Introduction: Africa’s Immunization Landscape and Its Significance
Africa stands at a pivotal moment in its public health journey. With a current population of 1.4 billion and projections to reach 3.3 billion by 2075, the continent’s immunization landscape holds immense significance—not only for health outcomes but for economic and social development. Immunization programs have already saved millions of lives, reduced disease burdens, and helped build resilient health systems. Yet, as Africa grows and evolves, so too does the need to accelerate and expand these efforts to match the continent’s dynamic future. On the 28th of April, Africa’s health and political leadership stepped up to do just that through the launch of the first Africa-led Continental Immunization Strategy.
Progress Achieved: Key Milestones and Improvements
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Over the past five decades we have seen the great impact of vaccinations, immunization has saved more than 50 million lives on the African continent and has contributed to over 50% of the reduction in infant mortality in Africa.
Ninety percent of countries no longer have maternal and neonatal tetanus, indigenous wild polio virus has also been eradicated in Africa since 2020 and four countries have eliminated measles and rubella .
The continent has succeeded in eliminating diseases like wild poliovirus, and routine vaccination rates for childhood diseases such as measles, diphtheria, and tetanus have steadily improved. Today, more children than ever before receive life-saving vaccines, and several countries have introduced new vaccines, including those for pneumonia, rotavirus, human papillomavirus, and malaria.
These achievements are the result of robust political commitment by African nations, community engagement, and partnership with global initiatives like Gavi, the Vaccine Alliance, international organizations such as WHO, UNICEF, Gates Foundation, and World Bank. Bilateral partners across the world and civil society have played critical roles in providing access to affordable vaccines, strengthening health systems and primary health care.
Untapped Potential: Gaps, Challenges, and Opportunities
Despite these successes, significant gaps remain. Coverage rates are uneven, with rural and marginalized communities, fragile and conflict affected communities, climate affected communities facing major challenges. Disruptions from COVID 19 pandemic linger, weak health infrastructure, increasing urban slums and high population movement are major factors that must be addressed to achieve and sustain high immunization rates. Increased outbreaks of vaccine-preventable diseases including vaccine derived polio virus, underscore the need for readiness, and more comprehensive prevention, preparedness and response systems. Logistical challenges, weak data systems, inadequate human resources and distribution, climate incursions, gender inequities, vaccine hesitancy, human resources constraints especially at the community level, and inadequate domestic resources while global funding shortfalls further limit progress.
According to the 2024 WHO and UNICEF Estimates of National Immunization Coverage (WUENIC), DTP3 coverage in Africa stands at 76 per cent, unchanged from 2023, which is well below the IA2030 target of 90 per cent. Approximately 7.8 million children in the region missed out on DTP1 in 2024, an increase in zero dose children compared to 2023. Though continental efforts have reached more children, amidst a rising number of births, the pace of change is insufficient to reduce zero-dose children and achieve universal coverage.
Furthermore, the continent stands at a defining moment for the sustainability of its public health programs, including immunization programs, given the decline in external health financing to most African countries and the rising debt crisis. For example, Official Development Assistance is projected to decline by an additional 9 per cent – 17 per cent over 2024 level. While exact global dollar figures vary by source, the United States alone terminated 83 per cent of USAID programs in early 2025, creating a $60 billion funding gap. This is compounded by inadequate domestic health financing, with only few African countries meeting the 15 per cent national budget allocation for health. Furthermore, over 90 per cent of Africa’s vaccines and medical countermeasures are imported, making the continent’s immunization programs vulnerable to global supply chain disruptions.
However, these challenges also present opportunities to re-imagine immunization programs. Innovations in digital health, new technology, systems improvement, innovative last mile supply chain management for example offer new ways to reach underserved populations. Additionally, integrating immunization with primary health care and other health services can streamline delivery and maximize impact. The untapped potential is vast: by closing coverage gaps, Africa can reduce mortality from vaccine preventable disease, curb disease outbreaks, and create a healthier, more productive workforce. Immunization investment in Africa will boost human development and drive economic growth- it is a best in class investment and priority for Africa.
In this regard, Africa CDC is intensifying its efforts to tackle immunization challenges across the continent by strengthening leadership and focusing on Member states priorities.
Benefits of High Immunization Rates: Health, Economic, and Social Impacts
The benefits of achieving high immunization rates extend far beyond individual health. Widespread vaccination protects communities through herd immunity, reducing the spread and impact of infectious diseases. This, in turn, lessens the burden on health systems, freeing resources for other critical needs.
Economically, immunization is one of the highest-yielding public health investments. Healthy children are more likely to attend school, and healthy adults are more productive, contributing to economic growth and stability. Socially, immunization empowers communities, reduces health disparities, and enhances trust in public institutions.
Return on Investment: Every Dollar Invested for Africa’s Present and Future is worth it
The return on investment (ROI) in immunization is compelling. Studies estimate that for every dollar spent on vaccines, there is a return of up to $54 in economic and social benefits, including costs averted from illness, disability, and lost productivity. A modelling analysis suggests that investments in vaccination programmes in 94 Gavi supported countries (mostly countries in Africa) will result in US$ 0.8 trillion in returns over the next ten years. This estimated net benefit is about 20 times larger than the costs forecasted for vaccination programmes over the next ten years, from 2021-30.
Looking ahead to 2075, when Africa’s population is projected to reach 3.3 billion, the stakes—and the rewards—will be even greater unless we ensure high and sustained coverage. Investing in immunization now lays the groundwork for a healthier, more prosperous future. As disease threats evolve, sustained and increased investment will ensure that the continent can protect its growing population and capitalize on the demographic dividend.
Openness for Partnerships: The Role of Collaboration and International Support
Africa’s immunization success story is inseparable from the power of partnership. Governments, international agencies, the private sector, and civil society have all contributed to progress so far. Moving forward, greater openness to collaboration will be essential to build a sustainable value chain for immunization from childhood to adulthood including local manufacturing, end to end digitized systems, tailored service delivery and primary health care that ensures no one is left behind.
By leveraging shared resources, expertise, and innovation, partners can help close coverage gaps, reduce zero dose and under immunized populations, introduce new vaccines, and build resilient health systems capable of withstanding stresses and responding to disease outbreaks and emerging threats. The continent’s youthful population and rapid urbanization present unique opportunities for tailored solutions and scalable impact.
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Conclusion: A Call to Action and Future Outlook
Africa’s immunization goals can be achieved through leadership, commitment, innovation, and partnership as described in it’s recently launched Continental Immunization Strategy. As the continent prepares for a future defined by rapid population growth, the time to invest in immunization is now.
Action Items for advancing resilient immunization in Africa include:
Strengthen Leadership, Political Commitment and Community Engagement.
Prioritize Domestic Investment in immunization for Long-Term Returns
Leverage Innovation, Digitization, AI and Technology
Integrate Immunization with Primary Health Care, MNCH and broader health systems strengthening
Invest in Local Manufacturing and Sustainable Value Chains, and
Foster Partnerships and Collaboration.
Every dollar spent on immunization delivers exponential returns—for better health, stronger economies, and productive communities.
By unlocking the full potential of immunization, Africa can secure a brighter, healthier, and more prosperous future.
Folake Olayinka is Director of Immunization, Africa Centres for Disease Control and Prevention, and Charles Shey Wiysonge is Senior Consultant for Immunization, Africa Centres for Disease Control and Prevention.
https://immunizationdata.who.int
New evidence shows investments in vaccination produce even greater returns than previously thought
