The Progress of Nations 2000

ILEAGUE TABLE: THE DPT3 COVERAGE MEASURE

I mmunization remains the single most feasible
and cost-effective way of ensuring that all
children enjoy their rights to survival and
good health. In the developing world, immunization saves the lives of 2.5 million children
every year. Because of its recognized power
and efficacy, renewed efforts are being made
globally to mobilize more resources for another
push to ensure that all children are protected
by immunization and that new vaccines for
other common killer diseases are developed.
A mixed performance
The series of immunizations known as DPT can prevent diphtheria, pertussis (whooping cough) and tetanus, but these
three diseases still kill 600,000 children and afflict millions of
others every year in developing countries. To be fully protected, children must receive three doses of the vaccine,
administered at the ages of one month, one month and a half
and three months. The percentage of children receiving the
final dose (DPT3) is therefore a revealing and vital gauge of
how well countries are providing immunization coverage for
their children.
This league table shows progress, or lack of it, towards the
lofty goal of immunizing 90% of children in all countries by
the end of 2000. As the table indicates, 40 developing countries - and many industrialized countries - have done extremely
well, attaining or exceeding the 90% coverage goal set at the
1990 World Summit for Children. The high performers are
found primarily in the Americas, Central Asia, Europe and the
Middle East and North Africa, but in sub-Saharan Africa, a
region beset by economic hardship, armed conflict and AIDS,
three countries - Gambia, Malawi and Mauritius - also
attained 90% coverage or above. On average, however, only
about half of the children in sub-Saharan Africa are protected.
Countries in East Asia and the Pacific generally have high coverage, while South Asia, with a regional average of 70%,
remains well below the goal.
The world average is now 77%, the result of a massive immunization campaign in many countries during the 1980s.
That kind of push needs to be extended to provide coverage for
all children. The new Global Alliance for Vaccines and Immunization (GAVI) has been created to renew this effort. It aims to
help poor countries that meet specific criteria (see 'Plans to
save more children with Hib vaccine', page 24) overcome the
great gaps they face in immunizing their children. GAVI aims
by the year 2005 to have assisted these countries in attaining at
least 80% DPT3 and measles coverage in all districts.

SUB-SAHAltRAN AFRIICA MIDI)IIE EAST' ANI)
NOITII AFRICA

Gambia
Malawi
Mauritius
Botswana
Tanzania
Benin
Zimbabwe
Mozambique
Rwanda*
Kenya
South Africa
Namibia
z a................ _................ _ _...........................................
Zambia*
Ghana
Madagascar
Senegal*
Guinea-Bissau*
C6te d'lvoire
Eritrea
Ethiopia
Lesotho*
Sierra Leone
Gabon*
Mali
M a!............................................
Burundi
B u d!............................................................
S Regional average
Cameroon
Central African Rep.
Guinea
Uganda
B r.i.. a s0.........._..............
Burkina Faso
Togo
Angola
Mauritania*
Chad
S a ia.............. _ _ __................
Somalia*
Congo*
Niger
Nigeria
Liberia
Congo, Dem. Rep.

96
96
90
82
82
81
81
77
77
76
76
74
70
68
68
65
63
61
60
58
57
56
54
52
50
48
46
46
46
46
37
37
36
28
24
24
23
22.........................
21
19
10

Iran
Oman
Lebanon
Libya
Syria
Iraq
Tunisia
Saudi Arabia
U. Arab Emirates
Israel
Kuwait
Morocco
Egypt
Jordan
Regional average
Algeria
Sudan
Yemen
Turkey

100
100
97
97
97
96
96
94
94
93
93
93
92
91
84
80
72
68
56

Immunization drop-out
rates signal flawed
systems
The high BCG-DPT3 drop-out rates of
10% to 59% (at right) spell bad news
for the health of young children and
present a challenge for local health
delivery systems. Health systems in
countries where the drop-out rate is
more than 10% are considered flawed
by health experts.
The figures show that caregivers
had been in contact with health care
systems because their young children
had received an anti-tuberculosis BCG

GG