Deficiencies in Immunization Campaigns Highlighted in New UNICEF Report

By Gottlieb, Scott | Bulletin of the World Health Organization, August 2000 | Go to article overview

Deficiencies in Immunization Campaigns Highlighted in New UNICEF Report


Gottlieb, Scott, Bulletin of the World Health Organization


Despite considerable progress in recent years, immunization programmes aimed at eradicating diphtheria, pertussis, tetanus and poliomyelitis are still failing to reach millions of children, leaving many at risk of catching these killer diseases.

A United Nations Children's Fund (UNICEF) report into children's welfare published in July warns that despite the success of worldwide vaccination drives, much work remains to be done. In particular, the Progress of Nations report says that the widespread use of diphtheria-tetanus-pertussis vaccine (DTP) is still lagging behind the organization's goals in dozens of developing countries, many of them in Africa.

Among its efforts, UNICEF has set about an ambitious agenda to eradicate poliomyelitis by the end of this year and obtain final certification to confirm elimination by 2005. Despite the organization's programmes, the report makes clear that these and similar tasks will not be easily achieved.

For example, there are still 30 million infants in the developing world who are not immunized before their first birthday, according to the report. Annually, 370 000 children under the age of five years die from whooping cough and another 50 000 die from tuberculosis. More than half of all pregnant women are not immunized against maternal tetanus, which kills 30 000 women every year.

The report says that half of the infants born in developing countries are unprotected against tetanus and 200 000 die from the disease each year because their mothers have not been immunized with tetanus toxoid. Whooping cough still afflicts 20-40 million people every year, primarily in developing countries, although a pertussis vaccine has been available for more than 70 years.

A large part of the problem is related to inadequate funding. While DTP can be easily prevented by immunizing women of childbearing age, the vaccine is still not available in some countries. In the Democratic Republic of Congo, only one child in ten receives the necessary three doses of DTP. According to the report, there are 17 countries in which there is no state funding for any common childhood vaccines. Overall, UNICEF said that more low-income countries are spending more money on immunization but it is still not enough.

UNICEF has set a goal of immunizing 90% of children in all countries for DTP by the end of 2000. So far, 40 developing countries and many industrialized countries have done extremely well, attaining or exceeding the 90% coverage goal. In addition, three countries in sub-Saharan Africa have also attained the 90% goal. On average, however, only about half of the children in sub-Saharan Africa are protected. …

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