By Nana Karikari, Senior Global Affairs Correspondent
The World Health Organization reported Wednesday that vaccination programs across Africa have saved tens of millions of lives over the past two decades. This success now faces severe headwinds as progress slows in several nations. A comprehensive analysis of immunization in the region revealed that more than 500 million children have been reached through routine vaccination since 2000. These efforts prevent over 4 million deaths annually. Vaccines have saved more than 50 million lives in Africa over the past five decades. This achievement has resulted in “gaining an estimated 60 years of life expectancy for each infant life saved” during that period.
Geopolitical Shifts Straining Health Security
Health systems in the continent of 1.5 billion people face growing uncertainty. The U.S. pullback from global health funding under President Donald Trump’s “America First” policy has created significant gaps. Disruptions linked to the war in the Middle East are further straining aid budgets and supply chains. In 2024 alone, vaccines saved nearly 2 million lives. Key milestones include the 2020 eradication of wild poliovirus which the WHO called “a historic milestone for Africa.” Additionally, most countries have eliminated maternal and neonatal tetanus.
Breakthroughs in Disease Eradication
Vaccines against malaria are now being introduced in 25 countries. The disease kills more than 400,000 people annually with most victims being children under five. Mohamed Janabi, the WHO regional director for Africa, called that “a major scientific and public health breakthrough” during an online press briefing. Measles interventions have also seen historic success. Nearly 20 million measles-related deaths have been averted in Africa since 2000. 44 African countries have introduced a second dose of the
measles-containing vaccine. This helped increase coverage rates from 5% in 2000 to 55% in 2024. In 2025, Cabo Verde, Mauritius, and Seychelles became the first sub-Saharan African countries to achieve measles and rubella elimination status.
Ghana’s Leadership in Vaccine Sovereignty
Ghana has emerged as a continental leader in the race for vaccine independence. In early 2026, the Parliament of Ghana launched a dedicated Parliamentary Caucus on Immunization. This body aims to secure domestic funding as the country prepares to transition out of Gavi support by 2030. The National Vaccine Institute is currently overseeing a $75 million seed fund to establish local manufacturing infrastructure. President John Mahama recently stated that the 2026 push for “Made-in-Ghana” vaccines is a direct response to the structural failures seen during previous global health crises. This effort includes a national survey to build public confidence in locally produced medicines across all 16 regions.
The Widening Equity Gap
Dr. Mohamed Janabi warned that “progress is uneven and in some places really slowing.” The COVID-19 pandemic increased the number of children who have never received a single vaccine. Ten countries account for 80% of children who haven’t received any vaccine in the region. Janabi described this as “a profound equity issue.” Sania Nishtar, chief executive of Gavi, the Vaccine Alliance, noted the disparity in coverage. “These immunization 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,” Nishtar said.
Financial Crisis and U.S. Withdrawal
The return of Donald Trump to the White House in 2025 led to devastating aid cuts. The U.S. withdrawal from the WHO in January resulted in the loss of about 40% of the agency’s overseas development funding. Janabi urged African governments to increase domestic health financing to mitigate the impact. Funding is emerging as the “biggest threat” to Africa’s immunization efforts according to Shabir Madhi. Madhi is a professor of vaccinology and dean of the Faculty of Health Sciences at South Africa’s University of the Witwatersrand. He noted that many aid-funded programs have already scaled back or shut down, reducing access to clinics, health workers, and cold-chain infrastructure.
Supply Chains and Conflict Impacts
The U.S.-Iran war has disrupted supply chains and increased gas prices. This is particularly concerning for a continent where “many of our facilities depend on generators,” said Adelheid Onyango. Onyango serves as the WHO Africa director for health systems and services. The agency is yet to quantify the war’s full impact on health delivery. Professor Madhi emphasized that the current reliance on external donors is unsustainable. “It can’t be that we continue relying on the likes of Gavi Vaccine Alliance, which has done a tremendous amount of work in terms of ensuring that there’s increasing uptake of new vaccines,” said Madhi.
Paths Toward Sustainability
The Gavi Vaccine Alliance is currently experiencing its own financial crunch. Madhi argued that countries must determine what percentage of immunization programs they should fund internally. Dr. Sania Nishtar emphasized the power of policy in driving health outcomes. “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,” Nishtar said. She pointed to the Gavi Leap reform agenda as a way to unlock progress through innovative and self-reliant programs designed for the long term.
Future Targets and Structural Hurdles
Africa remains off track for the Immunization Agenda 2030 targets. The goal is 90% coverage for four key life-stage vaccines including DTP3 and HPV. Routine schedules now protect against 13 diseases, up from eight in 2000, yet coverage remains uneven. Rapid population growth and weak health systems remain major hurdles. Climate change and political instability also threaten to reverse gains. Dr. Mohamed Janabi stressed the urgency of the current situation. “Africa has made remarkable progress in less than a generation, expanding immunization and saving millions of young lives,” Janabi said. “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.”
A Precarious Balance
The future of African public health now rests on a precarious balance between historic medical achievement and volatile global politics. While scientific breakthroughs like the malaria vaccine offer a roadmap for total disease eradication, the withdrawal of traditional Western funding necessitates a shift toward continental self-reliance. For the millions of children currently in the “equity gap,” the success of the 2030 Agenda will depend less on the availability of medicine and more on the stability of the global supply chains and the political will of local governments to prioritize health as a cornerstone of national security.
