Global immunization progress threatened by misinformation and funding cuts

Global immunization progress threatened by misinformation and funding cuts

Immunization efforts are under growing threat as misinformation, population growth, humanitarian crises and funding leave progress compromised and millions of children, young people and adults at risk, UNICEF and Gavi warn during World Immunization Week April 24-30.

Outbreaks of vaccine-replicating diseases such as measles, meningitis and yellow fever are surging worldwide, and diseases such as diphtheria, which have long been contained or have virtually disappeared in many countries, are at risk of re-emergence. In response, the agencies call for urgent and sustained policy attention and investment to strengthen immunization programs and protect significant progress in reducing child mortality over the past 50 years.

“Vaccines have saved more than 150 million lives over the last five decades,” said Director General Dr. Tedros Adhanom Ghebreyesus. "Funding cuts in global health have achieved these hard-fought danger results. Vaccine vaccine outbreaks are surging across the globe, exposing countries to risk and exposing more costs in treating diseases and responding to outbreaks with countries with limited resources.

Rising outbreaks and strained health systems

Measles is making a particularly dangerous comeback. The number of cases has increased year-on-year since 2021, tracking the reduction in immunization coverage that has occurred in many communities during and since the Covid-19 pandemic. Measles cases reached an estimated 10.3 million in 2023, a 20% increase from 2022.

The agencies warn that this upward trend is likely to have continued into 2024 and 2025 as outbreaks have worsened worldwide. In the past 12 months, 138 countries reported measles cases, 61 of which experienced large or disruptive outbreaks - the highest number in a 12-month period since 2019.

Meningitis cases in Africa also rose sharply in 2024, and the upward trend only continued in the first three months of this year. More than 5,500 suspected cases and almost 300 deaths have been reported in 22 countries. This follows approximately 26,000 cases and nearly 1,400 deaths in 24 countries last year.

Yellow fever cases in the African region are also rising, 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 stocks and the use of yellow fever vaccines in routine immunization programs. Yellow fever outbreaks have been confirmed in the WHO Region of the Americas since the beginning of this year, with a total of 131 cases in 4 countries.

These outbreaks come amid global funding cuts. A recent WHO RACID survey of 108 WHO country offices - primarily in low- and lower-middle-income countries - shows that almost half of these countries are facing moderate to severe disruptions to vaccination campaigns, routine immunization and access to supplies due to reduced donor funding. Disease surveillance, including vaccine outcomes, is also affected in more than half of the countries surveyed.

At the same time, the number of missed routine child immunizations has increased in recent years, even as countries have made efforts to catch up with 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 essential health services is often disrupted.

“The global funding crisis severely limits our ability to vaccinate over 15 million vulnerable children against measles in fragile and conflict-affected countries,” said Catherine Russell, Executive Director of UNICEF. "Immunization services, disease surveillance and outbreak response in nearly 50 countries are already being disrupted - with setbacks at levels similar to those experienced during Covid-19. We cannot afford to lose ground in the fight against preventable diseases."

Further investment in the 'Big Cate-up Initiative', launched in 2023 to reach children who missed vaccines during the Covid-19 pandemic, and other routine immunization programs will be crucial.

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 increasing challenges. Each year, vaccines save nearly 4.2 million lives against 14 diseases – and nearly half of those lives are saved in the African region.

Vaccination campaigns have led to the elimination of meningitis A from Africa's meningitis belt, while a new vaccine that protects against five strains of meningitis promises broader protection.

Progress has also been made in reducing yellow fever cases and deaths by increasing routine immunization coverage and emergency vaccine stocks, but recent outbreaks in Africa and the Americas region underscore the risks in areas with no reported cases in the past, low routine immunization coverage, and gaps in preparedness campaigns.

In addition, the last two years have seen significant 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 from 21% to 40% between 2020 and 2023, reflecting a concerted global effort to eliminate cervical cancer. Advances in immunization also include an increase in global coverage of pneumococcal-conjugated vaccines, particularly in the Southeast Asia region, alongside introductions in Chad and Somalia, countries with high disease burdens.

Another milestone is the subnational rollout of malaria vaccines in nearly 20 African countries, laying the foundation to save half a million additional lives by 2035 as more countries take up the vaccines and accelerate as part of the tools to combat malaria.

Call to action

UNICEF and Gavi urge parents, the public and politicians to strengthen support for vaccination. The agencies emphasize the need for sustained investment in vaccines and immunization programs and call on countries to meet their commitments to the 2030 Immunization Agenda (IA2030).

Within integrated primary health systems, vaccination can protect against disease and connect families to other essential care, such as: B. prenatal care, nutrition or malaria screening. Immunization is a “best buy” in health with a return on investment of $54 for every dollar invested, providing a foundation for future prosperity and health security.

Increased outbreaks of highly infectious diseases are a problem for the entire world. The good news is that we can fight back, and Gavi's next strategic period has a clear plan to strengthen our defenses by expanding investment in global vaccine stocks and targeted preventive vaccination in countries most affected by meningitis, yellow fever and measles. However, these important activities are at risk if Gavi is not fully funded for the next five years, and we urge our donors to support our mission in the interest of helping everyone, everywhere, be safer from preventable diseases. “

Dr. Sania Nishtar, CEO of Gavi, The Vaccine Alliance

Gavi's upcoming high-level mediation summit on June 25, 2025 seeks to raise at least $9 billion from our donors to fund our ambitious strategy to protect 500 million children and save at least 8 million lives from 2026 to 2030.

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