Providing children with essential immunizations in the first few years of life is crucial to any country's fight against infectious disease.
WHO and its Member States recognised this more than three decades ago when they chose six diseases — tuberculosis, diphtheria, neonatal tetanus, whooping cough, poliomyelitis and measles — as the targets for an initiative called the Expanded Programme on Immunization (EPI).
The goal was to encourage countries to adopt EPI vaccines as the basis of their national programmes for childhood immunizations and to provide technical support to help the build effective programs. Many countries did so, including China, and have continued to use EPI as the basis of their national immunization programmes. What's more, overall reported immunization rates are high compared with other countries: 90 per cent of children receive EPI vaccines, and the rates of many of the target diseases have fallen sharply in the past three decades.
Adding life-saving and safer, but more expensive, vaccines to China's EPI is increasing quickly these years. In 2002, hepatitis B was the first new vaccine added in almost 20 years. In 2008, more vaccines were introduced into EPI, to protect children in China against a total of 12 diseases: tuberculosis, diphtheria, tetanus, pertussis, poliomyelitis, measles, rubella, mumps, hepatitis B, hepatitis A, Japanese encephalitis, and meningococcal meningitis types A and C. There are many other non-EPI vaccines on the market in China that are available to children of families able and willing to pay.
The WHO's mission in China is to expand access to routine EPI vaccines and to support and encourage the Chinese government to add new life-saving and safer vaccines to the list of EPI immunizations supported by the government. Encouragingly, the Chinese government passed a law in 2005 stipulating that EPI immunizations for children be provided free of charge. However, in some areas, sufficient public funding has not been identified to shoulder that cost. A major challenge that remains for national and provincial governments is to ensure that township and village doctors receive appropriate compensation and incentives for delivering EPI vaccines. It is hoped that these issues can be resolved through the medical reform which is currently under way in China.