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Ciro A. de Quadros, MD, MPH

Albert B. Sabin Vaccine Institute, New Canaan, Conn

In this issue of the Journal, we highlight the promise and controversies surrounding vaccines in the developed and developing world. We are honored and gratified that Associate Editor Daniel J. Tarantola was willing to pull together our first issue on this topic since the October 2000 disease eradication and elimination issue. Leading vaccine authorities worldwide contributed their views, including Ciro A. de Quadros, author of the this month’s Editor’s Choice. Additional papers on vaccines will appear in November 2004, in the context of global health history, again with papers contributed by experts from around the world.

Mary E. Northridge, PhD, MPH

Editor-in-Chief, AJPH

Over the last quarter century, immunization has been a greater contributor to improving health in the world than any other medical intervention. This success is most notable in the Americas, the first region of the world to eradicate smallpox and also the first to eradicate poliomyelitis (the last indigenous case occurred in Peru in 1991). The strategies developed in the Americas were then applied in the rest of the world, and the eradication of polio is in sight.

This success led the Pan American Health Organization (PAHO) to set the goal of eradicating measles by 2000. Countries applied a PAHO-recommended 3-pronged vaccination strategy aimed at interruption of transmission: a one-time catch-up vaccination campaign aimed at all children aged 1 through 14 years; maintaining high levels of routine vaccination of all children by 12 months of age; and follow-up campaigns every 4 years targeting all children aged 1 through 4 years, designed to address the accumulation of susceptible children. More than 1 year has elapsed since the last indigenous case of measles was detected in the Americas (Venezuela, September 2002), signifying that indigenous transmission of measles in the region has been interrupted. PAHO has now set the target of eradicating rubella from the Americas by 2010, and countries are now implementing strategies that will certainly achieve this goal.

The success of immunization programs in the Americas is due to the high level of commitment of all involved governments to the implementation of programs that improve public health, coupled with the strong leadership of PAHO. Just as the disease eradication initiatives launched in the Americas have been expanded globally, innovative implementation strategies for immunization programs in the region have been emulated elsewhere.

But the challenges ahead loom ever larger. While the first half of the 20th century witnessed the development of several vaccines, the second half experienced a quantum leap in technologies that allowed for the research and development of vaccines for more than 30 diseases. There is now a real prospect that vaccines will be developed for diseases that were formerly thought to be chronic and degenerative but are now known to be the result of infection.

This enormous progress in research and development in the field encourages us to believe that this century will be the Century of Vaccines. Therefore, it is incumbent upon governments to ensure that resources will be available for the early introduction of the new vaccines that will be at the disposal of policymakers. This is the most certain way to eradicate other vaccine-preventable diseases and eliminate unnecessary human suffering worldwide.

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This Article Extract Full Text (PDF) Submit a response View responses Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by de Quadros, C. A. Search for Related Content PubMed Articles by de Quadros, C. A.