Strengthening the Expanded Programme on Immunization in Africa: Looking beyond 2015

Thursday, 21st of November 2013 Print
[source]PLoS Medicine[|source]

Since 1974 when the global EPI program was launched, there have been several international efforts to increase EPI coverage, including Universal Childhood Immunization. GAVI, MDG, Decade of Vaccines and Global Vaccine Action Plan goals coupled with specific regional efforts such as the WHO African Region,s EPI strategic plans of action, and the Reach Every District (RED) approach s well as the efforts of national EPIs, have seen global coverage reach record highs. Global coverage of the 3rd dose of DTP rose from 5% in 1974 to 85% in 2010. However, sub-Saharan Africa reached only 77% DTP3 coverage in 2010.

In this article, the authors assess immunization systems strengthening, accelerated disease control efforts, and the introduction of new and underutilized vaccines across Africa.  The article shows that weak infrastructure and shortage of skilled human resources are the major bottlenecks. In addition, the article singles out the need for affordable and adapted vaccines to be made available. More details on this technical update are available at:


Summary Points

  • There have been significant improvements in the performance of the Expanded Programme on Immunization (EPI) in Africa since its inception in 1974. However, there exist wide inter- and intra-country differences.
  • Successes such as the introduction of hepatitis B (HepB), Haemophilus influenzae type B (Hib), and meningococcal group A vaccines across the continent are milestones indicating growth and development in the right direction. Conversely polio and measles outbreaks, as well as high vaccine drop-out rates across the continent, indicate failures within the EPI system that require evidence-informed corrective interventions.
  • With the 2015 deadline for the Millennium Development Goals (MDGs) approaching, it is necessary for Africa to take stock, critically assess its position, take ownership of the regional and country-specific problems, and develop precise strategies to overcome the challenges identified.
  • There is need for increased immunisation systems strengthening, as many are plagued by weak infrastructure and shortage of skilled human resources. More affordable and adapted vaccines need to be made available.
  • Increased political and financial commitments from African governments are key factors for both maintaining current achievements and making additional progress for EPI in Africa.

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