Immunization, Vaccines and Biologicals

Global Immunization Vision and Strategy: Questions and Answers

1. What is the Global Immunization Vision and Strategy ?

In response to challenges in global immunization, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF), in consultation with other partners, developed the Global Immunization Vision and Strategy (GIVS). GIVS is the first ever global ten-year framework to fight vaccine-preventable diseases through immunization and covers the period 2006 to 2015.

2. What is the vision presented in GIVS ?

GIVS aims for a world in 2015 in which:

  • immunization is high on all health agendas;
  • every child, adolescent and adult has equal access to immunization;
  • more people are protected against more diseases;
  • immunization and related health interventions are sustained under changing conditions;
  • vaccines exert the maximum impact on global health and security; and
  • equitable access to vaccines is guaranteed for all people by the global community.

3. What are GIVS’ strategic areas ?

The four key strategic areas are:

  • immunization of more people against more diseases;
  • introduction of a range of newly available vaccines and technologies;
  • integration of other critical health interventions with immunization; and
  • management of vaccination programmes within the context of global interdependence.

GIVS provides over two dozen strategies from which countries can choose for implementation, according to their specific needs.

4. What are the GIVS goals ?

GIVS sets a number of ambitious immunization goals which include ensuring that:

  • deaths due to vaccine-preventable diseases are reduced by at least two thirds compared to 2000 levels by 2015;
  • national vaccination coverage levels reach at least 90% and vaccination coverage in every district reaches at least 80% by 2010 or earlier; and
  • measles deaths are reduced by 90% compared to 2000 estimates by 2010 or earlier.

A report on the progress in implementing GIVS was made at the 2008 World Health Assembly. It highlighted improvements in routine immunization coverage, the introduction of new vaccines and the reduction in measles deaths. It also outlined further efforts needed. In addition, governments present at the Assembly reaffirmed their commitment to achieving the GIVS goals.

5. Where does global immunization now stand ?

  • Immunization currently averts between 2 and 3 million deaths annually in all age groups from diphtheria, tetanus, pertussis (whooping cough), and measles. Hepatitis B vaccination prevents an additional 600 000 future deaths from liver cirrhosis and liver cancer annually.
  • Global immunization coverage (as measured by estimates of delivery of three doses of diphtheria-tetanus-pertussis or DTP3) was estimated at 81% in 2007, its highest level ever. Out of about 129 million annual surviving infants, 105 million children under the age of one were vaccinated with DTP3.
  • The incidence of polio across the world has been reduced by at least 99% since 1988. Three regions ― the Americas, Europe and Western Pacific ― are certified polio free.
  • Global measles deaths dropped by 74% between 2000 and 2007, from an estimated 750 000 to 197 000.
  • But in spite of progress, much remains to be done. Worldwide, about 24 million children under one year of age did not receive DTP3 in 2007. Seventy-three percent of these children live in ten countries: Bangladesh, China, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Niger, Nigeria, Pakistan and Uganda.

6. What challenges face immunization today ?

  • vaccinating more people with existing and new vaccines especially where health systems and infrastructure are weak;
  • obtaining long-term financing to introduce new vaccines;
  • meeting increasing demand for immunization; and
  • reducing vulnerability to epidemics and other health emergencies.

7. How much will GIVS cost and who will pay for activities carried out under it ?

A WHO/UNICEF study examined the cost, financing and impact of childhood immunization programmes in low-income countries. It estimated the total cost for immunization activities for the period 2006-2015 in these countries at US$ 35 billion. This figure was updated to US$ 29 billion in January 2009.

Several funding mechanisms have been established to support low-income countries to strengthen and sustain national immunization programmes and to ensure reliable global supply of quality vaccines. For example, the GAVI Alliance is a public-private partnership which promotes large-scale immunization in the poorest countries of the world. It supports the introduction of new and underused vaccines, improvements in injection safety and strengthening health systems that deliver routine immunization services.

Immunization programmes are benefiting from resources generated through the International Finance Facility for Immunization (IFFIm), an innovative financing mechanism. A number of donor countries are supporting the IFFIm with an anticipated total investment of approximately US$4 billion. The world’s return on this investment includes not only lives saved, but also increased productivity and reduced poverty leading to stronger economies.

8. What will be the human and economic returns of the investment in GIVS activities ?

Significant returns are expected as a result of GIVS, especially in fulfilling the United Nations Millennium Development Goal Four Reduce Child Mortality (MDG4) which aims to reduce under-five mortality by two thirds by 2015. Immunization is one of the most cost-effective public health investments and could be preventing 4-5 million child deaths per year by 2015.

9. Who was involved in the development of GIVS ?

GIVS was presented and discussed at WHO and UNICEF meetings at global, regional and country levels, as well as during meetings with governments and immunization partners including: Australian Aid, Canadian International Development Agency, Centers for Disease Control and Prevention of the United States Health and Human Services Department, United Kingdom Department for International Development, Ministry of Foreign Affairs of France, Bill & Melinda Gates Foundation, GAVI Alliance, Government of the Netherlands, Norwegian Agency for International Development, Programme for Appropriate Technology in Health, Federation of Red Cross and Red Crescent Societies, United Nations Foundation, United States Agency for International Development, World Bank and WHO’s Strategic Advisory Group of Experts on Immunization.

Last updated: 18 February 2009