against vaccine-preventable diseases of public health importance and preparing for the possible emergence of diseases with pandemic potential will contribute significantly to improving global health and security...
In response to immunization needs worldwide, global partnerships, such as the Global Alliance for Vaccines and Immunization, The Vaccine Fund, and the Measles Partnership, have been created in order to attain shared goals. Such partnerships bring together major stakeholders in immunization from the public and private sectors, including the vaccine industry. Initiatives for eradication of poliomyelitis, reducing measles mortality and elimination of maternal and neonatal tetanus have shown that partnerships enable immunization services to be brought to even the most hard-to-reach communities."
Immunization is among the most successful and cost-effective public health interventions. Immunization programs have led to eradication of smallpox, elimination of measles and poliomyelitis in regions of the world, and substantial reductions in the morbidity and mortality attributed to diphtheria, tetanus, and pertussis.
By convention, the success of routine immunization programs in reaching children has been measured by the vaccination coverage achieved with the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) among children aged 12-23 months. WHO and UNICEF base estimates of routine vaccination coverage for all diseases (including DTP3) on review of administrative coverage data, surveys, national reports, and consultation with local and regional experts. Prevention of hepatitis B virus infection is assessed by vaccination coverage with the third dose of hepatitis B vaccine (HepB3) among children aged 12-23 months. As of 2004, a total of 153 (80%) of 192 WHO member states were using the vaccine. Of these 153 countries, 102 (67%) had HepB3 coverage of ≥80%, 36 (24%) had coverage of <80%, and 15 (10%) either had not reported coverage data or had not introduced the vaccine nationwide. Overall vaccination coverage with HepB3 is increasing and had reached 48% of WHO member states in 2004 .
Prevention of Hib infection also is assessed by vaccination coverage with the third dose of the vaccine (Hib3). Ninety-two (48%) of the WHO member states have introduced Hib vaccine since 1986; in 2004, a total of 78 (85%) reported Hib3 coverage of ≥80% among children aged 12-23 months.