Communicable diseases in the CCEE/NIS.

The European Region is passing through a period of rapid transition with the most dramatic changes in the CCEE and NIS. The provision of adequate vaccine supplies has become a priority for many Member States in their efforts to sustain immunization activities. The Regional Office has therefore launched a special programme on vaccines for CCEE/NIS. New operational targets for the Expanded Programme on Immunization (EPI) in Europe in the 1990s were established by the European Advisory Group in 1993. These operational targets highlight the steps countries need to follow to achieve the European target 5. Immunization coverage generally remains high and stable in the Region. In 1990-1992 pockets of non-immunized individuals in different countries led to out-breaks of disease. Currently, the low coverage with DPT(DT vaccines in many provinces of the Russian Federation is one of the reasons for the epidemic of diphtheria that has affected the country since 1990. Despite the difficulties experienced by many CCEE and NIS, progress has been observed. Morbidity from poliomyelitis declined during 1990-1993. There remain only a few hot spots with endemic transmission of wild poliovirus: the Balkans, trans-Caucasus and central Asia. The diphtheria situation deteriorated in 1990, becoming increasingly dramatic in 1992 and 1993. Almost all cases have been reported from the Russian Federation and the Ukraine. Increasing diphtheria morbidity has been observed in Belarus, Kazakhstan and Uzbekistan.