Immunization, Vaccines and Biologicals

'Game changers' needed if global immunization targets are to be reached

SAGE participants seated around the meeting room
WHO/C. Scudamore

The strategy to eradicate the remaining strains of wild poliovirus was discussed at length during the meeting of WHO's Strategic Advisory Group of Experts on immunization (SAGE) held from 8-10 November in Geneva.

Reviewing the latest global epidemiology, SAGE expressed alarm that the risk of failure to finish global polio eradication constitutes a programmatic emergency of global proportions for public health, and was not acceptable under any circumstances. Failure, SAGE warned, would lead to a major resurgence of the disease with many children crippled for life again every single year. At the same time, it would also represent the most expensive public health failure in history, with far-reaching consequences on overall global immunization efforts, seriously undermining the credibility of public health efforts with donors and stakeholders.

SAGE urged that rapid steps be taken to tighten accountability for programme and individual performance within governments as well as implementing and donor agencies, to ensure that more children are reached during eradication strategies and that the effort is fully financed. "There must be consequences at all levels for individuals, institutions and governments who fail to deliver on their mandate," SAGE reported.

Given the ongoing international spread of poliovirus from infected areas, SAGE encouraged the application of appropriate vaccination recommendations for all travelers to and from polio-infected areas. At the same time, SAGE stressed that communities and civil societies must be engaged and mobilized to put pressure on governments to ensure that they remain committed to the disease's eradication. SAGE recommended that polio-infected countries be requested to submit an annual progress report to the World Health Assembly.

SAGE reviewed the draft Decade of Vaccines Global Action Plan and asked the drafting team to pull out a few critical 'game changers' which if implemented would move the immunization field into a new era of activity and high impact. SAGE will reconvene in February 2012 to review the Decade of Vaccines Action Plan for submission to the 2012 World Health Assembly.

Other topics discussed during the meeting included the negotiations around the legally binding instrument on mercury and thiomersal containing vaccines; Global Vaccine Safety Blueprint; monitoring national immunization coverage and reinforcing surveillance; optimizing immunization schedules for conjugate pneumococcal vaccines; progress of tuberculosis vaccine candidate trials and use of hepatitis A vaccines.

The report of the meeting will be published in the WHO Weekly Epidemiological Record on 6 January 2012. The meeting documents ― including presentations and background readings ― can already be found on the web at:

Last updated: 15 November 2011