Gavi and IRC’s REACH consortium deliver 20 million vaccine doses in crisis settings, reduces delivery cost per dose to US$ 2

As delegates from around the world and across the private sector and civil society gather for the 2025 World Health Summit, the Reaching Every Child in Humanitarian Settings (REACH) consortium has officially administered over 20 million vaccine doses to children in humanitarian and conflict-affected settings – namely in Chad, Ethiopia, Somalia, Nigeria, South Sudan, and Sudan. REACH is funded by Gavi, the Vaccine Alliance (Gavi) and led by the International Rescue Committee (IRC), in collaboration with an array of local civil society organizations.

Despite global advances in immunization, 14.3 million children worldwide remain unvaccinated. Most live in fragile and conflict-affected settings where traditional health systems cannot safely and effectively reach them. To address this challenge and serve communities in conflict or crisis zones – some of which haven’t seen a vaccine in over a decade – ZIP, Gavi’s Humanitarian Partnerships, was launched in 2022, partnering directly with humanitarian organizations to deliver immunization to communities that government health systems have been unable to reach. As part of this programme, REACH relies on a specialized humanitarian model addressing complex barriers, leveraging the IRC’s humanitarian expertise, which has proven essential in ensuring that even the hardest-to-reach children receive the full national schedule of vaccines.

Through community-based and context-adapted strategies, REACH is now delivering more than 1 million vaccine doses every month across a range of life-saving antigens. As the programme has scaled, average delivery cost per dose has fallen from around US$ 3.75 per dose in the first year to around US$ 2 by September 2025, making routine immunization increasingly affordable and impactful even in the most fragile environments.

“Today more lives than ever are being protected through immunization – even in the most challenging and conflict-affected settings,” said Thabani Maphosa, Chief Country Delivery Officer at Gavi, the Vaccine Alliance. “And yet accessing communities that are beyond government reach remains the final frontier. Through REACH, we're closing that gap by making immunization part of humanitarian response, working with innovative partners such as IRC to deliver vaccines where public health resources remain limited.”

Reaching children living in fragile and conflict-affected communities is a public health imperative – not just for the communities they live in, but for global efforts to prevent the resurgence of vaccine-preventable diseases. Cutting back on immunization and broader primary healthcare programmes significantly increases the risk of preventable disease outbreaks – especially in humanitarian settings where health systems are weak or collapsing. Without sustained investment in prevention and treatment, diseases are more likely to spread unchecked, mutate, and become harder to contain—posing risks to both regional and global health security. As vaccine skepticism rises in high-income countries, REACH’s progress stands as a powerful reminder of the life-saving value of vaccines – and the importance of reaching every child, no matter where they live.

“We cannot say that protecting every child with a lifetime of immunity isn’t worth the investment,” said Mesfin Teklu Tessema, Senior Director of Health at the IRC. “That investment is not only cost-effective – it is essential. Infectious disease outbreaks cost the world an estimated US$ 60 billion every year. These outbreaks know no borders and can impact us all. In contrast, preventing diseases through equitable access to vaccination and routine immunization, particularly when delivered by frontline actors, has proven time and again to be highly effective.”

When REACH launched in 2022, only 16% of the 156 target communities were accessible to humanitarian actors. Centering humanitarian principles, the consortium has now negotiated access to 100% of those communities. Through flexible and adaptable delivery models, such as mobile clinics and community outreach units, hyperlocal partners and geospatial mapping, as well portable vaccine carriers, REACH is enabling immunization in regions where existing government health systems cannot function due to insecurity, conflict, or crises including those driven by climate change. By closely coordinating with the Ministry of Health and the national immunization programme, REACH intends to transition services back to government-led delivery when conditions allow.

Starting in 2026 and building on lessons learned from ZIP, Gavi will step up efforts to reach children in crisis-affected settings, working to ensure that immunization is more systematically integrated into humanitarian health responses. Through its Fragile & Humanitarian approach, Gavi will help extend vaccine coverage to children under five, strengthen delivery in under-served and conflict-affected areas, and deepen partnerships with humanitarian organizations. These efforts are part of Gavi’s broader commitment to sustain immunization in fragile contexts and ensure that no child is left behind due to conflict or crisis.

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