Kate O'Brien, Director of the Department of Immunization, Vaccines and Biologicals at WHO
On July 15, WHO and UNICEF unveiled their latest national immunization coverage estimates (WUENIC), the most comprehensive dataset on vaccination trends against 13 diseases. The results are a mix of progress and urgent calls to action.
In 2023, an impressive 108 million children globally received three doses of the vaccine against diphtheria, tetanus and pertussis (DTP) – a key marker for global immunization coverage. However, the data reveals a stark reality: 14.5 million missed all doses of DTP containing vaccine, putting them at grave risk of diphtheria, tetanus, and pertussis. Even more concerning is that over half of these children live in fragile, conflict-ridden areas, where their vulnerability is compounded.
Worse still, 6.5 million children did not complete their follow-up DTP doses, and global immunization coverage of this critical core measure of programme performance has stagnated since 2022. The pandemic's impact lingers, with 600,000 more zero dose children in 2023, than 2022, and 1.7 million more than in 2019. This increase over pre-pandemic levels rises to 2 million when under-vaccinated children are also included. This stagnation in recovery and strengthening of coverage highlights the dire need to innovate, find locally impactful approaches, and most critically, enhance the political and social leadership that are the basis for intensified actions needed to meet the Immunization Agenda 2030 targets: 90% coverage and a 50% reduction in the number of zero-dose children (to no more than 6.5 million) by 2030.
The data on measles vaccine coverage is particularly alarming. Despite measles being a highly preventable disease, nearly 35 million children are still missing one or more doses of vaccine through RI. These figures fall woefully short of what's needed to prevent outbreaks and deaths, underscoring the urgency of closing immunization gaps. The WUENIC estimates particularly highlight that the 91 countries without significant measles outbreaks in the past 5 years are at least 10 percentage points higher in their MCV1 coverage than the average coverage among the 103 countries that have suffered measles outbreaks. This hammers home the point that high routine immunization coverage of measles vaccine forms the foundation on which prevention of outbreaks is achieved, though that achievement often includes supplementary, gap filling outreach efforts. These supplementary efforts are insufficient to fully avoid outbreaks, when the foundation of coverage through the routine delivery channel is lacking.
Yet, amidst this global stagnation, there are some bright areas, particularly in Africa. The region defied the odds increasing routine immunization coverage, with 1.5 million more children vaccinated with DPT vaccine than in 2019 and a fall in the number of zero dose children from 7.3mn in 2022 to 6.7mn in 2023 . This progress, despite the challenges of a growing child population, reflects the growing national prioritization and focus on resilient immunization programmes.
WHO and UNICEF, alongside Gavi and other partners, are committed to the IA2030 strategy, aiming for universal vaccine access and disease prevention. Turning these goals into reality, means that countries must lead the charge.
Revitalizing immunization programs, strengthening community-centered health systems, ensuring vaccine supply, and boosting demand through community engagement are critical components of success. Policy and resources should urgently prioritize routine immunization, particularly for measles, and focus on reducing zero-dose children.
The message is clear: the time is now for action, to secure a healthier future for all. The world cannot afford to wait any longer.
Global forum for vaccine sovereignty and innovation sets bold targets
On June 20 in Paris, the Global Forum for Vaccine Sovereignty and Innovation marked a significant step towards enhancing global immunization efforts. The event was hosted by Gavi, the Vaccine Alliance, the Government of France, and the African Union with Team Europe partners.
Gavi's 2026–2030 Investment Opportunity was launched at the event, aiming to start off the replenishment period through the coming months, in support Gavi 6.0 strategy for 2026-2030. The alliance ambitiously aims to vaccinate one billion children by 2030, a goal driven by the urgent challenges of climate change, economic instability, and global health crises. In this period, Gavi plans to support the use of malaria vaccine to vaccinate 50 million children and HPV vaccine to protect 120 million girls from cervical cancer, potentially saving 1.5 million lives.
To achieve this, Gavi seeks $9 billion in new pledges out of the $11.9 billion needed for the strategic period. Encouragingly, $2.4 billion in new pledges were announced at the launch event, including $1.58 billion from the United States.
The forum also launched the African Vaccine Manufacturing Accelerator (AVMA), a pioneering initiative to boost vaccine production in Africa. Developed by Gavi in collaboration with the African Union and Africa Centres for Disease Control and Prevention, AVMA aims to create a robust vaccine ecosystem with strong regulatory frameworks and efficient procurement strategies. It is set to receive approximately $1.2 billion in donor funding over the next decade to procure vaccines manufactured in facilities on the continent.
As the world rallies behind these initiatives, our collective efforts will be pivotal in achieving these historic milestones, ensuring that millions more children, adolescents and adults receive life-saving vaccinations, and strengthening global health resilience.
Next steps for the TB Vaccine Accelerator: a global push for novel TB vaccines
Following the impactful Second High-Level Meeting of the TB Vaccine Accelerator Council in late May, WHO is spearheading a collaborative effort to fast-track the development, approval, and use of innovative tuberculosis (TB) vaccines. WHO's Immunization, Vaccines and Biologicals (IVB) and the Global TB departments alongside the Science division, are joining forces to bring countries and partners together to advance this critical mission.
In an exciting move, WHO has issued a call for proposals to support the TB Vaccine Accelerator secretariat. The Accelerator aims to unite key stakeholders across four pivotal areas: Vaccine Science and Research, Product Development and Manufacturing Policy, Financing and Access Strategy, and Country Readiness and Community Partnership. The goal is to establish robust, inclusive working groups, fostering both existing collaborations and new partnerships, particularly involving those from high TB burden countries.
