The Road Ahead

Seth Berkley, MD
Chief Executive Officer, The GAVI Alliance

The last decade has seen remarkable progress in global immunization, huge strides which have and are continuing to transform the health, lives, and futures of millions of families around the world.  Global immunization rates have risen from 73 percent in 2000 to 83 percent, with the largest increases coming from low-income countries, and the total number of unimmunized children has fallen from 32.9 million to 22.6 million over the same period.  But while such advances are to be applauded, it would be a mistake to confuse progress with job done.

In terms of the scale of what needs to be done, the reality is that we have only just begun, and considerable challenges still lie ahead.  For, while increases in immunization coverage are cause for celebration, they merely represent the number of children in receipt of their third dose of diphtheria-pertussis-tetanus (DPT) vaccines, the current gauge for routine immunization.  Yet when you factor in the number of children that are fully immunized with the range of World Health Organization (WHO)-recommended vaccines a very different picture starts to emerge.  WHO recommends that every child receives 11 antigens—Bacillus Calmette-Guérin vaccine, DPT, measles, polio, hepatitis B, Hib, pneumococcal, rotavirus and rubella—but currently only five per cent of children are fully immunized in this way.

Organizations like my own, the GAVI Alliance, are making some headway by moving beyond the DPT model and introducing more effective vaccines like the 5-in-1 pentavalent vaccine which combines DPT with hepatitis B and Hib.  And besides providing the world’s poorest children with better access to a broader range of vaccines, we are also finding ways to shorten the time it takes for new vaccines to reach them.  Recently-introduced vaccines such as pneumococcal and rotavirus vaccines protect against the two diseases that kill more children in developing countries than any others.  We are also expanding beyond children.  Cervical cancer now rivals childbirth as a cause of death in young women.  This year developing countries began exploring the addition of HPV to their vaccination program for girls from 9–11 years old.  

But if we are to ever see every child on this planet fully immunized then we need to do more.  Through global collaborations we can secure adequate resources for immunization, develop supportive health systems and infrastructure and work with countries to train health workers, all of which will help maximize the benefits of vaccines around the world for years to come.  Indeed, this is the goal of the Decade of Vaccines Collaboration.  Through the development of the Global Vaccine Action Plan, the Decade of Vaccines aims to find new and effective ways to stimulate the discovery, development and delivery of lifesaving vaccines.  Through global collaborations, we now have the opportunity to extend, by 2020 and beyond, the full benefits of immunization to all people, regardless of where they are born, who they are, or where they live thus saving lives, reducing morbidity and allowing children around the world to grow to their full potential.


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