The past, present, and future of immunization in the Americas
The implementation of the EPI has helped to catalyze progress in different areas, including: 1. Vaccination laws. Since the first Law on Vaccination was passed in Belize in 1963, lawmakers in every country of the Region have made efforts to ensure that their national budgets include free universal vaccine coverage in national programs, following guidelines of the WHO Strategic Advisory Group of Experts (SAGE) on Immunization Global Advisory Committee, the PAHO TAG regional committee, and national immunization committees made up of independent experts known for their integrity, leadership and achievements. Member States also underscore their commitment to vaccination by continuing to declare it as a public good. 2. Management. Since the creation of the EPI in the Americas, country ownership has been the guiding principle: periodic meetings of national program directors have been held, and countries have boosted innovation and collective creativity by sharing immunization and vaccine-preventable disease surveillance data, along with their immunization experiences including improvement of the cold chain, information systems, supplies, and program financing. 3. Revolving Fund. Demonstrating how countries prioritize immunizations, national immunization programs are in large part, and in the majority of countries, funded by a country’s own resources. The Revolving Fund, an example of comprehensive PAHO technical cooperation for Member States, was created in 1979 and has been one of the pillars for success of self-sustained national immunization programs throughout the Region. The Fund ensures that all vaccine requirements are consolidated (economy of scale) to cover up to 8 million births per year (80% of Latin America and the Caribbean). 4. New vaccines introduction. All of this has helped ensure the sustainability of EPI in the Region of the Americas, and its expansion outward from a child-only vaccination focus, with vaccines that only target 6 diseases to immunization for entire families with vaccines that target more than 15 diseases including Haemophilus influenzae type b, hepatitis B, mumps, rubella, influenza, yellow fever, pneumococcus, rotavirus and human papilloma virus.