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The Children's Vaccine Initiative: Achieving the Vision
TABLE 4-1 Estimated Worldwide Usage of Vaccines, 1990 (in millions of doses)
Vaccine
North America Europe, and Japan
UNICEF PAHO, and WHO
Other
Total
BCG
5
160
20
185
DTP
40
219
50
260
Hepatitis B
15
35
50
Influenza
75
10
85
Measles and combined
15
131
30
165
Meningococcal
10
20
30
60
Polio (OPV, IPV)
60
450
190
700
Rabies
1
3
4
8
Total
211
983
358
1,552
Percentage of total
14
63
23
100
SOURCE: Adapted from N. Baudrihaye, European Federation of Pharmaceutical Industries Association, Brussels, 1992; with additional information provided by Akira Homma, PAHO, 1993; John Gilmartin, UNICEF, 1993; Terrel Hill, UNICEF, 1993.
much larger than that in the industrialized world (almost 80 percent of the 143 million live births occur in the developing world), the amount spent on vaccines in the industrialized world greatly exceeds that spent by UNICEF, PAHO, and WHO. The total worldwide value of human vaccines sold in 1992 has been estimated to be as high as $3 billion (Technology Management Group, 1993), of which only $65 million represented UNICEF purchases (John Gilmartin, UNICEF, personal communication, 1993).
Regional Demand
Assessments of country-level demand for vaccines must take into account the size of the target population, estimated extent of immunization coverage, anticipated vaccine wastage, number of scheduled doses, and any special immunization campaigns or strategies that would lead to a surge in demand. Determination of demand for vaccines is more problematic when special, intensive immunization strategies are considered (World Health Organization/Children's Vaccine Initiative, 1992c). For example, the ongoing global campaign to eradicate polio in the Americas has led to increased demand for and, at brief intervals, temporary shortages of polio vaccine (Pan American Health Organization, 1992). In 1992, UNICEF
