Vaccinations in the health strategies of developing countries.

The initiative established by the World Health Organization in 1974 under the title of the Expanded Programme on Immunization (EPI) has resulted in immunization programmes being strengthened in developing countries so that they now cover 66% of children reaching their first birthday with a dose of DPT or polio vaccines. Immunization programmes are currently preventing over 2 million deaths among children in developing countries from measles, neonatal tetanus and whooping cough. Future challenges for the EPI include: raising and sustaining immunization coverage; controlling the target diseases, with specific focus on the control of measles, the elimination of neonatal tetanus and the eradication of poliomyelitis; introducing new or improved vaccines; promoting other primary health care practices; and research and development. Immunization will become an increasing priority for developing and industrialized countries alike as an increasing array of vaccines become available for public health use. Further research to simplify and reduce the costs of vaccine production and administration and to better understand the factors contributing to the acceptability of immunization services is needed as a complement to research to develop additional vaccines.