Vaccine programmes 'flawed' for many

Some vaccination programmes are failing, says Unicef

Millions of children are still catching killer diseases because vaccine programmes are failing to reach them.

A United Nations Children's Fund (Unicef) report into children's welfare published on Wednesday warns that despite the success of a world-wide polio vaccination drive, much work remains to be done.

In particular, the "Progress of Nations" report says the uptake of the diptheria, pertussis (whooping cough) and tetanus jab (DTP) is still poor in dozens of countries - many in Africa.

DTP Immunisation - bottom five (%)

DR Congo 10

Liberia 19

Nigeria 21

Haiti 22

Niger 22

In the Democratic Republic of Congo, only one child in ten receives the necessary three doses of DTP, making it the worst performer in the world.

In addition, neonatal tetanus kills 200,000 infants in the first month of life every year - nearly a quarter of these in India.

The illness can be easily prevented by immunising women of childbearing age, but the vaccine is not available in some countries.

There are still 17 countries in which there is no state funding for any common childhood vaccines, although overall, Unicef said that more low-income countries are spending more money on vaccination.

However, even in regions beset by war and other health crises such as the spread of HIV, there are some remarkable success stories.

Neonatal tetanus - estimated deaths

India 48,600

Nigeria 34,600

Pakistan 21,600

Ethiopia 13,400

Bangladesh 10,400

The DTP vaccination rates in Gambia, Mauritius and Malawi all exceeded 90%.

On average, only half the children in sub-Saharan Africa are immunised fully. The world average is 77%.

Unicef also uses vaccination drop out rates as a measure of the effectiveness of national immunisation programmes.

In Mauritania, Somalia, Venezuela, Niger and Bolivia, more than half the women who bring their children for one vaccination never come back for the second.

Anything about a 10% drop out rate means the vaccination programme is 'flawed' according to Unicef.

Towering success

However, the worldwide drive to eradicate polio has yielded enormous success over the past decade.

In 1988, when the programme was launched, there were 35,000 cases of this disabling disease worldwide.

Last year there were 7,000 cases, and there are many new countries in which polio appears to have been wiped out.

The progress has been made through huge national immunisation days - at one, in India, an estimated 147m children were given the vaccine.

Professor William Foege, a former director of the US Centers for Disease Control and Prevention, and a key figure in the eradication of smallpox two decades ago, described the polio programme as "A stunning success".

He said: "Not since the eradication of smallpox over 20 years ago has the power of immunization been so evident.

"The world has watched and applauded as immunization efforts have pushed back the wave of disability, suffering and death brought on by polio."