Vaccines failing to reach those most in need, UNICEF warns

The momentum required to sustain global immunisation is faltering due to the high cost of powerful new vaccines, UNICEF has warned. This is despite unprecedented success achieved during the 1980s, when coverage rates worldwide were increased from 5 to 80 per cent.

Funding is insufficient to get the new generation of vaccines to those countries that are home to the poorest 10 per cent of the world's children, who bear the heaviest burden of disease. The problem is exacerbated by the fact that, as reported in the Progress of Nations report, about 40 million babies, one third of all births, go unregistered around the world. Without proof of birth, a child cannot be legally vaccinated in at least 20 countries.

"It should be one of the biggest news stories of all time: the prospect of vaccines that could save the lives of eight million children each year," says Dr Ralph Henderson, assistant director-general of the World Health Organisation. In a commentary issued with the report, he adds: "Could the reason be that these eight million are, overwhelmingly, the unseen, unheard children of the poor?"

The unconscionable facts were that some diseases such as yellow fever were on the increase again, and some vaccines already on the market had never even made it to intended targets. The antigen for hepatitis B, which kills about one million people a year, has been available since the early 1980s. But many of the countries that need it - including Cambodia, Tanzania and Vietnam - cannot afford it, though its cost has dropped from $150 to less than $1 per dose.

The birth registration problem was the most shocking finding, said UNICEF Ireland's director, Ms Maura Quinn. Registration was vital not only for vaccination purposes in developing countries but for child protection from exploitation, she added. It meant children were less likely to be abused by sex traffickers or forced to work at a very young age.

The report underlines the need for special protection of adolescents. In 1997, about three million people aged between 15 and 24 became infected with HIV. It also notes that more girls under 19 die from pregnancy-related causes than any other factor, and that 73 million children aged between 10 and 14 are working, not counting many millions believed to be in domestic service.

Child death rates, however, continue to plummet in industrialised countries, while countries which have introduced measures to reduce children's exposure to lead, particularly in petrol, are meeting with success.