EXPANDED PROGRAM ON IMMUNIZATION - RESULTS AND PERSPECTIVES

The expanded program on immunization, jointly launched by WHO and UNIC EF in 1974 aimed in the beginning at immunizing 80 % of the Children o f the world against measles, tetanus, pertussis, poliomyelitis, diphth eria and tuberculosis. After reaching the objectives in 1990, countrie s have been urged towards eradication of poliomyelitis, elimination of neonatal tetanus, and measles control. Immunization against hepatitis B and yellow fever were also proposed according to local epidemiology . Tremendous results have been already delivered: the American contine nt has eliminated poliomyetitis since August 1991, it has reduced dram atically the incidence of measles. All the countries, including those from Africa, are organizing campaigns aiming at polio eradication. Act ive surveillance systems have been implemented. But financial and oper ational constraints persist, linked to vaccines prices, their heat sen sitivity, injection techniques, and to the sterilisation and waste dis posal. Major efforts are still needed.