Infectious diseases are the leading cause of death among children globally and contribute substantially to disease and disability among persons of all ages. Immunization programs have been remarkably successful in preventing millions of childhood deaths, eradicating smallpox, and eliminating circulation of polio and measles from many countries around the world. However, substantial challenges remain. Many diseases for which safe and effective vaccines are available pose a continued burden, as does the underutilization of vaccines in most countries (e.g., pneumococcal, rotavirus, and HPV) and diseases for which vaccines are being developed (e.g., HIV, tuberculosis, and malaria). Globally mobile populations including refugees, and stateless and internally displaced persons are often difficult to reach and may not be included in national immunization programs. Achieving the United Nations’ Millennium Development Goals of reducing the under five year mortality rate by two thirds by 2015 will require substantive action, including increasing the proportion of one year-old children immunized against measles.
The goals of global vaccination are to control, eliminate, or eradicate infectious diseases in a way that strengthens health systems and is sustainable as new vaccines are introduced. Success in global immunization requires action by the full range of stakeholders involved in the vaccine and immunization enterprise: research and development, regulation and manufacturing, and program implementation and monitoring. New partnerships such as the Global Alliance for Vaccines and Immunizations have led to increased support for immunization worldwide, spurring introduction of new vaccines in low-income countries and expanded vaccination coverage. The U.S. government and NGOs have contributed to progress through vaccine research and development, participation in multilateral and bilateral partnerships, technical assistance, and program support.
Given the breadth of global immunization activities in Goal 5, some of the objectives and strategies relevant to this topic are included elsewhere in this Plan. For example, all vaccine research and development issues are included under Goal 1 because the approach and stakeholders necessary to achieve these objectives are largely the same in the United States and the rest of the world. Similarly, issues related to vaccine safety, communications, and program implementation are included under this goal, as well as under other goals of the Plan, as there are unique intellectual perspectives for them. While many of the objectives in these areas are similar for the U.S. and abroad, the strategies differ internationally because U.S. stakeholders focus on partnerships and providing assistance rather than on direct implementation.
In the era of global pandemics and mass travel, the public health of U.S. citizens is closely related to diseases occurring in other countries. Even though many vaccine-preventable diseases (VPDs) such as polio, measles, and rubella have been eliminated in this country, the U.S. remains vulnerable to importations as long as these diseases continue to persist elsewhere. Support for overseas (pre-departure) vaccination of mobile populations, including refugees and immigrants migrating to the United States, will reduce the likelihood of importation. Support for developing and introducing new vaccines to address diseases in other countries and assisting with strengthening and enhancing capacity of their immunization programs contributes toward providing an “umbrella of protection” for the United States and fulfilling the U.S. government’s broader commitment to global public health.
Meeting this commitment to support global immunization is also reflected in other federal public health initiatives and development initiatives beyond the Plan. The Global Health Initiative—currently led by the U.S. Department of State, U.S. Agency for International Development, and the Centers for Disease Control and Prevention (CDC), with active engagement of other agencies, including the Department of Defense, National Institutes of Health, and the Health Resources Services Administration—and the Food and Drug Administration’s global vaccine regulatory capacity-building efforts through the World Health Organization are two examples of federal initiatives that incorporate immunization as a component of a broad U.S. interest to improve maternal and child health. Additionally, the CDC has a Global Immunization Strategic Framework that focuses on how the agency will support immunization programs around the world. These and other initiatives are consistent with the objectives outlined in the Plan.
- Support international organizations and countries to improve global surveillance for VPDs and strengthen health information systems to monitor vaccine coverage, effectiveness, and safety
- Support international organizations and countries to improve and sustain immunization programs as a component of health care delivery systems and promote opportunities to link immunization delivery with other priority health interventions, where appropriate.
- Support international organizations and countries to introduce and make available new and underutilized vaccines to prevent diseases of public health importance.
- Support international organizations and countries to improve communication of evidence-based and culturally and linguistically appropriate information about the benefits and risks of vaccines to the public, providers, and policy-makers.
- Support the development of regulatory environments and manufacturing capabilities that facilitate access to safe and effective vaccines in all countries.
- Build and strengthen multilateral and bilateral partnerships and other collaborative efforts to support global immunization and eradication programs.
For more information on this goal and the defined set of strategies for achieving each objective mentioned above, view the National Vaccine Plan.