The World Health Organisation (WHO) has reported that vaccination programmes across Africa have saved tens of millions of lives over the past two decades, even as global health progress begins to slow in several countries.
A comprehensive analysis of immunisation in the region shows that more than 500 million children have been reached through routine vaccination since 2000. According to the WHO, these efforts prevent over 4 million deaths each year. Over the past five decades, vaccines are estimated to have saved more than 50 million lives in Africa—adding roughly 60 years of life expectancy for each infant life saved.
Growing pressure on health systems
Despite these gains, health systems across the continent—home to about 1.5 billion people—are facing increasing strain. The WHO cites reduced global health funding, including shifts in U.S. foreign aid policy under President Donald Trump’s “America First” approach, alongside disruptions from geopolitical conflicts affecting supply chains and humanitarian budgets.
In 2024 alone, vaccines prevented nearly 2 million deaths. Key milestones also include Africa’s certification as free of wild poliovirus in 2020, which the WHO described as a historic achievement. Most countries have also eliminated maternal and neonatal tetanus.
Progress in disease control
New vaccines are also expanding protection against malaria, now being rolled out in 25 countries. The disease still kills more than 400,000 people annually, mostly children under five. WHO Regional Director for Africa, Dr Mohamed Janabi, described the rollout as a major public health breakthrough.
Measles control has also improved significantly, with nearly 20 million deaths averted since 2000. Forty-four countries have introduced a second dose of the measles vaccine, helping increase coverage from 5% in 2000 to 55% in 2024. Cabo Verde, Mauritius, and Seychelles have already achieved measles and rubella elimination status.
Equity gaps remain wide
However, progress remains uneven. The COVID-19 pandemic increased the number of children who have never received a single vaccine, with just ten countries accounting for around 80% of unvaccinated children in the region.
Dr Janabi described the situation as a “profound equity issue,” while Gavi chief executive Dr Sania Nishtar said immunisation outcomes continue to reflect deep inequalities, especially in fragile and hard-to-reach areas.
Funding pressures and global instability
Health experts warn that funding remains the biggest threat to Africa’s immunisation gains. The return of Donald Trump to the U.S. presidency in 2025 and subsequent aid cuts have reduced global health financing, with reports indicating the loss of a significant share of overseas development support to WHO-linked programmes.
Professor Shabir Madhi of the University of the Witwatersrand said many aid-funded health initiatives have already scaled back or shut down, affecting access to clinics, health workers, and cold-chain systems.
Conflict-related disruptions, including tensions in the Middle East, have also affected fuel prices and supply chains—adding pressure on health systems that rely heavily on generator-powered facilities.
Calls for sustainability
Health leaders are urging African governments to increase domestic financing and reduce reliance on external donors. Gavi officials say countries must define how much of their immunisation programmes they can sustainably fund themselves.
While acknowledging the financial strain, experts say long-term stability will depend on stronger local investment, improved policy direction, and sustained political commitment to immunisation.
Outlook to 2030
Africa remains off track to meet the Immunisation Agenda 2030 target of 90% coverage for key vaccines. Although routine immunisation now protects against 13 diseases—up from eight in 2000—coverage remains uneven, with rapid population growth, weak health systems, and climate-related challenges adding pressure.
Despite these setbacks, health officials insist the progress made so far shows what is possible when immunisation is prioritised. The challenge ahead, they say, is ensuring that no child is left behind as the continent works toward more sustainable, self-reliant health systems.