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The value of vaccination 221
Figure 1 Disparities in immunization rates
% of children (12–23 months) immunized
100
80
Europe and
Central Asia
South Asia
Sub-Saharan Africa
60
40
20
0
DPT
Measles
Source: World Bank, 2004
There are several factors behind this loss of momentum. First,
although dramatic progress has been made in increasing worldwide
vaccination coverage from below 5 per cent to above 70 per cent,
the task has inevitably become harder now that the easiest-to-reach
populations have been vaccinated. Many of those whom campaigns
have not yet reached are either living in inaccessible areas, out of
range of clinics and health services, or reluctant to be vaccinated or
to vaccinate their children. Because these communities are more
elusive, the average cost per vaccination has increased, and it may
be that other apparently cheaper health interventions have become
more attractive.
Second, there are many practical problems impeding vaccine
delivery. Delivering vaccines to patients requires functioning
freezers and refrigerators (which in turn require a constant supply
of energy); good roads and reliable transport to move the vaccines
from port to clinic; clinics with access to people who need to be