Vaccination rates in Africa have been declining, and a new strategy has been launched to address this trend. According to a landmark analysis, global immunisation efforts have saved at least 154 million lives over the past 50 years, with 52 million of those lives saved in Africa. However, progress has slowed, and in 2025, about 7.1 million African children did not receive even a single routine vaccine dose. The Africa Centres for Disease Control and Prevention has launched the Continental Immunisation Strategy 2026-2030 to address this issue.
The Continental Immunisation Strategy covers six key areas, including financing and political commitment, data and digital systems, life-course vaccination integrated with primary healthcare, community engagement, vaccine manufacturing and supply, and emergency preparedness and epidemic-ready immunisation systems. Experts have identified five priorities that apply to all these areas, including sustainable domestic financing, fit-for-purpose digital systems, integration with primary healthcare, genuine community partnership, and vaccine sovereignty linked to epidemic preparedness.
Sustainable domestic financing is crucial for immunisation in Africa. The greatest threat to immunisation in Africa is not the availability of effective vaccines, but whether countries can finance and deliver them reliably. International partners have helped countries introduce vaccines, procure doses, and strengthen delivery systems, but predictable national budgets are essential. Immunisation is a best buy that returns about $54 for every dollar invested, and predictable domestic financing gives countries more control over priorities and strengthens accountability to citizens.
Digital technology can also help improve immunisation in Africa. Many programmes still rely on paper registers kept by health workers, which are increasingly ill-suited to highly mobile populations and expanding vaccine schedules. Electronic immunisation registries linked to birth registration and national health-information platforms can show who received which vaccine and improve stock management. Rwanda, for example, integrated its vaccine registry with electronic birth systems in 2022.
Making immunisation part of resilient primary healthcare is also essential. The original Expanded Programme on Immunisation was designed primarily to protect infants against a few childhood diseases, but today's realities are different. Africa has a rapidly growing and urbanising population, and vaccine schedules now include adolescents, pregnant women, and adults. Vaccination should therefore become a routine part of primary healthcare throughout life.
Building trust through genuine community engagement is critical for immunisation programmes to succeed. People are more likely to accept vaccines when they feel respected, listened to, and involved. Community health workers, religious leaders, traditional authorities, and civil-society organisations can all help build trust. In Sierra Leone's Kailahun District, health teams worked with trusted local voices to rebuild confidence in vaccination after rumours spread.
Strengthening Africa's vaccine sovereignty and epidemic preparedness is also a key priority. The continent still imports about 99% of the vaccines it uses, but the Continental Immunisation Strategy supports the African Union's ambition to produce 60% of Africa's vaccine needs locally by 2040. Existing or expanding capabilities include the Institut Pasteur de Dakar in Senegal, Biovac and Aspen Pharmacare in South Africa, and manufacturers in Egypt and Tunisia.
Key points
- Sustainable domestic financing is crucial for immunisation in Africa.
- Digital technology can help improve immunisation in Africa.
- Community engagement is critical for immunisation programmes to succeed.
