Harare -- The World Health Organization Regional Office for Africa has developed a strategy aimed at accelerating implementation of the Expanded Programme on Immunization (EPI) activities over three years (2003-2005) in order to improve the health of children in the African Region. 
The strategy proposes a number of interventions and outlines the roles of Member States, WHO and other development partners in implementing the strategy designed to reduce morbidity, disability and mortality due to vaccine-preventable diseases. These diseases cause an estimated 1.1 million deaths annually in the African Region.

The objectives of the acceleration are: to optimize the delivery of sustainable, quality immunization services; to speed up efforts to achieve polio eradication, measles control, neonatal tetanus elimination and yellow fever control, and to quicken the pace of the introduction of new vaccines and appropriate technologies into national immunization programmes in a sustainable manner.

Health Ministers attending the 52nd session of the WHO Regional Committee for Africa taking place from 8 to 12 October in Harare, Zimbabwe, Congo, are expected to discuss and endorse the strategy which also sets targets for achieving its objectives.

Among these targets are that by 2005:

•  the process of independent certification of polio-free status will lead to full regional certification; 

• 100% of immunization injections used in all countries will be safe;

• all countries will be able to sustain financing of EPI, particularly by increasing government funding through a budget line for vaccines and immunization in the national health budget; 

• all countries at risk of yellow fever increase yellow fever immunization coverage to at least 80%, and conduct emergency response for all confirmed cases of yellow fever within three days following laboratory confirmation;  

•  at least 80% of the countries will attain a minimum coverage of 80% of the three-dose diphtheria/pertussis/tetanus vaccine (DPT3) in all districts;

• at least 80% of the countries will attain a neonatal tetanus incidence rate of less than one case per 1,000 live births in every district; 

• at least 80% of the countries will attain a minimum of 80% female Tetanus Toxoid coverage among pregnant women in every district; 

• countries with low routine measles coverage ( below 50%) and presumed high mortality (Case Fatality Rate of above 4%) will reduce measles morbidity by 90% ,and measles mortality by 95% (in comparison with pre-vaccine era figures); 

• countries with moderate measles routine coverage (between 50%-75%) and presumed low/medium mortality (Case Fatality Rate of between 0.5% and 4%) will reach and maintain near zero measles mortality; 

• countries with high routine measles coverage (more than 75%), and presumed low mortality (Case Fatality Rate of below 0.5%) will eliminate indigenous transmission of the measles virus; 

• increase routine yellow fever immunization coverage to at least 80%; 

• half of the countries in the Region will be supported to include Haemophilus influenzae type B vaccine.

The strategy also envisages that by 2003:

•  there would be no cases of acute flaccid paralysis due to the wild poliovirus in the Region;  

•  all countries will adopt auto-destruct syringes or any equally safe injection technologies (such as UNIJECT) for all immunization injections, and 

•  all countries will have been supported to include the hepatitis B vaccine in their national immunization programmes. 

To achieve its objective, the strategy recommends major interventions such as the strengthening of the immunization systems, including the quality of immunization delivery in Member States; accelerated disease control (including polio eradication, neonatal tetanus elimination, measles and yellow fever control, prevention of vitamin A deficiency), acceleration of the introduction of new vaccines, new policies and technologies; strengthening EPI disease surveillance and strengthening laboratories to support surveillance services.

The strategy recommends: enhanced political commitment to achieving set goals at country level; the promotion of sustainable advocacy, communication and social mobilization; the development of national and district level planning; the development of mechanisms for EPI partners and acceleration of training and capacity building at country level.

On the role of countries, it recommends that Member States should own the acceleration process, strengthen human capacity, and mobilize financial resources for national immunization programmes, with greater emphasis on improving the quality of service delivery and coverage in each district. Countries will coordinate the activities of partners in this process.

It says that while WHO would provide technical support to countries, whenever it is needed, for the implementation, monitoring and evaluation of EPI the Task Force on Immunization (TFI) would be the forum for the coordination of partner support. More partners will be encouraged to join the TFI and invest more in EPI.

If this plan if followed, says the strategy paper, by 2005 Member States are expected to achieve certification of polio eradication; eliminate neonatal tetanus; control measles and yellow fever and introduce new vaccines in a sustainable manner and generally reach higher levels of routine immunization coverage (measured by 80% DPT-3 coverage in each district) for all EPI antigens. 

Public Information and Communication Unit
World Health Organization - Regional Office for Africa
P.O. Box 6 Brazzaville, Congo. 
Tel: + 1 321 953 9378; Fax: 1 321 953 9513 
In Harare: Mobile 091 231 405