Global Immunization Efforts Under Threat: Resurgence of Preventable Diseases Amid Funding Crisis
The world faces a growing crisis in immunization efforts as misinformation, population growth, humanitarian emergencies, and funding cuts combine to jeopardize decades of progress. This alarming trend leaves millions vulnerable to preventable diseases, with outbreaks of measles, meningitis, and yellow fever on the rise, and the potential re-emergence of diseases like diphtheria, once considered largely eradicated. The World Health Organization (WHO), UNICEF, and Gavi, the Vaccine Alliance, are issuing urgent calls for sustained political attention and investment to reinforce immunization programs and protect the substantial gains achieved in reducing child mortality over the past half-century.
The resurgence of measles is particularly concerning. Cases have been steadily climbing since 2021, mirroring the decline in immunization coverage observed during and after the COVID-19 pandemic. An estimated 10.3 million measles cases were reported in 2023, a 20% increase from the previous year. This upward trajectory is predicted to continue into 2025, fueled by intensifying outbreaks worldwide. In the past year, 138 countries reported measles cases, with 61 experiencing large or disruptive outbreaks, the highest number in any 12-month period since 2019. This resurgence highlights the fragility of public health gains when immunization efforts are disrupted.
Meningitis cases in Africa have also witnessed a sharp rise in 2024, a trend persisting into 2025. Over 5,500 suspected cases and nearly 300 deaths were reported in the first three months of 2025 alone, across 22 African countries. This follows approximately 26,000 cases and almost 1,400 deaths in 24 countries during 2024. Yellow fever, a disease that had seen dramatic declines over the past decade thanks to global vaccine stockpiles and routine immunization programs, is also experiencing a resurgence. In 2024, 124 confirmed cases were reported across 12 African countries, and outbreaks have been confirmed in four countries in the WHO Region of the Americas in 2025.
Compounding these outbreaks are significant funding cuts to global health initiatives. A recent WHO survey of 108 country offices, predominantly in low- and lower-middle-income nations, revealed that nearly half are experiencing moderate to severe disruptions to vaccination campaigns, routine immunization services, and access to essential supplies due to reduced donor funding. Disease surveillance, crucial for early detection and response to outbreaks, is also compromised in more than half of the surveyed countries. These funding shortfalls cripple the ability to maintain and expand vital immunization programs, leaving populations vulnerable.
The number of children missing routine vaccinations continues to increase, despite global efforts to catch up on vaccinations missed during the COVID-19 pandemic. In 2023, an estimated 14.5 million children missed all their routine vaccine doses, a concerning rise from 13.9 million in 2022 and 12.9 million in 2019. More than half of these children reside in countries grappling with conflict, fragility, or instability, where access to basic health services is often severely disrupted. These children are particularly vulnerable to the devastating consequences of vaccine-preventable diseases, highlighting the urgent need for targeted interventions in these challenging contexts.
Despite these formidable obstacles, collaborative initiatives by WHO, UNICEF, Gavi, and other partners have enabled countries to expand vaccine access and bolster immunization systems through primary health care. Vaccines prevent an estimated 4.2 million deaths annually from 14 diseases, with nearly half of these lives saved in the African Region. Successful vaccination campaigns have led to the elimination of meningitis A in Africa’s meningitis belt. A new vaccine protecting against five strains of meningitis promises broader protection, with ongoing efforts to expand its use for outbreak response and prevention. Progress has also been made in reducing yellow fever cases and deaths through increased routine immunization coverage and emergency vaccine stockpiles. However, recent outbreaks underscore the persistent risks in areas with low vaccination coverage, gaps in preventive campaigns, and no prior history of the disease.
Significant strides have been made in other areas of immunization in the past two years. HPV vaccine coverage in the African Region, which bears the highest cervical cancer burden globally, nearly doubled between 2020 and 2023, reflecting a concerted global push to eliminate cervical cancer. Global coverage of pneumococcal conjugate vaccines has also increased, particularly in the South-East Asia Region, with introductions in high-burden countries like Chad and Somalia. Sub-national introduction of malaria vaccines in nearly 20 African countries marks another crucial milestone, potentially saving half a million additional lives by 2035 as more countries adopt the vaccines and scale-up accelerates.
UNICEF, WHO, and Gavi are urgently calling on parents, the public, and policymakers to strengthen support for immunization. They emphasize the need for sustained investment in vaccines and immunization programs, urging countries to honor their commitments to the Immunization Agenda 2030 (IA2030). As integral components of primary health care systems, vaccinations not only protect against disease but also connect families with other vital services like antenatal care, nutrition programs, and malaria screening. Immunization represents a highly cost-effective health intervention, yielding a return of $54 for every dollar invested, and lays the foundation for future prosperity and health security. Gavi’s upcoming high-level pledging summit in June 2025 aims to secure at least US$9 billion to fund its ambitious strategy, protecting 500 million children and saving at least 8 million lives between 2026 and 2030. Securing this funding is critical to bolstering global defenses against preventable diseases, expanding vaccine stockpiles, and implementing targeted preventive vaccination in countries most affected by meningitis, yellow fever, and measles. The global community must prioritize investment in immunization to safeguard public health gains and protect vulnerable populations from the devastating consequences of resurgent vaccine-preventable diseases.
