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World Immunization Week 2024 – 50 years of global progress

This year’s World Immunization Week marks the 50-year jubilee of the World Health Organization (WHO) Expanded Programme on Immunization (EPI) (now the Essential Programme on Immunization) – an immense global endeavour that has had an outsized impact on the prevention of infectious diseases through vaccination.

The EPI was launched in 1974 with the ambitious vision of building a systematic, coordinated, fundamentally equitable global immunisation program. Since then, the many-sided project has made the concept of immunisation for all people ‘humanly possible’. 

The original aim of the EPI was to ensure all children – regardless of demographic status or geographical location – would have access to life-saving vaccines. 

Initially, the focus was on six vaccine-preventable diseases: tuberculosis, diphtheria, pertussis, tetanus, polio and measles. 

Over decades, the EPI has expanded along with advances in vaccinology and immunisation practice, and it now includes 13 universally recommended vaccinations across the life-course (via the addition of Haemophilus influenzae type B, hepatitis B, rubella, pneumococcal disease, rotavirus, human papillomavirus and [for adults] COVID-19 to the preceding list) as well as 17 further vaccines with context-dependent recommendations. 

The real-world effects have been extraordinary. Key milestones along the EPI’s 50-year journey have included the eradication of smallpox, in 1980, and a more than 99 per cent reduction in the incidence of polio globally. More recently, major progress has been made towards the global elimination of rubella. 

The EPI continues to work in support of the WHO Immunization Agenda 2030, which aims to ensure these and other ‘hard-won gains’ are maintained and built upon – ‘leaving no one behind, in any situation or at any stage of life’. 

Given the persistence of a range of complex challenges – including ongoing barriers to equity; health system gaps; and the stalling or reversal of vaccination coverage rates in some countries, including as a result of the COVID-19 pandemic – now is not the time for complacency.

It has been estimated, however, that over the last 50 years global immunisation efforts have saved up to 154 million lives.

That is cause for celebration – as well as a testament to the EPI’s monumental impact on global health.