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220 Fighting the Diseases of Poverty
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Accelerate the development and introduction of new vaccines
and technologies
Accelerate research and development efforts for vaccines
needed primarily in developing countries
Make immunization coverage a centerpiece in international
development efforts
As we will see part 2 of the paper, such an initiative is urgently
needed.
A difficult present
Lost momentum
The rapid progress towards universal vaccination coverage in the
1970s and 1980s has slowed in recent years.
Decliningfundingforimmunizationhasbeenmirroredinstagnating
or falling coverage. UNICEF funding for vaccination fell from $182
million to $51.4 million between 1990 and 1998 (Gauri, 2002). Global
coverage of the diphtheria, tetanus, and pertussis (DTP3) vaccine has
stalledataround74percentsince1990(GAVI,2003).Fifty-sevendeveloping
countries have yet to eliminate neonatal tetanus, and 200,000
babies died of the disease in 2000 (WHO, 2002). Yellow fever has made
a comeback, despite the availability of an effective vaccine; the
number of outbreaks increased sharply after governments curtailed
programs in the belief they had vanquished the disease (GAVI, 2001).
Developing countries lag behind the West in terms of vaccination
coverage. Measles immunization rates are over 90 per cent in
Europe but below 70 per cent in South Asia and below 60 per cent
in Sub-Saharan Africa (see figure 1) (World Bank, 2004). Ten developing
countries reported cases of polio in June 2005, despite the
massive (and largely successful) global effort to eradicate the virus
(WHO, 2005). Sixty-two per cent of countries, meanwhile, had still
not achieved full routine immunization coverage in 2003, with GAVI
estimating that at least 9.2 million additional infants need to be
reached to achieve full coverage (GAVI, 2003).