Global immunization through the lens of development.

Abstract

Supporting global immunization programs is a profound way to control disease and improve the lives of many, particularly in the developing world. In 1974, the World Health Organization (WHO) created the Expanded Programme on Immunization (EPI), a worldwide effort mobilized to help countries increase immunization coverage of basic childhood vaccines—diphtheria, measles, pertussis, polio, tetanus, and tuberculosis—using the third dose of diphtheria, tetanus, and pertussis (DTP3) as a measure of progress. Building on the historical success of smallpox eradication, the WHO sought to increase global vaccination coverage (which was <5% in 1974) among children younger than one year of age. However, one-fifth of the world's children, especially those who live in low-income countries, are not fully vaccinated with these traditional vaccines during their first year of life.1 The Global Vaccine Action Plan (GVAP) for 2011–2020 has established immunization coverage targets of at least 90% DTP3 coverage nationally and at least 80% DTP3 coverage in every district.2 Countries can take a variety of actions to attain these targets, depending on their needs and the current status of their health system and immunization program. This year, on the 40th anniversary of EPI, through the collective work of many partners, we are witnessing a time of unprecedented support and commitment to ending preventable child and maternal deaths within a generation, a top priority of the U.S. Agency for International Development (USAID). In this Decade of Vaccines,2 we join global efforts to extend the full benefits of immunization to all people, regardless of where they are born, who they are, or where they live. And USAID continues its long-standing partnership with the U.S. Department of Health and Human Services (HHS) and other actors on the global stage. Our work as a development agency contributes to global efforts outlined in this report by the National Vaccine Advisory Committee (NVAC) Global Immunizations Working Group, “Enhancing the Work of the Department of Health and Human Services National Vaccine Program in Global Immunization: Recommendations of the National Vaccine Advisory Committee.”3 The challenges and recommendations in the report highlight holistic approaches to technical and financial investments in health as well as increased coordination among the partnership of actors. We support these efforts, particularly through a developmental lens, emphasizing support to national governments toward investing in health, immunization programs, and human and institutional resources.