Opportunities and Challenges of Vaccination

Infectious diseases are still a global health problem. This was demonstrated clearly by the cases of SARS and the problems relating to avian influenza in recent years. On a global scale, infectious agents are responsible for the death of 15 –17 million people and therefore account for one third to one fourth of the total of 57 million deaths due to disease every year. Almost six million avoidable deaths every year are caused by the three most threatening infections AIDS (Acquired Immunodeficiency Syndrome), tuberculosis and malaria.

About four million people die of diseases of the respiratory tract and almost two million of intestinal infection. The impact of infectious diseases on the quality of life and workforce capacity is even more dramatic: 40 % of chronic disease and disability are due to infectious diseases. Vaccinations are among the most efficient and most cost-effective tools to avoid infectious disease.

As they not only protect the individual but also maintain the whole population in a good state of health, successful vaccinations are of national economic relevance and a decisive contributor to economic prosperity. Smallpox has been eradicated from the globe. Cases of poliomyelitis occur in only a few countries of the world, and even there the incidence is limited to a few thousand cases per year. Until shortly before World War II, about 10,000 children died of measles, pertussis or diphtheria in Germany every year; vaccines have mostly brought these diseases under control. Over five million lives are saved by available vaccines throughout the world every year. Basic vaccines that cost only a few euros can save the life of a child in a developing country.

What has been achieved so far is no reason for complacency because dangerous causal agents change and new infectious diseases emerge. Therefore, the activities to tackle known causative organisms, identify hitherto unknown agents as early as possible and protect from newly emerging infectious diseases must continue.

The ad-hoc commission of the Leopoldina studied the current situation of infectious diseases and their prevention by immunization. The problem areas and options for action discussed below together with the current research and development needs provide the background for the recommendations addressed to scientists, political decision makers and the interested general public.