The impact of the immunisation programme on vaccine-preventable diseases in South Africa: A review of progress over a 10- to 15-year period

Abstract

Immunisation is the most cost-effective public health intervention currently available. No other undertaking, not even the development of antibiotics has had as much impact in lowering mortality. The Expanded Programme on Immunization (EPI) in South Africa has made significant progress in the control of vaccine-preventable diseases. South Africa has been declared free of wild poliovirus. The number of measles cases per year dropped from an average of 10,000 to 15,000 cases between 1980 and 1997 to an average of less than 100 confirmed cases per year from 1998 to 2006, with 830 cases during the worst measles outbreak. Haemophilus influenzae type b (Hib) cases have been markedly reduced and maternal and neonatal tetanus has been eliminated. Review of routine coverage data indicates a progressive increase in the routine coverage from 2000 to 2006, with 84% fully immunised coverage recorded at national level in 2006. Efforts of the immunisation programme are directed at maintaining a high routine coverage and improving the quality of routine data. The major challenges relate to: sustaining the achievements, introducing new vaccines, integrating with other child survival strategies, and gaining recognition. There is a need to strengthen the programme in order to sustain the achievements. EPI has a potential to contribute significantly to the fourth Millennium Development Goal, of reducing childhood mortality by two thirds by 2015, particularly when integrated with other child survival strategies.