|Immunization Policy, 1996 (WHO - OMS, 1996, 63 p.)|
The first edition of the EPI document Immunization Policy was published almost a decade ago (EPI 1986) and has been used extensively as a basis for immunization programmes throughout the world. At that time, many programmes were in the early stages of development and global goals referred to the achievement of coverage targets. Since then, the EPI has changed its focus to the control or elimination of major childhood diseases, and new vaccines have become available, while yet others are being developed. In May 1989, the Forty-second World Health Assembly set the agenda for the EPI in the 1990s. Challenges included the reduction of measles incidence and elimination of neonatal tetanus by 1995, global eradication of poliomyelitis by the year 2000, and the achievement of 90% immunization coverage for all vaccines by the year 2000. These challenges were reinforced in the Declaration on the Survival, Protection, and Development of Children, which was endorsed at the World Summit for Children held at the United Nations in September 1990 (World Summit Child 1990).
Immunization programmes in different countries now present a broad spectrum of progress. Some countries, particularly the poorest and those affected by war or civil disturbance, continue to have low immunization coverage, while others are close to eliminating certain of the target diseases. This indicates a need for policy-making at the national level, in response to the local epidemiology of disease and in accordance with national infrastructure of health services. However, general recommendations on immunization will continue to form a wider framework for policy-making and will be of direct use in countries with limited experience in policy-making.
This document provides a review of present immunization policies recommended by WHO/EPI. Special emphasis has been devoted to principles and topics which are new, have changed since 1986, or are considered controversial. Other EPI documents such as EPI for the 1990s (EPI 1992a), Revised Plan of Action for Global Measles Control (EPI 1993b), Plan of Action - Global Poliomyelitis Eradication by the year 2000 (EPI 1992b) and The Immunological Basis for Immunization (EPI 1993c) may be helpful. Reports from the annual Global Advisory Group meetings also provide information on immunization policy. Other publications review EPI vaccines and the immunization schedules used in various countries (Cutts and Smith 1994, Dudgeon & Cutting 1991, Plotkin and Mortimer 1988, Modern Vaccines 1990).