TY - JOUR T1 - Routine immunization: an essential but wobbly platform JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT SP - 295 LP - 301 DO - 10.9745/GHSP-D-13-00122 VL - 1 IS - 3 AU - Robert Steinglass Y1 - 2013/11/01 UR - http://www.ghspjournal.org/content/1/3/295.abstract N2 - Despite their vital role, routine immunization programs are taken for granted. Coverage levels are poor in some countries and have stagnated in others, while addition of new vaccines is an additional stressor. We need to strengthen: (1) policy processes, (2) monitoring and evaluation, (3) human resources, (4) regular delivery and supply systems, (5) local political commitment and ownership, (6) involvement of civil society and communities, and (7) sustainable financing. Rebalancing immunization direction and investment is needed. One-third of the way through the so-called Decade of Vaccines, this is an exciting time for immunization. The World Health Assembly has endorsed a Global Vaccine Action Plan (GVAP),1 in which immunization is to be extended as a human right beyond infancy across the entire life cycle. Powerful new life-saving vaccines against some causes of pneumonia and diarrhea, the biggest contributors to child mortality, are being introduced. With a global sense of purpose and vastly increased resources, new partners have entered the vaccine and immunization arena. Anticipating the end of poliomyelitis, some are already scanning the horizon for the next disease to eradicate. However, at this promising moment, the immunization, disease control, and development communities collectively would do well to reflect on past and current directions so as to engage in a genuine debate about the need to restore balance within the realm of immunization. One school of thought holds that investments to achieve broad health system strengthening (HSS) goals will, like the tide, raise all boats and so contribute to the strengthening of routine immunization (RI).2 The proponents of this theory use a preferred metric of reduced child mortality from all causes. Another school claims that investments in single-disease control, elimination, or eradication initiatives will strengthen RI and health systems more broadly.3 The preferred metric among these thinkers is declining … ER -