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



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