Africa's Routine Vaccine Systems Deliver Against Cancer, Malaria, But Funding Pressures Loom

 Africa’s routine immunisation programmes are delivering measurable public health impact at scale, with millions of lives saved, and families and communities protected from the devastation of vaccine-preventable diseases.

Immunization coverage has expanded markedly on the continent since 2000 when just eight vaccine-preventable diseases were included in routine immunization schedules compared with 13 currently. Introduction of vaccines such as the malaria and the human papillomavirus (HPV) vaccines are providing vital protection for children, young girls and women.

HPV vaccines have helped avert close to 1 million cervical cancer deaths in 29 African countries as of 2024, while some of the 25 countries that provide the malaria vaccine are reporting strong early impact such as reduced severe disease and hospitalization, according to an assessment by Gavi, the Vaccine Alliance, and World Health Organization (WHO) in Africa ahead of the African Vaccination Week and World Malaria Day marked respectively on 24–30 April; and 25 April.

Global leader in protecting women and girls against cervical cancer

Recent HPV national introductions and multi-age campaigns in Nigeria, Ghana, Ethiopia, and Angola have reached millions of girls within weeks, often through school-based and integrated delivery models, even as health systems responded to other outbreaks and competing priorities. Since 2019, the number of African countries with HPV vaccination programmes has increased from 12 to 35, and coverage rates have risen from 5% (in 2014) to 47% (in 2024) – placing the region second globally in terms of coverage, behind only the Americas. Across Africa, HPV vaccination has generated an estimated US$ 1.8 billion in economic benefits through avoided treatment costs, productivity gains, and lives saved.

Malaria vaccines deliver early impact

Through the Gavi-supported malaria vaccine programme, implemented by countries in partnership with WHO, UNICEF and others, more than 52 million doses have been delivered since 2023 in some of the world’s highest-burden, fragile, and operationally complex settings. Early reports from Kenya, Malawi, Ghana and Cameroon show reduced severe disease and hospital admissions, reinforcing pilot data. The same pattern is visible in Burkina Faso, where the vaccine has been introduced and expanded nationwide to all 70 health districts. Alongside other control measure these efforts have already contributed to a 32% decline in reported malaria cases between 2024 and 2025. This also included sharp reductions in cases among children under five, and nearly halved malaria-related child deaths. Initial estimates from Burkina Faso’s Ministry of Health indicate household savings of more than US$26.6 million in direct healthcare costs highlighting how vaccines, combined with strong national programmes, can shift transmission at scale.

Translating this momentum into sustained impact, WHO is working with partners and governments to reinforce the operational systems that underpin malaria vaccine rollout. Regional political platforms, including the Economic Community of West African States Assembly provide an important space for sustained ministerial engagement as countries move from introduction to long-term programmatic integration.

Dr Robert Lucien Jean-Claude Kargougou, Minister of Health of Burkina Faso: “For decades, malaria placed a heavy burden on Burkina Faso’s health system and on families, especially during the rainy season. Thanks to strong political commitment and the expansion of malaria vaccination to all 70 health districts, combined with the distribution of bed nets, seasonal chemoprevention, and community mobilisation for sanitation and the elimination of mosquito breeding sites, we are recording a drastic and historic decline in cases and deaths, fewer hospitalisations, and real savings in healthcare costs.”

“HPV and malaria vaccines have enabled us to open up new frontiers in healthcare against one of Africa’s deadliest cancers and old diseases,” said Thabani Maphosa, Chief Country Delivery Officer, Gavi, the Vaccine Alliance. “The success of these programmes is testament to the commitment and hard work of governments, partners and healthcare workers, and a reflection of strong community trust in the ability of vaccines to save lives and protect families. Today, these hard-won gains are under threat, putting, leaving hundreds of thousands of children in danger. The world must continue to prioritise investment in immunisation.”

“In Africa, vaccines are delivering some of the most effective and high-impact interventions we have, from preventing cervical cancer through HPV vaccination to advancing malaria control with new tools and approaches,” said Dr Mohamed Janabi, WHO Regional Director for Africa. “HPV vaccination offers exceptional public health returns and brings us closer to cervical cancer elimination. At the same time, the malaria response is entering a new phase driven by country ownership. Ending these diseases is achievable when we act decisively, together.”

Future progress at risk

Building on years of planning, community engagement and raising awareness, Africa is poised to change the game in the fight against both cervical cancer and malaria. Ten more African countries plan to introduce the HPV vaccine with Gavi support by 2030. Five more African countries are expected to introduce the malaria vaccine with Gavi support by 2030. Overall, the programme seeks to reach 50 million children across the continent with a full course of malaria vaccines by the end of the decade.

However, this progress is at risk. While lower-income countries continue to mobilise record financing for immunisation, sustained prioritisation of investment in immunisation and increased domestic resource mobilisation – as advocated for by the Alliance and partners such as the Africa Centres for Disease Control and Prevention (Africa CDC) – will be critical to maintain progress and achieve the full potential of these critical life-saving programmes. The malaria programme faces a nearly 30% budget shortfall, which has led to a scale back in support. Bridging this gap and protecting as many vulnerable children as possible will require additional domestic and donor financing.

In the 2026–2030 period, HPV and malaria programmes, alongside other Gavi-supported vaccines, will be financed for the first time through country vaccine budgets – with Gavi handing decision-making over 90% of its procurement budget directly to countries. In a time of funding constraints, this approach aims to provide governments a five-year resource view and control over which vaccines to prioritise based on national strategy, context and needs. However, due to funding gaps countries will have to make difficult choices that Gavi estimates will lead to 600,000 fewer lives saved by the end of the decade.

×