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    Expanded Programme on Immunization: global overview.

    World Health Organization [WHO]. Expanded Programme on Immunization [EPI]

    [Unpublished] 1985. [19] p. (EPI/GAG/85/WP.1)

    This year's progress and evaluation report of the Expanded Program on Immunization (EPI) includes background information, a summary of the progress, actions needed to realize the EPI goal, and a draft resolution for consideration by the executive board. The EPI has its basis in resolution WHA27.57, adopted by the World Health Assembly in May 1974. General program policies, including the EPI goal of providing immunizations for all children of the world by 1990, were approved in resolution WHA30.53, adopted in May 1977. In 1982, the Assembly warned that progress would have to be accelerated to meet the 1990 goal and urged Member States to act on a 5-point program (resolution WHA35.31). Immunization, one of the most cost-effective of all health services, remains tragically underutilized. In the developing world, excluding China, less than 40% of infants receive a 3rd dose of DPT or polio vaccine, in part because it is only now being introduced in some programs, and over 3 million children still die annually from measles, neonatal tetanus, and pertussis, while over 250,000 children are crippled by poliomyelitis. The 1st point of the World Health Assembly 5-point action program calls for the promotion of EPI in the context of primary health care, with special emphasis on involving communities as active partners in the program and on delivering immunization with other health services so that they are mutually supportive. The use of "channelling" strategies and immunizations days currently are providing powerful stimuli to community participation in a number of programs. Points 2 and 3 of the action program stress the need to invest adequate human and financial resources in EPI. Support for immunization programs, both from within national programs and from external resources, has increased markedly. More support is coming from many organizations long associated with EPI, and the number of collaborators is growing. Point 4 of the action program calls for ensuring that programs are continuously evaluated and adapted so as to achieve high immunization coverage and maximum reduction in target-disease deaths and cases. Evaluation continues to be a priority for EPI. Point 5 calls for the pursuit of research as a part of program operations. Investments in research on the cold chain have resulted in a marked increase in the range and quality of products now available on the market. In the European Region the coverage goal of EPI has been largely achieved. Dramatic progress has been made in the Region of the Americas since the beginning of EPI. The Southeast Asia Region has made steady progress since the start of EPI. In the Western Pacific Region the main program constraints relate to strengthening the cold chain and to improving the quality of vaccines. Progress in increasing immunization coverage has been very good in most of the Eastern Mediterranean Region, and there has been extensive use of national program reviews and meetings of national managers in supporting country programs. Progress in the African Region has been satisfactory in many countries and exemplary in a few. Management capacity within national programs remains the most severe global constraint for EPI.
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