Africa’s vaccine gains are under threat: Five things the new immunisation strategy must get right

Charles Shey Wiysonge, Stellenbosch University; South African Medical Research Council Africa has reached an important moment in its immunisation journey. Coverage is not rising fast enough to keep pace with population growth, persistent inequities and a growing number of vaccines. At the same time, outbreaks and financing pressures are intensifying. Vaccination has transformed child survival. A landmark analysis found that global immunisation efforts have saved at least 154 million lives over the past 50 years, 52 million in Africa. Vaccines have virtually eliminated meningitis A epidemics and eradicated wild poliovirus from Africa. But progress has slowed. In 2025, about 7.1 million African children (15.6% of those under a year old) did not receive even a single routine vaccine dose. Measles and other vaccine-preventable disease outbreaks are increasing, driven by immunity gaps, conflict, displacement and vaccine hesitancy. Meanwhile, donor budgets are under pressure from competing global crises.