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Review
. 2014 May 12;369(1645):20130433.
doi: 10.1098/rstb.2013.0433. Print 2014.

The contribution of vaccination to global health: past, present and future

Brian Greenwood  1
Affiliations
Review

The contribution of vaccination to global health: past, present and future

Brian Greenwood. Philos Trans R Soc Lond B Biol Sci. .

Abstract

Vaccination has made an enormous contribution to global health. Two major infections, smallpox and rinderpest, have been eradicated. Global coverage of vaccination against many important infectious diseases of childhood has been enhanced dramatically since the creation of WHO's Expanded Programme of Immunization in 1974 and of the Global Alliance for Vaccination and Immunization in 2000. Polio has almost been eradicated and success in controlling measles makes this infection another potential target for eradication. Despite these successes, approximately 6.6 million children still die each year and about a half of these deaths are caused by infections, including pneumonia and diarrhoea, which could be prevented by vaccination. Enhanced deployment of recently developed pneumococcal conjugate and rotavirus vaccines should, therefore, result in a further decline in childhood mortality. Development of vaccines against more complex infections, such as malaria, tuberculosis and HIV, has been challenging and achievements so far have been modest. Final success against these infections may require combination vaccinations, each component stimulating a different arm of the immune system. In the longer term, vaccines are likely to be used to prevent or modulate the course of some non-infectious diseases. Progress has already been made with therapeutic cancer vaccines and future potential targets include addiction, diabetes, hypertension and Alzheimer's disease.

Keywords: global health; vaccination; vaccine development.

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Figures

Figure 1.
Figure 1.
Edward Jenner by John Raphael Smith (Wellcome Library).
Figure 2.
Figure 2.
Uptake of measles vaccination and associated decline in the incidence of measles (WHO immunization database). (Online version in colour.)
Figure 3.
Figure 3.
Cases of paralytic poliomyelitis in 2013 (www.polioeradication.org (accessed 15 February 2014)). (Online version in colour.)
Figure 4.
Figure 4.
Infectious and potentially preventable causes of child mortality in 2012 [24]. (Online version in colour.)
Figure 5.
Figure 5.
Uptake of Haemophilus influenzae type b (Hib) and pneumococcal conjugate vaccines (PCV) [27]. (Online version in colour.)
See this image and copyright information in PMC

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