Africa’s Immunisation Struggle: Why Millions of Children Still Miss Lifesaving Vaccines

Vaccine-preventable diseases cost African countries a staggering USD 13 billion each year in direct and indirect expenses.

Despite overwhelming evidence of the effectiveness of vaccines in saving lives, over 500,000 children under the age of five die annually in Africa from diseases that are largely preventable. These include measles, diphtheria, tetanus, pertussis (whooping cough), and polio—diseases that have been brought under control or even eliminated in many other parts of the world.

However, for millions of African children, life-saving immunisation remains elusive. Challenges such as limited domestic healthcare funding, deep-rooted vaccine mistrust, political instability, and difficult-to-reach remote communities have severely hampered vaccination campaigns across the continent.

Immunisation Coverage: A Mixed Picture Across Africa

In 2023, only 16 African countries achieved over 90% coverage for essential childhood vaccines, particularly the third dose of the diphtheria, tetanus, and pertussis vaccine (DTP3) and the first dose of the measles-containing vaccine (MCV1). This falls short of the WHO’s Global Vaccine Action Plan targets and leaves millions of children unprotected.

Since 2018, 28 African countries have experienced large-scale measles outbreaks, despite the measles vaccine costing a mere USD 2.85 per vial. These outbreaks are not just public health crises; they are symptoms of systemic fragility and inequity in access to basic health services.

Zero-Dose Children: A Growing Concern

Perhaps even more alarming is the rise in “zero-dose” children—those who have received no vaccinations whatsoever. By 2023, this number had risen to 7.9 million, marking a 16% increase since 2019. Countries like Nigeria, South Sudan, and the Democratic Republic of Congo account for the majority of these cases, and the residual effects of COVID-19-related disruptions have only made matters worse.

Outbreaks in Somalia, Ethiopia, Zimbabwe, and recent cases of diphtheria and pertussis in Chad and Nigeria further underscore the urgency of addressing these immunisation gaps.

The Economic Toll: Billions Lost Annually

The consequences of under-immunisation extend beyond the health sector. Vaccine-preventable diseases cost African countries a staggering USD 13 billion each year in direct and indirect expenses. These include treatment costs, productivity losses, and economic drag from health emergencies—placing a heavy burden on already strained healthcare systems.

Yet, according to global health experts, immunisation yields a return of up to 37 times the cost invested. It remains one of the most cost-effective public health interventions available.

Strategic Continental Action: Africa CDC Takes the Lead

In response to these challenges, the Africa Centres for Disease Control and Prevention (Africa CDC), in collaboration with the African Union Commission (AUC), WHO, UNICEF, GAVI, PATH, and other partners, has launched the Continental Immunisation Strategy.

This framework, guided by the Addis Declaration on Immunisation and aligned with the Immunisation Agenda 2030, aims to create a resilient, unified, and equitable vaccine delivery system across the continent. The strategy focuses on:

• Strengthening cold chain infrastructure

• Training healthcare professionals

• Improving disease surveillance and data systems

• Mobilising emergency vaccine supplies

• Expanding pharmacovigilance (vaccine safety monitoring)

A Vision for Self-Sufficiency: Local Vaccine Production

“Africa currently produces less than 1% of the vaccines it uses,” noted Dr. Jean Kaseya, Director General of Africa CDC. “Our goal is to manufacture 60% of vaccines used in Africa locally by 2040.”

As of 2024, 25 vaccine manufacturing projects are in progress across the continent. Notably, eight vaccine antigens are expected to achieve WHO prequalification and become market-ready between 2025 and 2030. These projects signify a major push toward regional vaccine sovereignty, reducing dependence on global supply chains that have historically sidelined African nations during global crises, such as the COVID-19 pandemic.

Financing the Future: Mobilising Domestic Resources

Recognising that donor aid alone is insufficient, Africa CDC and its partners are working to mobilise domestic financing for immunisation. This includes innovative funding mechanisms, public-private partnerships, and incentive-based financing to ensure sustainability and close persistent coverage gaps.

Countries are being encouraged to integrate immunisation financing into national budgets, rather than rely exclusively on external funding. This shift is seen as essential for long-term success and sovereignty in healthcare planning.

Africa Vaccination Week: A Time for Action

Africa Vaccination Week serves as a powerful reminder that the challenges to immunisation are not insurmountable. With renewed political commitment, increased investment, and regional collaboration, the continent has both the tools and the momentum to protect its children, fortify its health systems, and build a brighter, healthier future.

As stakeholders reflect on the progress and the gaps, one message rings clear: the time to act decisively is now.