Immunization efforts are under growing threat as
misinformation, population growth, humanitarian crises, and
funding cuts jeopardize progress and leave millions of
children, adolescents, and adults at risk, warn WHO, UNICEF,
and Gavi during World Immunization Week, 24-30
April.
Outbreaks of vaccine-preventable diseases such
as measles, meningitis, and yellow fever are rising
globally, and diseases like diphtheria, which have long been
held at bay or virtually disappeared in many countries, are
at risk of re-emerging. In response, the agencies are
calling for urgent and sustained political attention and
investment to strengthen immunization programmes and protect
significant progress achieved in reducing child mortality
over the past 50 years.
“Vaccines have saved more than
150 million lives over the past five decades,” said WHO
Director-General, Dr Tedros Adhanom Ghebreyesus. “Funding
cuts to global health have put these hard-won gains in
jeopardy. Outbreaks of vaccine-preventable diseases are
increasing around the world, putting lives at risk and
exposing countries to increased costs in treating diseases
and responding to outbreaks. Countries with limited
resources must invest in the highest-impact interventions –
and that includes vaccines.”
Rising outbreaks and
strained health systems
Measles is making an
especially dangerous comeback. The number of cases has been
increasing year on year since 2021, tracking the reductions
in immunization coverage that occurred during and since the
COVID-19 pandemic in many communities. Measles cases reached
an estimated 10.3 million in 2023, a 20 per cent increase
compared to 2022.
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The agencies warn that this upward
trend likely continued into 2024 and 2025, as outbreaks have
intensified around the world. In the past 12 months, 138
countries have reported measles cases, with 61 experiencing
large or disruptive outbreaks – the highest number observed
in any 12-month period since 2019.
Meningitis cases in
Africa also rose sharply in 2024, and the upward trend has
continued into 2025. In the first three months of this year
alone, more than 5,500 suspected cases and nearly 300 deaths
were reported in 22 countries. This follows approximately
26,000 cases and almost 1,400 deaths across 24 countries
last year.
Yellow fever cases in the African region
are also climbing, with 124 confirmed cases reported in 12
countries in 2024. This comes after dramatic declines in the
disease over the past decade, thanks to global vaccine
stockpiles and the use of yellow fever vaccine in routine
immunization programmes. In the region of the Americas,
yellow fever outbreaks have been confirmed since the
beginning of this year, with a total of 131 cases in 4
countries.
These outbreaks come amidst
global funding cuts. A recent WHO
rapid stock take with 108 country offices of WHO-mostly
in low- and lower-middle-income countries-shows that nearly
half of those countries are facing moderate to severe
disruptions to vaccination campaigns, routine immunization,
and access to supplies due to reduced donor funding. Disease
surveillance, including for vaccine-preventable diseases, is
also impacted in more than half of the countries
surveyed.
At the same time, the number of
children missing routine vaccinations has been increasing in
recent years, even as countries make efforts to catch up
children missed during the pandemic. In 2023, an estimated
14.5 million children missed all of their routine vaccine
doses-up from 13.9 million in 2022 and 12.9 million in 2019.
Over half of these children live in countries facing
conflict, fragility, or instability, where access to basic
health services is often disrupted.
“The global
funding crisis is severely limiting our ability to vaccinate
over 15 million vulnerable children in fragile and
conflict-affected countries against measles,” said UNICEF
Executive Director Catherine Russell. “Immunization
services, disease surveillance, and the outbreak response in
nearly 50 countries are already being disrupted-with
setbacks at a similar level to what we saw during COVID-19.
We cannot afford to lose ground in the fight against
preventable diseases.”
Continued investment in the
‘Big Catch-Up initiative’, launched in 2023 to reach
children who missed vaccines during the COVID-19 pandemic,
and other routine immunization programmes will be
critical.
How immunization addresses these
challenges
Joint efforts by WHO, UNICEF, Gavi and
partners have helped countries expand access to vaccines and
strengthen immunization systems through primary health care,
even in the face of mounting challenges. Every year,
vaccines save nearly 4.2 million lives against 14 diseases –
with nearly half of these lives saved in the African
region.
Vaccination campaigns have led to the
elimination of meningitis A in Africa’s meningitis belt,
while a new vaccine that protects against five strains of
meningitis holds promise for broader protection, with
efforts underway to expand its use for outbreak response and
prevention.
Progress has also been made in reducing
yellow fever cases and deaths through increasing routine
immunization coverage and emergency vaccine stockpiles, but
recent outbreaks in Africa and in the Region of the Americas
highlight the risks in areas with no reported cases in the
past, low routine vaccination coverage and gaps in
preventive campaigns.
In addition, the past two years
have seen substantial progress in other areas of
immunization. In the African region, which has the highest
cervical cancer burden in the world, HPV vaccine coverage
nearly doubled between 2020 and 2023 from 21 per cent to 40
per cent, reflecting a concerted global effort towards eliminating
cervical cancer. The progress in immunization also
includes increases in global coverage of pneumococcal
conjugate vaccines, particularly in the South-East Asia
Region, alongside introductions in Chad and Somalia,
countries with high disease burden.
Another milestone
is the sub-national introduction of malaria vaccines in
nearly 20 African countries, laying the foundation to save
half a million additional lives by 2035 as more countries
adopt the vaccines and scale-up accelerates as part of the
tools to fight malaria.
Call to
action
UNICEF, WHO, and Gavi urgently
call for parents, the public, and politicians to strengthen
support for immunization. The agencies emphasize the need
for sustained investment in vaccines and immunization
programmes and urge countries to honour their commitments to
the Immunization Agenda 2030 (IA2030).
As
part of integrated primary healthcare systems, vaccination
can protect against diseases and connect families to other
essential care, such as antenatal care, nutrition or malaria
screening. Immunization is a ‘best buy’ in health with a
return on investment of $54 for every dollar invested and
provides a foundation for future prosperity and health
security.
“Increasing outbreaks of highly infectious
diseases are a concern for the whole world. The good news is
we can fight back, and Gavi’s next strategic period has a
clear plan to bolster our defences by expanding investments
in global vaccine stockpiles and rolling out targeted
preventive vaccination in countries most impacted by
meningitis, yellow fever and measles,” said Dr Sania
Nishtar, CEO of Gavi, the Vaccine Alliance. “These vital
activities, however, will be at risk if Gavi is not fully
funded for the next five years and we call on our donors to
support our mission in the interests of keeping everyone,
everywhere, safer from preventable diseases.”
Gavi’s
upcoming high-level pledging summit taking place on 25 June
2025 seeks to raise at least US$ 9 billion from our donors
to fund our ambitious strategy to protect 500 million
children, saving at least 8 million lives from
2026-2030.
