WHO is working to improve immunization financing in China and ensure universal access to the national EPI vaccines. In 2004 and 2005, WHO provided the funding and expertise needed for a full analysis of the costs and financing of China's national EPI. WHO did this in its role as a partner of the GAVI Alliance, a consortium of public and private sector partners that support global immunizations. Additional work is needed to strengthen policy analysis and identify options for strengthening immunization financing. WHO is also working on developing effective models for implementing school entry immunization requirements to ensure that children who enter pre-school and school are fully immunized, as well as on models to improve immunization coverage in poor populations.
WHO is also making progress in encouraging China to expand its list of EPI vaccines. In 2002 the government added hepatitis B vaccine in what was a very significant move for the nation's health: hepatitis B affects a vast swathe of China with some 10 per cent of people chronically infected and at high risk of liver cancer or cirrhosis. Over the past years, immunization rates have increased markedly. A national serosurvey in 2006 demonstrated that chronic hepatitis B infection had fallen to 1% in children aged less than 5 years; 90% lower than among the same age group tested in 1992. WHO supports studies in China to determine the burden of disease that could be prevented by new vaccines against Hemophilus influenzae type b, Neisseria meningitides, and rotavirus — common causes of meningitis and diarrhea in children.
Enabling China to eliminate measles is another key priority. China is a member of WHO's Western Pacific group of countries which in September 2005 resolved to eliminate measles in the region by 2012. With support from WHO, China MOH developed national guidelines and strategies to eliminate measles in China 2006-2012. The projects in Guizhou and Sichuan Provinces have reduced measles incidence sharply through conducting supplementary immunization activities (SIAs), and strengthening routine immunization, the enforcement of the school entry immunization requirement, and measles surveillance. Recently, WHO has supported Chongqing's 2009 measles SIAs.
WHO is also a major partner in supporting China's efforts to eradicate poliomyelitis. As part of the WHO's Western Pacific Region, China was certified polio-free in 2000. However, in 2004 the country experienced an outbreak caused by a vaccine-derived polio virus, highlighting the need to remain vigilant. With support from WHO, China has built an outstanding laboratory surveillance network for poliovirus that has also been extended to measles and rubella. Phase I of polio laboratory containment, required as part of global certification, has been completed.
On the vitally important issue of vaccine safety and efficacy, WHO is giving technical support to the government to bring China's regulations up to the best international standards. This has included training for industry inspectors, work to develop surveillance for tracking problems following immunizations, and periodic reviews of China's regulatory system for vaccines.