For Every Generation, Vaccines Work

Brazzaville-Africa Vaccination Week 2026 concluded under the theme "For Every Generation, Vaccines Work," The theme is more than a slogan; it is a reality that our continent has now proven in real time - and a reminder that immunization remains one of the surest foundations of Africa's future. The lingering question is whether we will build systems strong enough to ensure that every child, in every community, benefits from them.

The progress is undeniable. In 2024 alone, vaccination is estimated to have averted 1.9 million deaths across Africa, contributing to more than 51 million lives saved over the past five decades. Coverage of the second dose of the measles vaccine rose from 43 percent in 2022 to 55 percent in 2024. Through the 'Big Catch-Up' initiative 18.3 million children aged between 1 - 5 years were reached between 2023 and 2025, including 12.3 million zero-dose children, and over 100 million doses delivered.

Africa is also leading in innovation and ambition. Twenty-five countries are rolling out the world's first malaria vaccines - designed to protect African children against a disease that still kills one of them nearly every minute. The continent has maintained its wild-poliovirus-free status since 2020. Today, vaccines protect people across the life course - from infancy to older age - including against cervical cancer and other preventable diseases. These achievements underscore the transformative power of immunization as a cornerstone of health, resilience and human development.

In November 2025, three African nations achieved something no country on the continent had done before. Cabo Verde, Mauritius and Seychelles became the first African countries to be certified as having eliminated both measles and rubella - two diseases that, for generations, claimed the lives and futures of African children. The African Regional Verification Commission confirmed it. The data confirmed it. A milestone that critics once dismissed as out of reach for Africa was met; and met by Africans. Vaccines have quietly transformed the course of human history - and on this continent, they are now shaping its future.

And yet despite this progress, Africa remains off-track on six of the seven Immunization Agenda 2030 targets. An estimated 6.7 million children in Africa received no routine vaccine at all in 2024, and a further 2.8 million were under-immunized. Coverage of the third dose of the diphtheria-tetanus-pertussis vaccine - the standard global benchmark - has stalled at 76 percent, the lowest on the continent, and has barely moved in fifteen years. The challenge before us is therefore not whether vaccines work; Africa has already answered that question. The challenge is whether we can ensure that their benefits reach everyone, everywhere, without exception.

The burden is concentrated in fragile, conflict-affected and climate-stressed settings, many of them across our continent and where half of the world's zero-dose children live. In 2023 alone, outbreaks of cholera, measles, meningitis and circulating vaccine-derived poliovirus contributed to nearly 200,000 preventable deaths across the continent. Too often, a child's chance of being fully protected depends less on what science can deliver than on where that child is born. Equity remains the unfinished business of immunization. Some will argue that this is a problem of financing, and that without predictable external support little can change. They are partly right. There is no doubt that donor budgets are tightening; global health priorities are shifting; and the demands on partners have never been greater. Gavi's Leap reform and its 6.0 strategy that began this year will place even greater expectations on countries and Alliance partners alike. But while financing matters, the deeper issue is ownership.

Programmes that are designed in our capitals, financed by our national budgets and delivered by our own health systems, are the ones that endure. Sustainable immunization programmes cannot depend indefinitely on external priorities or emergency campaigns. They must be anchored in national leadership, domestic investment strong institutions and accountability to the populations they serve.

Africa has already shown what is possible when political leadership aligns with public health ambition Through the leadership of the African Union Commission, Member States and partners such as the Organization of African First Ladies for Development (OAFLAD) and the World Health Organization (WHO), forty-three African countries have eliminated maternal and neonatal tetanus. Forty-four countries have established National Immunization Technical Advisory Groups to decide which vaccines their children need based on evidence. These achievements show that when countries lead, progress follows.

Continental frameworks are also laying the foundation for greater self-reliance. The Addis Ababa Declaration on Immunization, the establishment of the African Medicines Agency, and the ambition to manufacture 60 percent of Africa's vaccines on African soil by 2040 are not merely aspirations; they are investments in sovereignty, resilience and long-term sustainability . The question before us is no longer whether Africa can build these systems, but whether we will collectively finance, strengthen and sustain them. Immunization is not only a public health intervention - it is one of the most strategic investments a country can make in human capital, economic growth, and long-term development. Healthy populations are the foundation of productive societies, and vaccines are among the smartest investments we can make to secure that future. Every dollar invested in immunization generates an estimated forty-four dollars in economic and social benefits through lives saved, healthier communities and increased productivity.

But vaccines also depend on something no laboratory can manufacture - trust. A vaccine only works when a mother chooses to bring her child to the clinic, and a community chooses to keep bringing them back. Across this continent, that choice is made and that trust is sustained every day by women - mothers, grandmothers, midwives, teachers, market traders. First Ladies as mothers of nations have been particularly powerful champions in mobilizing demand, combating misinformation and keeping immunization high on national agendas. , When religious and traditional leaders lend their voices, when health workers are trained, supported and equipped to deliver vaccines with dignity and when communities are genuinely engaged, immunization rates increase. When misinformation and distrust fill the vacuum left by weak engagement, coverage falls. Demand generation is not peripheral to immunization success; it is fundamental to it.

Three actions can change the trajectory:

First, African governments should protect immunization financing within national budgets and treat immunization as a human capital and national development investment.

Second, partners must align behind country-led priorities rather than create parallel ones, strengthen national systems and accelerate efforts to expand African manufacturing, regulatory capacity and decision-making authority.

Third, accountability must become more transparent and more public: publish country scorecards against the Addis Ababa Declaration Commitments and the Immunization Agenda 2030 targets and debate them honestly, in our parliaments, regional accountability platforms and on our airwaves.

Cabo Verde, Mauritius and Seychelles did not eliminate measles and rubella because they were wealthy nations. They succeeded because they made immunization a national priority and sustained that commitment over time. The rest of the continent can decide to do the same.

"For every generation, vaccines work" - but only when leaders, systems and communities work with them. That is the unfinished business of Africa Vaccination Week 2026, and it is ours to finish. Now is the time to move from commitment to action - ensuring that every child, everywhere on this continent, benefits from the life-saving power of vaccines.

Because when Africa is fully protected, Africa is healthier, stronger, and more resilient.

By H.E. Fatima Maada Bio, H.E. Ambassador Amma Twum-Amoah and Dr Mohamed Yakub Janabi

H.E. Fatima Maada Bio is President of the Organization of African First Ladies for Development (OAFLAD) and First Lady of the Republic of Sierra Leone. H.E. Ambassador Amma Twum-Amoah is the African Union Commissioner for Health, Humanitarian Affairs and Social Development. Dr Mohamed Yakub Janabi is the WHO Regional Director for Africa.