Regional initiatives provide leadership to drive immunisation forward

They might be separated by continents and more than 7,000 miles, but Vientiane in the Lao People's Democratic Republic and Abidjan in C?te d’Ivoire have something important in common. Both cities have recently played host to regional dialogues that could have profound and positive consequences for strengthening immunisation and health security in South-East Asia and Africa, respectively.

When it comes to fair access to vaccines, different regions of the world are facing different challenges.

The South-East Asia region, for example, has struggled to rebound from the impact of the COVID-19 pandemic. The hyper-connectedness of the region that has been such a source of social and economic strength over the past few decades became a source of vulnerability faced with the threat of a rapidly spreading pathogen such as SARS-CoV-2. As a result, the pandemic hit the region earlier than elsewhere and exacted a huge toll on economies, societies, and health systems, including immunisation. In contrast to the rapid progress on boosting immunisation in the region before the pandemic, DTP3 coverage – a key indicator of routine vaccine coverage – fell from?94% to 87% in the East Asia and Pacific region between 2019 and 2023.

Africa posted some of the strongest results in the latest estimates on immunisation cover?from the World Health Organization (WHO) and UNICEF, managing to increase the coverage of key vaccines compared with 2022 despite a rapidly increasing population. But it is not all good news. Many countries in the African region are still home to an unacceptably high number of children who have never been vaccinated, while health systems in many countries remain comparatively weak and underfunded.

The process of getting progress back on track and addressing the different vulnerabilities and risks faced by each region can be accelerated if countries and key partners work together to set joint targets, commitments and priorities, and share knowledge and ways of working. This is where regional initiatives can play an increasing role in fostering political will, expanding technical cooperation, and locking in economic commitments to drive forward immunisation, strengthen health systems, and boost regional and global health security.

The Vientiane event, hosted in August by ASEAN and Gavi, the Vaccine Alliance, on the sidelines of the 16th ASEAN Health Ministers’ Meeting, was a perfect platform for assembling regional partnerships to turbocharge progress. The meeting saw assembled health ministers pledge to increase investments in immunisation, and work with key partners to discuss a regional health financing target adapted to the specific needs and broader health priorities of countries in the ASEAN region.

Gavi has a long-standing relationship with many ASEAN member states, and will work with ASEAN to develop a plan for a shared vision for health cooperation to be presented to health ministers in 2025. That plan, we hope, can serve as a roadmap for sustainable and equitable immunisation in the South-East Asia region for decades to come.

The discussions in Vientiane came hot on the heels of a similar dialogue in Abidjan, where Ministers of Health and Finance from?nine African countries met in C?te d’Ivoire in July?this year and committed to investing in building sustainable and self-sufficient immunisation programmes by 2030. The ministers also committed to creating a knowledge-sharing forum to help prepare for their transition from Gavi funding.

The Abidjan declaration, as it is now known, is a great example of how countries can come together to find cooperative solutions to shared challenges, in this case including issues such as high levels of debt and other factors that have conspired to constrain public spending on health at a time when costs are rising – presenting a particular challenge for countries who must plan to sustain national immunisation programmes after graduating from Gavi support.

The burgeoning role of regional initiatives and political unions in discussions about how to strengthen and sustain immunisation is a powerful demonstration that, at the highest political levels, vaccines are now widely acknowledged as one of the most cost-effective health and development interventions. Increasingly, investing in immunisation is not seen as an optional extra, but rather as a centrepiece of broader policies on health and health security at both national and regional levels.

Gavi will continue to strengthen our engagement with regional partners to ensure we can build on this momentum as we continue to work towards our replenishment for the 2026–2030 period.