PREAMBLE
Immunization remains one of the most powerful, cost-effective investments in Africa's future. It is a vital pillar of public health and health security in Africa. The African region benefits most from the efforts of the Expanded Programme on Immunization launched in 1974, in terms of reduced infant mortality and increased survival rates: 1.8 million lives were saved in 2023 alone through vaccination efforts - nearly half the global total.
Despite these gains, routine immunization faces persistent challenges, with uneven coverage across regions over the last 20 years. According to the 2024 WHO and UNICEF estimates of National Immunization Coverage (WUENIC), DTP3 coverage in Africa stands at 76 per cent, unchanged from 2023, which is well below the IA2030 target of 90 per cent. Approximately 7.8 million children in the region missed out on DTP1 in 2024.
Persistent challenges such as low and unequal immunization coverage, increasing numbers of zero-dose children, fragmented financing, weak data systems, and recurrent vaccine-preventable disease (VPD) outbreaks continue to threaten progress towards Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs). Though continental efforts have reached more children, amidst a rising number of births, the pace of change is insufficient to reduce zero-dose children and achieve universal coverage.
Furthermore, the continent stands at a defining moment for the sustainability of its public health programmes, including immunization programmes, given the decline in external health financing to most African countries and the rising debt crisis. For example, Official Development Assistance is projected to decline by an additional 9 per cent - 17 per cent over 2024 level. While exact global dollar figures vary by source, the United States alone terminated 83 per cent of USAID programmes in early 2025, creating a $60 billion funding gap. This is compounded by the inadequate domestic health financing, with only few African countries meeting the 15 per cent national budget allocation for health. Furthermore, over 90 per cent of Africa's vaccines and medical countermeasures are imported, making the continent's immunization programmes vulnerable to global supply chain disruptions.
In this regard, Africa CDC is intensifying its efforts to tackle immunization challenges across the continent by collaborating with member states and partners at continental and regional levels. Immunization remains crucial in reducing mortality rates and achieving the Sustainable Development Goals (SDGs); however, vaccination coverage remains static at 75 per cent, significantly below the IA2030 target of 90 per cent. Notable regional disparities also continue, emphasizing the need for coordinated actions to strengthen health systems.
In various conversations, delegates have commented that the CIS is explicitly acknowledging conflict and fragility that several member states are experiencing either as whole country or in pockets.
To achieve its vision of a resilient, equitable, and self-reliant Africa, the CIS defines three strategic outcomes that position immunization as a driver of primary health care strengthening, health system resilience, and epidemic preparedness. These outcomes address persistent challenges and emerging opportunities, align with continental and global priorities, and guide Member States in delivering life-saving vaccines in a sustainable and equitable manner.
Africa CDC, through the Immunization Unit within the Primary Health Care Center, is stepping up to support African Union Member States' immunization agendas and is developing its Continental Immunization Strategy (CIS), providing a pragmatic, time-bound pathway to strengthen immunization systems across Africa by anchoring vaccination firmly within resilient, epidemic-ready Primary Health Care (PHC) and health-security architectures. The CIS is designed to close equity gaps, reach zero-dose and under-immunized populations, and sustain life-course immunization while advancing the Addis Declaration on Immunization (ADI) and Immunization Agenda 2030 (IA2030) goals.
