Global Health:

Summary of Conference on Immunization in Developing Countries

NSIAD-00-95: Published: Mar 1, 2000. Publicly Released: Mar 1, 2000.

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Benjamin F. Nelson
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Pursuant to a congressional request, GAO issued a report on factors that limit access to vaccines for children in developing countries, focusing on: (1) shifting donor priorities; (2) inadequate infrastructure and insufficient information for decision-making; and (3) the relatively high cost of newer vaccines.

GAO noted that: (1) GAO convened a conference in Washington, D.C. in order to provide Congress with informed discussion about actions that could be taken to address limiting factors; (2) conference participants agreed that the shortfalls identified in GAO's October report could be attributed to the absence of a meaningful, coordinated, worldwide commitment to immunizing children in poor countries; (3) conferees observed that developing country governments and their partners in the donor community have consistently undervalued immunization relative to other competing health sector priorities, despite the fact that immunization is one of the most cost-effective health investments; (4) conferees agreed that funding from all sources, including developing countries themselves, has not been adequate to ensure that children in these countries receive the vaccines recommended by the World Health Organization; (5) it was noted that donor assistance to national programs has been inconsistent and poorly coordinated; (6) to ensure that heightened commitments are translated into effective and sustained programs of action, the conferees suggested that donor agencies and developing country governments work together to prepare and carry out coordinated, country-specific strategies for addressing immunization shortfalls; (7) the conferees observed that inadequate national immunization systems have been a major impediment to achieving higher immunization rates in developing countries and that investments are required in a variety of areas to ensure that these systems can function effectively; (8) additional investments are also needed to provide the management expertise needed to forecast vaccine needs, procure supplies, and distribute them throughout the country in an efficient and timely manner; (9) several conferees observed that these efforts should include measures designed to generate the information that decisionmakers need to allocate resources for immunization and to manage these resources in an effective and efficient manner; (10) staging efficacy trials for new vaccines in developing countries can provide clear information on actual disease burdens and the potential impact of candidate vaccines in reducing these burdens; and (11) the advocacy on behalf of a heightened worldwide commitment to immunization should include efforts directed specifically at clarifying the cost-effectiveness of expanding immunization to include newer vaccines.

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