Prevention by Vaccination
Authors: COCKBURN W. CHAS 
Published: August 2010

Summary. The communicable diseases still sonstitute more than half the principal causes of death in the developing world. This presentation is primarily concerned with the problems of prevention in these areas.The communicable diseases can be roughly divided into groups:

Those, such as the parasitic diseases, diarrhoeal diseases, respiratory diseases and leprosy, for the control of which either further research or the use of methods which cannot be provided quickly are necessary, e.g. better water supplies and water disposal for the diarrhoeal diseases and
Those for which already established methods of control would, if satisfactorily applied, make and immediate and significant impact.

In the second group are the diseases of universal incidence, which can be controlled by immunization. With the exception of tuberculosis where other factors have also played a part, the “universal” diseases mentioned have been completely or verylargely controlled in the developed world.In the developing world with few exceptions, they are still uncontrolled. Despite the Known deficiencies in reporting, the recorded death rates ascribed to them are 60 to 300‐fold greater in the developing than in the developed world.In nearly all the countries not more than 20 Percent of children are vaccinated against them (except small‐pox where the rates in recent years are higher).The failure to prevent these readily preventable diseases is due to many widely different constraints, most of which can be removed or ameliorated if the will to do so is there.A change in the situation is overdue‐not only for the obvious reasons but also because it is wholly unrealistic to endeavour to mount family planning programmes without using every possible means of reducing the risk that children born within family planning programmes will die from preventable diseases.Practically every country has some kind of immunization programme: what has to be worked out is how the programme can be rapidly expandedand made effective.The major effort must come from the individual countries themselves. This for many reasons, but the most important is that once such a programme is begun, there is no forseeable end to it.WHO can make considerable contributions to the development of effective programmes by:

Stmulating governments in developing countries to appreciate the importance of immunization as a major weapon in their disease prevention armoury;
Assisting in the planning of practicable programmes geared to realistic arrreciation of national resources;
Providing independent assessment of the quality of vaccines offered to developing countries;
Easing currency restrictions;
Discussing with potential donor countries and inter‐national agencies, the contributions they can make and how to make them;
Studying with producers and others, means of supplying vaccines at minimum cost.

But neither WHO nor the individual developing countries can succed without help from other sources, and the means of providing this is what I hope will come out in the ddiscussion.We believe that is here a specific, clearly defined, opportunity for developed and developing countries and for vaccine producers and consumers to get together and effect in a very short time, a sub‐stantial improvement in child health in the world.In a world where the bio‐medical research workers highlight their efforts to understand and prevent or control the chronic degenerative diseases‐such as diabetes and the cardiovascular diseases: their attempts to unravel the natural history and causation of cancer: their anxieties about genetic engineering‐it is salutary to look at the picture of the diseases of public health importance in the world as a whole, and to reassess where the major efforts for prevention and control should be placed in countries at different stages of development.