Full text PDF - International Policy Network

The value of vaccination 221Figure 1 Disparities in immunization rates% of children (12–23 months) immunized10080Europe andCentral AsiaSouth AsiaSub-Saharan Africa6040200DPTMeaslesSource: World Bank, 2004There are several factors behind this loss of momentum. First,although dramatic progress has been made in increasing worldwidevaccination coverage from below 5 per cent to above 70 per cent,the task has inevitably become harder now that the easiest-to-reachpopulations have been vaccinated. Many of those whom campaignshave not yet reached are either living in inaccessible areas, out ofrange of clinics and health services, or reluctant to be vaccinated orto vaccinate their children. Because these communities are moreelusive, the average cost per vaccination has increased, and it maybe that other apparently cheaper health interventions have becomemore attractive.Second, there are many practical problems impeding vaccinedelivery. Delivering vaccines to patients requires functioningfreezers and refrigerators (which in turn require a constant supplyof energy); good roads and reliable transport to move the vaccinesfrom port to clinic; clinics with access to people who need to be