Who is safe? Report on the impact of inaction on immunization

A report from WACI Health, the Gavi Civil Society Organization (CSO) Constituency and PATH provides qualitative insights into the contextual factors influencing immunization investments in these countries. The specific objectives are:

• Mapping the financing and sustainability of immunization in 10 African Union member states (Comoros, DRC, Ethiopia, Kenya, Malawi, Mozambique, Nigeria, Senegal, South Sudan, and Uganda).
• Documenting stakeholders’ inputs on immunization sustainability in these countries.
• Preparing a synthesis report for dissemination to regional and national policymakers, communities, and
  CSOs 

Findings

Cluster context

The sampled countries have significant socio-economic challenges, with high poverty levels and low health
system performance. Infants and children under five years old, who are the primary targets for childhood
vaccines, form a substantial part of the population. However, the health systems in these countries are
underfunded, with low tax revenues and high debt levels limiting the fiscal space for health and immunization
services.

Impact of inaction – coverage and equity
The inadequate investments in health and immunization have led to low immunization coverage rates, especially in conflict-affected regions like Nigeria, Ethiopia, DRC, and South Sudan. Consequently, there is a notable increase in Zero dose children and under-immunized children.

This results in higher incidences of vaccine-preventable diseases, including Measles, Mumps, Diphtheria, Polio
and Cholera, affecting zero-dose children, under-immunized children and the general public. Additionally, there are significant disparities in health outcomes based on income levels, with the poorest groups experiencing higher under-five mortality rates and lower DTP3 coverage.

The lack of investment also leads to high out-of-pocket payments and increased vaccine hesitancy due to insufficient awareness and sensitization efforts. Further, the limited government investments result in weak cold chain systems and engender in significant vaccine wastage.