The countries in greatest need suffer from chronic financial constraints which limit their prospects for self-sufficiency in terms of vaccine procurement and delivery. Nevertheless, immunization has become an unquestioned priority in most countries and budget lines are gradually being established for service delivery and vaccine purchase.
Most countries finance all operational costs from internal sources.
In countries demonstrating the greatest need, cold chain equipment financed at the launching of the EPI is now aging. External funding is probably needed to replace it within the next five years. Each year, over 550 million injections are given through national immunization programmes in developing countries. Unsafe injections are a potential hazard placing patients, health workers and the general community at risk of serious diseases. This set of countries requires special support and special strategies to establish the basic immunization infrastructure and systems.