Immunization at Crossroads: Global Health Leaders Warn of Backsliding Amid Severe Threat

With the stakes so high, WHO, UNICEF, and Gavi are calling on world leaders, civil society, and the public to bolster support for immunization.

During World Immunization Week (24–30 April), the World Health Organization (WHO), UNICEF, and Gavi, the Vaccine Alliance, issued a dire warning: global immunization efforts are under severe threat. Misinformation, rapid population growth, escalating humanitarian crises, and drastic funding cuts are converging to jeopardize decades of progress. This confluence of challenges has left millions of children, adolescents, and adults at heightened risk of contracting deadly but preventable diseases.

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, emphasized the magnitude of the situation: “Vaccines have saved more than 150 million lives over the past five decades. But funding cuts to global health have put these hard-won gains in jeopardy.”

A Surge in Outbreaks: The Numbers Behind the Crisis

The data tells a chilling story:

• Measles: Once on the verge of eradication in many countries, measles is now surging. In 2023 alone, there were 10.3 million estimated cases—a 20% jump from 2022. The trend has continued into 2024 and 2025, with 138 countries reporting outbreaks, 61 of which are considered large or highly disruptive—the worst figures since 2019.

• Meningitis: In Africa, cases of meningitis spiked significantly in 2024. The first quarter of 2025 recorded over 5,500 suspected cases and nearly 300 deaths across 22 countries, a continuation of the previous year’s toll of 26,000 cases and almost 1,400 deaths.

• Yellow Fever: After years of decline, yellow fever is resurging. In 2024, 124 confirmed cases were reported in 12 African countries. The Americas are also experiencing outbreaks, with 131 cases spread across four countries so far this year.

These alarming trends are occurring amid substantial global funding cuts. A WHO rapid assessment of 108 countries—primarily in low- and lower-middle-income brackets—revealed that nearly half are facing moderate to severe disruptions to routine immunization services, vaccine supply chains, and disease surveillance systems.

The Domino Effect of Disruption

The setbacks are hitting the most vulnerable hardest. An estimated 14.5 million children missed all routine vaccinations in 2023, a troubling increase from 13.9 million in 2022 and 12.9 million in 2019. Over 50% of these unvaccinated children live in regions impacted by conflict, fragility, or instability—places where access to even the most basic health services is tenuous.

UNICEF Executive Director Catherine Russell warns that “Immunization services, disease surveillance, and outbreak response in nearly 50 countries are already being disrupted—with setbacks at a similar level to what we saw during COVID-19.”

A Resilient Response: What’s Being Done

Despite the setbacks, there are rays of hope. The global health community has launched ambitious initiatives to turn the tide:

• The Big Catch-Up Initiative: Launched in 2023, this campaign aims to vaccinate children who missed routine immunizations during the COVID-19 pandemic. It’s a crucial step to prevent further backsliding.

• Meningitis A Success: Africa has seen the successful elimination of meningitis A in its “meningitis belt” thanks to widespread vaccination, and a new five-strain meningitis vaccine is being rolled out for broader protection.

• Yellow Fever Control: Emergency vaccine stockpiles and routine immunization efforts have historically controlled yellow fever. However, expanding these programs to under-immunized regions is now a priority.

• HPV and Pneumococcal Coverage: Global coverage for the HPV vaccine nearly doubled in Africa from 21% to 40% between 2020 and 2023. Pneumococcal conjugate vaccines have also seen increased uptake, especially in South-East Asia and new introductions in high-burden countries like Chad and Somalia.

• Malaria Vaccine Rollout: Nearly 20 African countries have initiated sub-national introductions of the malaria vaccine. Experts believe this will help save up to half a million lives by 2035.

Economic Sense, Human Urgency

Immunization is not only a health imperative but also an economic one. With a return on investment of $54 for every $1 spent, vaccination is one of the most cost-effective health interventions. It also acts as an entry point to other essential services, such as antenatal care and malaria screening.

“Countries with limited resources must invest in the highest-impact interventions – and that includes vaccines,” Dr. Tedros reiterated.

The Road Ahead: A Call for Political and Financial Commitment

With the stakes so high, WHO, UNICEF, and Gavi are calling on world leaders, civil society, and the public to bolster support for immunization.

Dr. Sania Nishtar, CEO of Gavi, stressed, “We can fight back… but these vital activities will be at risk if Gavi is not fully funded for the next five years.” Gavi’s high-level pledging summit on 25 June 2025 aims to raise at least US$ 9 billion to protect 500 million children and save 8 million lives between 2026 and 2030.

 

Vaccines are one of humanity’s most powerful tools against disease, suffering, and death. The world now stands at a critical juncture: to either recommit to immunization with the urgency and investment it demands or risk a reversal that could cost millions of lives. The warning is clear, and the solution is within reach—if the world acts now.