The mandate of the Department of Vaccines and Biologicals (V&B) is predominantly that of building routine and supplementary immunization services, supporting laboratory networks, and to assuring a sufficient supply of potent vaccines. The programme is not primarily geared to respond to emergencies.

Nonetheless, V&B may be called upon to react to two different types of emergency situations:

• an outbreak of a vaccine-preventable disease included in the immunization schedule,

or,

• a man-made or natural disaster which is the potential setting for an outbreak of a vaccine-preventable disease.

In the first category, an outbreak of a vaccine-preventable target disease can generally be considered a failure (for whatever reason) of the existing infrastructure of a country. It may indicate a failure to have achieved sufficiently high immunization coverage levels to prevent the outbreak from occurring.

In the second category, extremes of overcrowding alter the transmissibility of diseases and increase the likelihood of an outbreak. Urgent action may be needed to prevent an outbreak of, for instance, measles or cholera, or to react quickly following reports of an outbreak starting in a camp situation.

Although V&B focuses primarily on routine services, there are certain functions undertaken by the programme either on a regular basis or from time to time which are either preparing for emergencies or responding to them. While any target disease could potentially create an emergency situation, diphtheria, measles, meningitis, polio, neonatal tetanus and yellow fever have all generated an emergency for the programme over the last decade.

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