Brazzaville/Geneva — Nearly 20 million measles-related deaths have been averted in Africa since 2000 thanks to increasing vaccination coverage, according to the first-ever detailed analysis of immunization targets on the continent.
The analysis, by World Health Organization (WHO) in the African region, and Gavi, the Vaccine Alliance, also found that alongside the 19.5 million measles deaths averted, more than 500 million children in Africa have been protected through routine immunization between 2000 and 2024.
Halving measles deaths in one generation
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Progress on measles underscores the impact of consistent investment in immunisation. Since 2000, 44 African countries have introduced a second dose of measles-containing vaccine into routine immunization, helping to increase coverage rates from 5% in 2000 to 55% in 2024. Supplemental campaigns have delivered 622 million vaccinations. These efforts collectively have halved measles deaths in the African region and led to a 40% drop in overall cases.
While the region has made significant progress towards protecting populations from measles, some countries have gone further. In 2023 and 2024, nine countries reported consistently low measles incidence rates (fewer than five cases per million), and in 2025, Cabo Verde, Mauritius and Seychelles became the first sub-Saharan African countries to achieve measles and rubella elimination status, the gold standard in protecting against both diseases.
Broad progress against vaccine-preventable diseases
The analysis also assessed overall progress and challenges in expanding immunization coverage against a broad range of diseases, as well as ongoing efforts to reach the targets of the 2030 Immunization Agenda--a global strategy to reduce vaccine-preventable deaths and diseases, expand vaccine access and strengthen immunization within primary health care.
Routine immunization schedules currently protect against 13 vaccine-preventable diseases, up from eight in 2000; meningitis deaths have fallen by 39%; the malaria vaccine has been introduced in 25 countries; and in 2024 alone, at least 1.9 million lives were saved through vaccination--42% of which were due to measles vaccination.
"Africa has made remarkable progress in less than a generation, expanding immunization and saving millions of young lives," said Dr Mohamed Janabi, WHO Regional Director for Africa. "But the progress is uneven, and even slowing, leaving too many children unprotected as key targets are still missed. We must urgently strengthen routine immunization to leave no child behind."
Additionally, 47 sub-Saharan Africa countries now provide hepatitis B as part of routine vaccination, with 16 countries providing a birth dose; 33 have introduced the rubella vaccine; and 29 countries offer the human papillomavirus vaccine, which protects against cervical cancer.
"This analysis highlighting twenty-four years of remarkable progress on the African continent demonstrates the immense life-saving power of vaccines when immunisation is prioritised as a matter of policy," said Dr Sania Nishtar, CEO of Gavi the Vaccine Alliance. "At the same time, we must acknowledge that these immunisation outcomes reflect very different realities, and we have more work to do to ensure we are consistently able to reach children, even in the most fragile and remote contexts. Through the Gavi Leap reform agenda, we hope to unlock further progress through novel, innovative approaches and by working with countries to build sustainable, self-reliant programmes for the long term."
Challenges remain
The analysis by WHO and Gavi plays a critical role in providing evidence to support policy formulation as well as assessing and understanding the impact of investments towards Immunization Agenda 2030 targets in the region.
The Immunization Agenda 2030 aims for 90% coverage of four key life-stage vaccines: the third dose of the diphtheria tetanus toxoid and pertussis vaccine (DTP3); the third dose of the pneumococcal conjugate vaccine (PCV3); the second dose of the measles-containing vaccine (MCV2); and one dose of the human papillomavirus vaccine (HPV).
Although millions more children are being vaccinated and efforts to reduce the number of unvaccinated children are proving successful, Africa is off track towards the 90% coverage target, as immunization coverage is uneven and a large number of children--often those that are the hardest to reach--are still being missed. This is worsening immunization inequity within countries.
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Rapid population growth, weak health systems, lack of integration of immunization programmes in primary health care, as well as the devastating impact of climate change, humanitarian crises and political instability are some of the major hurdles to reaching the optimal vaccination coverage.
Continued investment by countries and strong political commitment are critical to sustain gains and protect future generations. Focus on building or rebuilding resilient immunization systems at sub-national level is central to addressing prevalent immunization inequities and sustaining coverage at no less than 90%. WHO, Gavi and partners are working with governments to widen vaccination coverage as well as accelerate and scale up the introduction of new vaccines such as those for malaria and human papillomavirus.
Link to report: https://iris.who.int/bitstreams/158541be-2d2a-4b3d-b7d8-934727ce102b/download
