Accelerating policy, deployment, and access to new and underutilized vaccines in developing countries

O ver recent decades, the experi-ence of national immunization programs demonstrates that im-munization is one of the "best buys" in public health. 1 Rapid deployment and use of the traditional vaccines against child-hood killer diseases have been the most im-portant contributors to reductions in child mortality and increased life expectancy in developing countries. In the Americas, polio was eradicated from the region over fifteen years ago, indigenous measles trans-mission was eliminated in November 2002 and neonatal tetanus has been eliminated in all but one of the countries of the re-gion. 2 In 2003, the Pan American Health Organization's (PAHO) Directing Coun-cil, composed of all the ministers of health of the countries of the Americas, unani-mously adopted a resolution to eliminate rubella and congenital rubella syndrome (CRS) from the Americas by 2010, becom-ing the first region in the world to take on this challenge. 3 Immunization will continue to be es-sential in reducing child mortality in de-veloping countries and, thus, will prove critical to meeting the Millennium Devel-opment Goals (MDGs). 4 Immunization is directly associated with the achievement of child mortality reductions (MDG 4) and maternal health (MDG 5). It also con-tributes to a decrease in cancer (such as cervical cancer), a major disease of global and regional importance (MDG 6). The human papillomavirus vaccine has the po-tential to impact this last MDG. Beyond simply achieving the MDGs, further gains in the reduction of child mortality can be achieved through more effective and wider use of immunization strategies. 5 The World Health Organiza-tion's (WHO) Global Immunization Vi-sion and Strategy (GIVS) recognizes that Jon Kim Andrus, MD, oversees technical support to PAHO Member Countries of Latin America and the Caribbean, particularly for strategic planning and all key policy issues regarding vaccines and immunization. Vance Dietz, MD, MPH, TM, is Chief of the Global Measles Branch at the Centers for Disease Control and Prevention (CDC) and oversees measles technical support globally for the CDC. John Fitzsimmons, MURP, coordinates the management of PAHO's Revolving Fund for the purchase of vaccines for all PAHO Member Countries. Carlos Castillo-Solórzano, MD, MPH, works as a Regional Advisor for Immunization at PAHO with a primary focus on rubella elimination.