Abstract

PIP: The resolution creating the Expanded Programme on Immunization (EPI) was adopted by the World Health Assembly in 1974. Program policies were formalized in 1977, when the goal of providing immunization services for all children throughout the world by 1995 was set and WHO's priority attention to developing countries was specified. Immunization programs in Europe have had dramatic success in reducing morbidity and mortality from diphtheria, measles, neonatal tetanus, pertussis, and poliomyelitis. But there are still challenges to be met within the region. Targets adopted for the European region include 1) formal declaration of a commitment to the EPI goals and activities and definition of national targets for morbidity reduction for 1990 for each disease in the regional EPI; 2) development of a program to maintain immunization protection throughout life by 1986; 3) establishment of a system for monitoring suspected adverse effects of immunization by 1986; 4) completion of the basic immunization series by at least 90% of children no later than their 2nd birthday by 1990; 5) elimination of indigenous poliomyelitis, neonatal tetanus, and diphtheria by 1990; 6) elimination of indigenous measles by 1990 where effective immunization programs are already operating or 1995 in other areas; and 6) elimination of congenital rubella by the year 2000. In addition to optimizing their own national immunization rpograms, countries of the European region can also make valuable contributions to EPI programs elsewhere. In particular, monitoring of vaccine safety and efficacy can most readily be performed in developed regions, and quality control tests on vaccines will continue to be performed largely in laboratories in the industrial countries. Support will also be required in training staff from developing countries in appropriate testing techniques, and in giving the trainees both moral and financial support after their return to their own countries. Continued leadership from the countries of the European region will not only benefit the health of their own populations but will provide invaluable guidance to developing countries as their own immunization systems mature.