Immunization programmes worldwide are facing significant challenges that threaten to reverse decades of progress in reducing deaths from vaccine-preventable diseases, according to a joint alert from the World Health Organization (WHO), UNICEF, and Gavi, the Vaccine Alliance, issued during World Immunization Week from 24 to 30 April 2025.
The agencies warn that misinformation, rapid population growth, ongoing humanitarian crises, and cuts in funding are putting millions of children, adolescents, and adults at risk of diseases such as measles, meningitis, yellow fever, and diphtheria—illnesses that had been largely controlled or eradicated in many regions. These setbacks coincide with a troubling resurgence in outbreaks and growing disruptions to vaccination efforts globally.
WHO Director-General Dr Tedros Adhanom Ghebreyesus highlighted the threat posed by financial shortfalls, stating, “Vaccines have saved more than 150 million lives over the past five decades. Funding cuts to global health have put these hard-won gains in jeopardy. Outbreaks of vaccine-preventable diseases are increasing around the world, putting lives at risk and exposing countries to increased costs in treating diseases and responding to outbreaks. Countries with limited resources must invest in the highest-impact interventions – and that includes vaccines.”
One of the most alarming trends is the marked increase in measles cases worldwide. Reported figures indicate that measles cases climbed to an estimated 10.3 million in 2023, which represents a 20% rise compared to the previous year. This increase is linked to declines in immunization coverage that began during the COVID-19 pandemic and have persisted since. In the past year, infections have spread to 138 countries, with 61 experiencing large or disruptive outbreaks—the highest global level observed since 2019.
Meningitis has also seen a sharp rise, particularly in Africa. In the first quarter of 2025, more than 5,500 suspected cases and nearly 300 deaths were recorded across 22 countries. This follows a significant surge in 2024 which included around 26,000 cases and nearly 1,400 deaths in 24 countries. Yellow fever, which saw dramatic declines in historic incidence thanks to vaccination efforts, is resurging in the African region with 124 confirmed cases in 12 countries in 2024, and outbreaks have appeared recently in the Americas as well, with 131 cases reported in four countries.
These disease outbreaks are occurring at a time when global funding for immunization is under pressure. A WHO survey of 108 country offices mostly in low- and lower-middle-income countries revealed that almost half are experiencing moderate to severe disruptions to vaccination campaigns, routine immunisation, and vaccine supply due to reduced donor funding. More than half of these countries are also facing impacts on disease surveillance activities.
The number of children missing routine vaccinations is rising, reversing gains made before the pandemic. In 2023, approximately 14.5 million children missed all their routine vaccine doses—a figure that has increased steadily from 12.9 million in 2019 and 13.9 million in 2022. The majority of these unvaccinated children live in regions affected by conflict, fragility, or instability, where healthcare services are often disrupted.
UNICEF Executive Director Catherine Russell commented on the implications of funding cuts, stating, “The global funding crisis is severely limiting our ability to vaccinate over 15 million vulnerable children in fragile and conflict-affected countries against measles. Immunization services, disease surveillance, and the outbreak response in nearly 50 countries are already being disrupted – with setbacks at a similar level to what we saw during COVID-19. We cannot afford to lose ground in the fight against preventable diseases.”
The agencies underscored the importance of ongoing investment in initiatives such as the ‘Big Catch-Up’, launched in 2023, which aims to reach children who missed vaccinations during the COVID-19 pandemic alongside strengthening routine immunization programmes.
Despite these challenges, progress continues in various areas of immunization. Collaborative efforts by WHO, UNICEF, Gavi, and partner organisations have helped expand vaccine access and reinforce immunization systems, especially within primary healthcare. Vaccines currently save nearly 4.2 million lives annually from 14 diseases, with close to half of these lives saved in the African Region. Notably, vaccination campaigns have led to the elimination of meningitis A in Africa’s meningitis belt. Additionally, a newly developed vaccine protects against five meningitis strains and is being deployed for broader prevention and outbreak response.
There has been significant advancement in the reduction of yellow fever mortality through improved vaccination coverage and emergency stockpiling, although recent outbreaks indicate continued vulnerability in regions with low vaccination rates. Another positive development has been the rise in human papillomavirus (HPV) vaccine coverage in Africa, which nearly doubled from 21% to 40% between 2020 and 2023. Widespread introduction of pneumococcal conjugate vaccines in South-East Asia and parts of Africa, including Chad and Somalia, has also contributed to immunization gains.
A major milestone in the fight against malaria has been the sub-national introduction of malaria vaccines in nearly 20 African countries. This rollout is projected to save up to half a million additional lives by 2035 as vaccine uptake increases and immunization programmes scale up.
Looking ahead, the agencies have called on stakeholders, including governments and the public, to maintain and deepen their commitment to vaccine programmes, in line with the Immunization Agenda 2030 (IA2030). Immunization is recognised not only as a critical health intervention but also as a key entry point for delivering other vital primary healthcare services such as antenatal care, nutrition, and disease screening.
Dr Sania Nishtar, CEO of Gavi, the Vaccine Alliance, emphasised the importance of sustained support, saying, “Increasing outbreaks of highly infectious diseases are a concern for the whole world. The good news is we can fight back, and Gavi’s next strategic period has a clear plan to bolster our defences by expanding investments in global vaccine stockpiles and rolling out targeted preventive vaccination in countries most impacted by meningitis, yellow fever and measles. These vital activities, however, will be at risk if Gavi is not fully funded for the next five years and we call on our donors to support our mission in the interests of keeping everyone, everywhere, safer from preventable diseases.”
Gavi is preparing for a high-level pledging summit scheduled for 25 June 2025, aiming to raise at least US$9 billion to fund its strategic plan to protect 500 million children and save an estimated 8 million lives between 2026 and 2030.
The World Health Organization, UNICEF, and Gavi continue to advocate for greater investment and political resolve to ensure immunization remains a cornerstone of global health security and child survival.
Source: Noah Wire Services