A look at the immunization agenda in the African context

September 4, 2019
An infant gets vaccinated at a health facility.

Africa has made significant progress towards increasing access to immunization, including ramping up efforts in eradicating polio and the recent introduction of new vaccines such as malaria and the Human papillomavirus (HPV). Various countries in the continent have introduced vaccines against hepatitis B, yellow fever, and Haemophilus influenza type B. Despite these great strides, there is a lot to be done to protect these gains.

It is nearly a decade since countries endorsed the Global Vaccine Action Plan (GVAP) 2011-2020, a framework to prevent millions of deaths by 2020 through more equitable access to existing vaccines for people around the globe.  In an effort to meet GVAP targets, the World Health Organization (WHO) Regional Office held a regional sector-wide consultative meeting in Brazzaville, in July 2019, aimed at sharing ideas and charting a way forward for the Immunization Agenda 2030.

The two-day meeting brought together diverse partners in the immunization and health sector across the continent, including government officials, parliamentarians, regional economic communities, civil societies, academia, development agencies, and the private sector. The objectives of the meeting were to incorporate ideas in the development of the strategy, discuss and align with the regional priorities and eventually agree on the next steps and operationalization of the strategy at the regional and country level.

As an implementer of the Immunization Advocacy Initiative, the African Population and Health Research Center (APHRC) was represented at the meeting and is leading capacity strengthening and mentoring efforts that will see civil society organizations in Cote d’Ivoire, Ghana, and Kenya engage effectively in policy advocacy. Given that the civil society plays an important role in the health system, equipping them with the necessary skills in advocacy, evidence use and generation, budget tracking and analysis and ensuring their sustainability through effective institutional policies is critical in improving health outcomes. To align with the post- GVAP, the immunization project will leverage on capacity strengthening for a few selected civil society organizations and enable them to drive advocacy priorities in an effective way that will influence African government decisions to prioritize funding for immunization.

At the core of the discussions was the need to have an immunization agenda that would be people-focused and has country ownership that would, in turn, lead to the successful implementation of the GVAP. An emphasis was made on factoring life-course integration into the immunization agenda and having health interventions throughout life, from the new-born to old age. The life-course approach would focus on addressing population health needs over time, and as such, provide additional opportunities for integration with other age-appropriate interventions.

Forging partnerships among existing immunization stakeholders and identifying new alliances were highlighted as the cornerstones for immunization advocacy. Participants recognized the importance of working with non-traditional allies to hold governments accountable and ensure immunization is prioritized. Subsequently, participants unanimously agreed that scaling up innovation programs and having African-led innovations that would be recognized at the global level were crucial. Furthermore, participants followed this up with a call to adopt a downstream delivery for innovation at all levels.

With the implementation of the GVAP, came a few challenges, namely; information management and data quality, lack of sufficient inter-sectoral collaboration, vaccine refusal, and lack of political will from the African governments. The Immunization Agenda 2030 is expected to strengthen regional and country-level frameworks with the intention to address some of these challenges.

After the meeting, the stakeholders identified priorities and goals that were reflected in the Immunization Agenda 2030 based on the deliberations. They recommended a plan that clarifies the pathway to success for the next decade at the regional level, including having country metrics for monitoring and evaluation. Further, integrating immunization into the health agenda; Universal Health Coverage, and primary healthcare as well as having capacity strengthening and training for health workers were recognized as some of the needed interventions for immunization.

Finally, representatives discussed the operationalization of the Immunization Agenda 2030 and agreed that it would be essential to have country-focused advocacy and communications strategies that complement other immunization interventions. The outcome of this meeting is expected to contribute to the post-2020 global vision and strategy for vaccines and immunization which will be presented to the Member States at the World Health Assembly (WHA-73) slated for May 2020.


By Jane Mangwana, senior advocacy officer