AHAIC 2025: Experts discuss opportunities to enhance immunization gaps in Africa

If coca cola can reach some of the most remote parts of Africa, why can’t life-saving vaccines reach these places, Melissa Wanda, an advocate working with the global healthcare organization, PATH, wonders during a panel on vaccine coverage.

She was speaking on the subject of sustainable healthcare financing and immunization coverage in Africa at the just concluded Africa Health Agenda International Conference (AHAIC) 2025 in Kigali, Rwanda.

Immunization is considered as one of the most impactful and cost-effective available public health interventions. Yet, according to healthcare campaigners, in spite of funding challenges, substantial quantities of vaccines for preventable childhood diseases remain unused – from Malaria to measles to polio to Covid-19. And at the top of the numerous reasons for this is difficulty in reaching hard-to-reach communities, in addition to poor communication in the face of a campaign of mis and disinformation.

AHAIC serves as a major platform for discussing and addressing critical health challenges facing the African continent. The 2025 edition, convened at the Kigali International Convention Center, was the sixth event since the first was held in 2014. It comprised over five dozen sessions in the course of four days – 2^nd to 5^th March, 2025.  

Wanda was speaking on a panel titled: ‘Africa’s Journey to Sustainable Health Financing – Opportunities for Immunization. It featured authorities in healthcare, from immunization experts and advocates to government representatives and data specialists, all of whom highlighted multiple opportunities to expand immunization coverage to remote communities, including through the use of grassroots mechanisms as well as modern technologies.

The use of technology, according to Wanda, speaks to public private partnership, which also featured prominently throughout the four-day event.

According to the United Nations children’s agency, Unicef, 21 million children around the world, particularly in fragile settings (mostly in Africa), remain under-immunized, with 14.5 million having never received a single dose of any vaccine (the so-called zero dose children).

This is a concern in many countries, including in Sierra Leone where, despite progress in coverage, the government is working on a communication strategy with the goal of reaching the last mile.

“Reaching these underserved communities with immunization is critical to preventing outbreaks that threaten both regional and global health security,” said Chioma Nwachukwu, Head of Public Policy Engagement at the Global Alliance for Vaccine and Immunization – GAVI.

The Nairobi based health NGO, Amref Health Africa, co-organizes the AHAIC, alongside the Africa Centers for Disease Control and Prevention and the World Health Organization.

Dr Githinji Gitahi, Group Chief Executive Officer of Amref Health Africa, said at a pre-conference press briefing that Africa faces unique challenges from different member states, which must be addressed and led by Africans. But this, according to him, can’t be done in isolation.

“Many (African) countries still have the largest burden of infectious diseases. Now, with this, issues of non-communicable diseases are rising. The concern is how to get resources to tackle both,” he said.

Gitahi also spoke about the “seismic geopolitical change” that has seen richer countries, led by the United States, pulling the plug on much needed funding of lifesaving programmes on the continent.  

“Not only the United States, but other high income countries are starting to say that they are going to cut support…So we must ask ourselves, how are we going to look at the future with support declining with emerging threats of Non-Communicable diseases,” he said.

The conference was convened on the theme: ‘Connected for Change: Addressing Socio-Ecological Dynamics of Health.’

Like all the side events, the panel on Sustainable Health Financing discussed funding inadequacies, funding disruptions, financing sources, proper use of available finances, needed reforms in healthcare systems, as well as local ownership and leadership in the sector.

The panel of experts deliberated on opportunities to expand vaccine coverage in the face of all these obstacles, with lessons drawn from Kenya and Malawi.

In Kenya, for instance, Melissa demonstrated how the community health promoters approach can help in tracing defaulters of vaccine. The Kenyan government in 2023 flagged 100, 000 Community Health Promoters (CHP) who were digitally and financially enabled. These, she noted, could be used to trace defaulters. She also suggested extension of immunization services to cater for working mothers.

“In most of our settings, immunization services are provided on specific days and times. If we are able to extend that for working parents, that is an opportunity that can also be exploited to improve coverage,” she said.

Also highlighted was the largely untapped opportunity offered by Public private partnership. This brings in the use of technologies like drones to deliver services. In Kenya’s northern Kisumu region, they are already using that to supply blood to remote regions. Melissa said same could be done for vaccine.

But as important as making use of available shots is, sustainability is equally crucial, especially in light of potential disruptions in services threatened by funding cuts.

“It is hard to speak about primary healthcare and universal health coverage without talking about immunization,” said Emily Katarikawe, Executive Director of the Uganda-based CSO InPact, whose focus is to promote vaccine up-take.

She cited five areas Africa could struggle with if financing is disrupted. These include training and supporting front line healthcare providers like community health workers, which she and other activists say are already in short supply in many countries. She also stressed on the effect of disruption on community supply chain mechanisms – vis-à-vis ability to reach last mile.

“The absence of service continuity would mean that there is a likelihood of reoccurrence of childhoods illnesses that we have been able to prevent or bring down. It would also mean many more children will be under immunized…,” she said.

Katarikawe is also worried that funding disruption will empower anti-vaxxers.

“Any disruption in funding would mean that the social behaviour change that is enabling us to give the right information reach this mother for her to make an informed decision to take a child for immunization will not be available,” she said.

For fellow healthcare campaigner, Prof. Emmanuel Alhassan, domestic financing should be the focus for Africa now, and he sounded delighted that this came out prominently from the Kigali meet.

“One key takeaway from conference is the need for increase in domestic financing mobilization,” said the Nassarawa State University professor who is also the Nigeria Coordinator for the Prevent Epidemics programme.

“More needs to be done to own the mobilization efforts for domestic financing,” he added, stressing the role of regional bodies like Africa CDC.

The AHAIC comes hot on the heels of the 38^th African Union heads of state summit in Addis Ababa, Ethiopia, where the leaders highlighted slow progress toward continental immunization goals and called for accelerated action.

In 2017, the AU leaders endorsed the Addis Declaration on Immunization (ADI), which seeks to accelerate implementation of immunization programs on the continent. It included ten commitments that are geared towards increasing political, financial, and technical investments, among others.

At the latest heads of state summit in February, Sierra Leone’s President Julius Maada Bio hosted a side event, under the auspices of the African Union Health Commission, PATH, Gavi, WHO, UNICEF and other partners. The ADI progress report presented at that event indicated improvements in key areas such as increasing political will, enhancing vaccine delivery systems, and improving polio eradication efforts, but it also revealed slow progress, with a modest 4 percent improvement in overall performance from 42 percent in 2016 to 46 percent in 2022.

According to campaigners, this slow progress underscores the urgent need for accelerated action across the continent. And they said to address this requires a concerted effort to identify and overcome barriers, strengthen health care systems, and foster robust partnerships to ensure that immunization goals are met and sustained.

It turns out that this view is not just held by activists, but also some political leaders, as highlighted by President Bio, who noted that a strong immunization system is fundamental for national security, stressing that Africa cannot depend indefinitely on external funding.

“Africa’s immunization agenda must be owned and led by Africans today, with an urgency that cannot be overstated. It must be seen as a non-negotiable pillar of national security because without a healthy population, nothing else matters,” he said.

Article first published on https://manoreporters.com/news/health/ahaic-2025-experts-discuss-opportunities-to-enhance-immunization-gaps-in-africa/