To appreciate just how radical this proposal was, it’s worth remembering that in the 1970s just 5% of children were protected against vaccine-preventable diseases such as measles and polio.
But this was a time of great hope; a time for thinking big. The WHO knew that vaccines topped the list of worthwhile public health interventions, and there was growing optimism that the smallpox eradication programme that had been intensified in the late 1960s would soon rid the world of the disease.
Thus the Expanded Programme on Immunization (EPI) was born. It began with four vaccines that covered six diseases: polio, diphtheria, tuberculosis, pertussis, measles and tetanus.
The WHO began to send mobile teams to developing countries to vaccinate up to 500 children per day – often providing the only contact infants would have with healthcare professionals.
The EIP was met with great enthusiasm. Within its first five years, virtually all developing countries were vaccinating against all six diseases – although access to immunisation remained patchy.
Over time, better technology – notably in transport and storage – enabled the WHO to bring vaccines to vastly more people. Infant mortality fell, primary healthcare expanded, and the health and wealth of the world’s poorest nations improved.
Fast-forward to today and the EIP has grown into one of the world’s most successful public health programmes. Ever.
More vaccines are now available under the programme and 83% of children on average have access to basic immunisation.
The arrival of the GAVI Alliance, a public-private partnership, has helped to expand access even further, leading to renewed optimism that the goal of delivering vaccines to 99% of the world’s population can be achieved.
Still, there is room for improvement. Millions still die of vaccine-preventable diseases; the polio eradication effort faces many challenges; and measles-free countries in South America worry about imported cases from more developed nations where the disease has been allowed to make a comeback due to low immunisation rates. There is still much to do.
But today, take a moment to reflect on how much road has been travelled en route to the ambitious but achievable goal of bringing live saving vaccines to every child, everywhere.
Happy Birthday EIP