Ongoing conflicts and vaccine hesitancy are undermining efforts to immunize all children, according to a report tabled at the World Health Organization’s Executive Board meeting.

Over 120 million people were displaced by conflicts in 2024 alone, according to the WHO. Countries will have to put in significant efforts to achieve the 2030 target of averting 50 million vaccine-preventable deaths between 2021 and 2030.

“Over the next five years, Gavi will invest nearly 3 billion US dollars in fragile countries, about 35% of our programmatic resources,” a representative from the vaccine alliance Gavi told the EB. “We urge member states to continue investing in routine immunization, reach zero-dose children, and strengthen outbreak preparedness and response,” the representative said.

There has been some progress in addressing Neglected Tropical Disease (NTDs) and Tuberculosis (TB), though the gains are precarious, the WHO warned.

Between 2015 and 2021, the disease burden due to NTDs decreased from 17.2 to 14.1 million disability-adjusted life years, according to another report tabled.

The global number of people falling ill with TB declined for the first time since the COVID-19 pandemic in 2024 and stood at 10.7 million. Around 8.3 million people accessed care that year, the highest number since WHO began monitoring, a report on TB noted.

Globally, the net reduction in incidence rate between 2015 and 2024 was around 12.3%.

Anti-vaccine narratives

Apart from the worsening humanitarian crisis, particularly in Ukraine, Gaza, and Sudan, there is growing vaccine hesitancy.

The anti-science sentiment and politicization of science and public health risk are undermining trust in immunization and threatening progress, the WHO’s report said.

“Misinformation has become a major constraint, and we note with concern that some anti-vaccine narratives are amplified through coordinated influence operations, even by state actors,” a representative from Ukraine said.

“To regain momentum, Ukraine emphasizes strengthening primary health care and making continuous catch-ups a permanent, everyday function of the health system, rather than just a periodic campaign,” the representative added.

Immunization strategies are often poorly tailored to conflict settings, with coverage declining sharply during crises, WHO said.

Despite the COVID-19 pandemic, vaccinations averted over four million deaths annually between 2021 and 2024.

Immunization to control NTDs

In 2024, 1.4 billion people required interventions against NTDs, a 36% decrease from 2010. The estimated mortality from NTDs between 2015 and 2021 dropped from 139,000 to 119,000.

Immunization and eradication drives against NTDs have met with success. In 2024, over 880 million people were treated for at least one neglected tropical disease, 99% through mass drug administration interventions.

WHO acknowledged nine countries for eliminating at least one neglected tropical disease in 2023.

“The implementation context has changed radically, with the COVID-19 pandemic, humanitarian crises, climate change, and the fact that financing has dwindled. All of these things have made our health systems more fragile. It is important that we recommit the whole world to this agenda, and that Africa be placed at the heart of vaccine equity,” said Cameroon on behalf of the African Union.

TB’s precarious gains

TB remains one of the leading causes of death from an infectious agent. With funding cuts from the Trump administration and a drop in overall development assistance for health, the risk that hard-won gains may be reversed is high.

Russia advocated for a flexible and adaptable strategy to end TB. “We have to look at what, in fact, works in countries. We need to have separate strategies that include tailor-made approaches and that promote efforts to achieve those goals that have been set for high burden TB countries where there are few resources and where there are emergency situations,” the representative from Russia said.

Africa (25%) had the highest TB burden, followed by South-East Asia (34%) and Western Pacific (27%), the WHO’s report found, noting the high cost of treatment remains a huge area of concern.

Globally, the net reduction in incidence rate between 2015 and 2024 was only 12.3%, well below the End TB Strategy milestone of a 50% reduction by 2025.

Push for more funding, collaboration

Member states expressed the need for greater international collaboration and for countries to take responsibility for their citizens in the changing funding landscape.

“There is also a change of the global health architecture, which means that we need to have more coordinated efforts between countries, and we need to make sure that we have more technical support and financial support,” a representative of Cuba said.

Canada expressed similar sentiments. “Strengthening country ownership and accountability is crucial, particularly in the context of funding constraints. Recognizing that immunization is a cornerstone of resilient health systems, we call on all partners to align investments with country-led priorities,” the Canadian representative said.

Countries also urged using data more effectively for targeted immunization, sharing data across borders for better coordination, and integrating immunization in maternal and post-natal care programmes.

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