[The Expanded Program on Immunization in the WHO African region: current situation and implementation constraints]

The expanded Programme on Immunization in the African region was launched in 1978 and by the mid-eighties, all countries had established national immunization programmes. A mid decade evaluation, conducted in 1985, indicates that the regional immunization coverage was still under 20% for all antigens. For this reason, member states agreed to accelerate the programme. They adopted a resolution declaring 1986 the "African Immunization Year" and pursued implementation of various accelerated efforts until 1990. During the acceleration phase, the political commitment was strong, with the involvement of top national officials and First Ladies in launching the immunization campaign in many countries. The resources required were supplied mainly from external funding agencies. As a result, sixteen countries reached the 80% immunization coverage rates for antigens administered to the infants and remarkable progress has been achieved in the control of the EPI priority diseases. Concerning polio eradication, at least fourteen countries, representing 20% of the regional population have reported zero incidence of poliomyelitis for two consecutive years, during the period 1991-1993. In five of these countries independent teams of international and national experts assessed the quality of the epidemiological surveillance and confirmed that polio cases may have been eliminated. This suggests that a polio-free zone has emerged in the southern part of Africa, where most of these countries are located. In the meantime, an outbreak of poliomyelitis (with 28 cases confirmed by isolation of type 1 poliovirus) was reported from one country (Namibia) where no cases had been reported for the last few years. It is still unclear whether poliovirus was imported or the virus continued to circulate without causing paralytic cases.(ABSTRACT TRUNCATED AT 250 WORDS)