Every year immunization through vaccination averts two to three million deaths.
Photo: Ken Opprann

Vaccines are the most effective agents for preventing infectious diseases. Immunization currently averts an estimated two to three million deaths every year.

WHO’s Expanded Program on Immunization (EPI) includes vaccines against tuberculosis (TB), diphtheria, tetanus, whooping cough, polio and measles.

Key facts

  • Vaccines are the most effective agents for preventing infectious diseases.
  • Immunization prevents illness, disability and death from vaccine-preventable diseases including diphtheria, measles, whooping cough, pneumonia, polio, rotavirus diarrhea, rubella and tetanus.
  • Immunization currently averts an estimated 2 to 3 million deaths every year, but an estimated 22 million infants worldwide are still missing out on basic vaccines.
  • WHO’s Expanded Program on Immunization (EPI) includes vaccines against tuberculosis, diphtheria, tetanus, whooping cough, polio and measles.
  • With GAVI funding, many low-income countries have been able to introduce vaccines against meningitis, pneumonia and hepatitis B during the last ten years.

The Problems

  • High immunization coverage requires well-functioning delivery structures, including stable supply, functioning cold chain and immunization services.
  • Securing a supply of effective vaccines at affordable prices in poor countries is a huge challenge.
  • Disease surveillance systems are necessary to ascertain the effectiveness of vaccines in general use.
  • The time until a vaccine becomes available for implementation in low- and middle-income countries has often been more than ten years.
  • In spite of major efforts we still lack vaccines against important diseases like malaria and HIV, and efficient vaccines against tuberculosis.
  • The increasing emergence of antibiotic resistance necessitates preventive measures such as vaccines more than ever.

The Causes

  • Good health service infrastructure is not available in all countries.
  • Vaccine development requires large resources due to the necessary focus on safety and need for large clinical trials. All new vaccines are therefore expensive.
  • Diseases like malaria, HIV infection and tuberculosis provide very limited protective immunity. A good protective vaccine will therefore need properties which are not found with a natural infection.
  • For these diseases, possible laboratory correlates to protection are unclear and there are no good animal models for the disease. The early steps of vaccine development are therefore difficult.

The Solutions

  • There is a need for increased focus on routine immunization as an important tool.
  • Novel funding mechanisms such as GAVI, Iffim and the AMC, are important to reduce the time gap from vaccine availability to roll out in all parts of the world.
  • The need for developing new products remains considerable, and requires increased focus and long-term investment.
  • The challenges in product development are multi-disciplinary, and are so great that no one actor can succeed alone. Product Development Partnerships (PDPs) have been organized in order to meet these challenges and accelerate development. They coordinate and manage cross-disciplinary resources all the way from the research and development stage to the introduction of products into the market.

Suggested actions, international consensus and way forward

  • The Global Vaccine Action Plan (GVAP) was endorsed by the 194 Member States of the World Health Assembly in May 2012. GVAP is a framework to prevent millions of deaths by 2020 through more equitable access to existing vaccines for people in all communities. GVAP aims to strengthen routine immunization to meet vaccination coverage targets; accelerate control of vaccine-preventable diseases with polio eradication as the first milestone; introduce new and improved vaccines and spur research and development for the next generation of vaccines and technologies.
  • GAVI is a key international financing mechanism to support accelerated introductions in poor countries.  GAVI will continue to support important introductions of new vaccines such as vaccines against Rotavirus, Pneumococcal disease, Human Papilloma Virus (HPV) and others.

Norwegian position

The Norwegian government will:

  • Continue its political, technical and financial support to GAVI to help introduce new, effective vaccines, and strengthen health systems and price competition in the vaccine market to benefit developing countries.
  • Contribute to the development of new mechanisms and new knowledge to improve access to vaccines for poor countries, including through research cooperation.Continue the fight against polio and measles through awareness raising and economic support, with emphasis on the countries with the greatest burden of disease.
  • Work in a coordinated manner through the relevant mechanisms to improve access to vaccines and strengthen production capacity in developing countries.
  • At the World Health Assembly May 2013 (WHA66) Norway endorsed the Draft action plan for the prevention and control of noncommunicable diseases 2013–2020, and finds it important to have a main focus on polio eradication and routine vaccination.
  • Norway believes it important to have a focus on vaccine prices and procurement mechanisms. Also for middle-income countries (MIC), for which GAVI funds are not available, high vaccine prices are a hindrance to introducing new vaccines.

How Norwegian actors contribute

  • Norway is a key contributor to the Global Vaccine Alliance (GAVI).  In 2011, the Government decided to increase its funding to GAVI to the level of NOK 1 billion a year from 2015.
  • Norway, through the Norwegian Institute of Public Health (NIPH), is an observer to WHO Strategic Advisory Group of Experts (SAGE) on Immunization


Published 11.02.2014
Last updated 16.02.2015