An estimated 51.2 million lives have been saved through vaccines in the African region over the past 50 years. For every infant life saved over that period, close to 60 years of life are lived, a new report by World Health Organisation (WHO) finds.

These achievements have been possible under the Expanded Programme on Immunization (EPI), a WHO initiative launched in 1974 as a global endeavour to ensure equitable access to life-saving vaccines for every child, regardless of their geographic location or socioeconomic status.

The report, which assesses the life-saving impact of vaccines, was released today at the start of this year’s African Vaccination Week and World Immunization Week being marked from 24–30 April under the theme “Safeguarding Our Future: Humanly Possible”.

With the continuous support from WHO, UNICEF and Gavi, the Vaccine Alliance and many others, today most countries in the region provide antigens for 13 vaccine-preventable diseases, up from the initial six when the EPI was introduced.

Notable achievements have been made, including reduction in measles deaths, with an estimated 19.5 million deaths averted over the last 22 years. The region has also witnessed a sharp decline in meningitis deaths by up to 39% in 2019 compared with 2000. Maternal and neonatal tetanus has nearly been eliminated in the region, and in a historic public health achievement, the African region was declared free of indigenous wild poliovirus in 2022 following years of relentless work to protect every child from the virus.

“From disease prevention to eradication, the success story of vaccines is a compelling one. Millions of people are alive and healthy today thanks to the protection vaccines offer,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “We have half a century of momentum and have accomplished so much. Now we must sustain and expand vaccine equity to end the threat of vaccine-preventable diseases.”

The rollout of new vaccines such as the first ever malaria vaccine, and expansion of existing vaccines, such as for HPV, which protects against the leading cause of cervical cancer, has also set up future generations in Africa with an opportunity to thrive.

“Today we celebrate the monumental advances governments and partners have taken across Africa in the last fifty years to ensure so many more children on the continent are living past their fifth birthday thanks to vaccination,” said UNICEF Regional Director for Eastern and Southern Africa, Etleva Kadilli.

“Leaders, partners and donors must strive to protect immunization gains in the region, especially in the face of backsliding rates in recent years.”

“Children that are not, or not enough, vaccinated often come from communities missed across the spectrum of social services. We must focus our efforts on finding them and ensuring they receive the life-saving vaccines and other services they need. Together, with leaders and communities, we can make this a reality,” said Gilles Fagninou, the UNICEF Regional Director for West and Central Africa.

Through Gavi, an alliance of immunization partners including WHO and UNICEF established in 2000 to expand the impact of the EPI, countries are supported to deliver vaccines against vaccine-preventable diseases including cervical cancer and malaria, and to respond to outbreaks of diseases such as Ebola and cholera.

“The evidence is clear: vaccines are one of the most impactful and cost-effective investments in health and development in history. Over the past two decades, Gavi has worked with 40 African countries to expand immunization coverage while delivering new innovations like the HPV and malaria vaccines and responding to deadly outbreaks – saving millions of lives and generating billions in economic benefits,” said Thabani Maphosa, Managing Director of Country Programmes Delivery at Gavi, the Vaccine Alliance. “With climate change, crises and the threat of infectious disease on the rise it is more important than ever that governments invest in immunization to help ensure everyone, everywhere has an equal opportunity for a safe and healthy future.”

While progress in vaccine coverage has been made, the region still faces challenges in achieving and sustaining high immunization coverage rates for most of the vaccine-preventable diseases. There are also challenges in ensuring equitable vaccine access across the continent, with a significant number of children yet to receive a single dose of life-saving vaccines while others are not receiving enough doses.

In addition, the disruptive impact of COVID-19 further strained immunization efforts. The region is yet to fully recover from the pandemic’s disruptions to immunization.

In 2022, coverage for the first and third doses of the diphtheria–tetanus–pertussis-containing vaccine (DTP1 and DTP3, respectively) and the first dose of the measles-containing vaccine (MCV1) in the region was estimated at 80%, 72% and 69%, respectively (all below the 2019 level). Only 13 of the 47 countries in the region achieved the global target coverage of 90% or above with DTP3 in 2022.

Efforts to address gaps in immunization coverage have been intensified through the “Big Catch-Up” initiative that aims to reach children who have been underserved or missed by routine vaccination programmes. Innovative initiatives such as the Zero-Dose Immunization Programme have also been established to reach communities that are living in conflict and fragile areas with essential health services.

Further efforts are needed to accelerate progress to meet the goals of Immunization Agenda 2030, a strategy endorsed during the WHO World Health Assembly in 2020, which seeks to reduce mortality and morbidity from vaccine-preventable diseases, ensure equitable access to vaccines and strengthen immunization within primary health care. A regional framework to implement the Immunization Agenda has been adopted.

To sustain progress, key strategies need to be implemented. These include controlling protracted and frequent outbreaks of vaccine-preventable diseases; increasing investment in health systems and infrastructure for effective vaccine delivery; enhancing surveillance systems to respond swiftly to outbreaks; addressing vaccine hesitancy and misinformation; bolstering domestic funding for immunization programmes; increasing the use of innovation and technology for better vaccine delivery; and investing in research and development for vaccine development.

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