Strategies to improve immunisation coverage: Helping the Young World achieve its potential

At Genesis, we believe the future lies in the Young World. Across the Young World—spanning Africa, the Middle East, Asia, and parts of South-East Asia—rapidly growing urban populations face a high burden of communicable diseases such as pneumonia and diarrhoea.

Crowded living conditions and inadequate water, sanitation, and hygiene infrastructure can drive disease transmission. These same regions are also highly vulnerable to extreme climate events, such as flooding, which further increase the risk of outbreaks. Weak health systems often struggle to detect, prepare and respond to disease outbreaks effectively, compounding the challenge.

Reducing childhood morbidity and mortality is critical to unlocking the potential of young populations. Vaccination is one of the safest, most cost-effective ways to achieve these reductions. Modelling suggests that over 150 million lives have been saved since the launch of WHO’s Expanded Programme on Immunisation nearly 50 years ago; a 40% of the global reduction in infant mortality can be attributed to vaccines. Yet, childhood immunisation coverage has stagnated, as evidenced by recent polio outbreaks in Afghanistan.

In many Young World countries, vaccine programmes rely heavily on donor funding. Even when governments procure vaccines, donors often support essential programme components, including supply chain management, demand generation, and financing. The withdrawal of funding, such as USAID’s recent $131 million cut to UNICEF’s and the Global Polio Eradication Initiative’s polio immunisation efforts, threatens vaccine access for millions of children. The consequences of funding cuts could include:

Reduced vaccine coverage and the potential for increased transmission and disease
Expiration of stockpiled vaccines due to distribution delays
Shortages of healthcare and community outreach workers to administer vaccines
Suspension of campaigns to promote vaccine uptake and address hesitancy
Gaps in disease surveillance and outbreak monitoring
Reductions in research and development for new vaccines

To mitigate these risks, governments must explore cost-effective, sustainable solutions in both the short and long term. Key strategies could include:

Strengthening domestic health financing to reduce dependency on donor funding
Exploring initiatives like Covax which had demonstrable success in facilitating access to Covid-19 vaccines in lower and middle-income countries
Considering efficiencies to maximise coverage while reducing costs and wastage
Conducting an investment case to prioritise the mix of interventions and vaccines provided routinely to optimise limited resources
Strengthening disease surveillance mechanisms by implementing wastewater and environmental surveillance to detect early disease outbreaks
Leveraging data-driven approaches, as seen during COVID-19 vaccination efforts, to optimise vaccine distribution
Partnering with last-mile distributors to ensure vaccines reach underserved populations
Applying behavioural science insights to improve vaccine uptake