New immunization initiatives and progress toward the global control of hepatitis B

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Abstract
Global immunization is undergoing fundamental changes with the creation of the Global Alliance for Vaccines and Immunization, and the Vaccine Fund. This review discusses the implication of these changes for global control of hepatitis B with vaccine, which is now progressing rapidly. Through the 1970s and 1980s there was a steady increase in routine immunization of children in the world which peaked in 1990 with approximately 75% of the world's children receiving routine immunizations. During the 1990s, support for immunization and routine coverage stagnated and declined in some regions. In parallel, since 1982, hepatitis B vaccine has become increasingly available in the industrial world and in middle-income countries. Hepatitis B vaccine adoption was limited in the poorest countries until a new alliance called the Global Alliance for Vaccines and Immunizations began in 1999. The Vaccine Fund was also established that year to bring additional financial resources to immunization. Through the work of the Global Alliance for Vaccines and Immunization and the Vaccine Fund, new and traditional partners in immunization are working more effectively together, providing more resources to improve immunization worldwide, and making underutilized vaccines such as hepatitis B available to the poorest children of the world. Within 5 years, hepatitis B vaccine will be almost universally available to the world's children, saving an estimated 1 million lives per year.