At the 77th World Health Assembly, Gavi, The Vaccine Alliance, urged nations to prioritize vaccinating “zero-dose” children, particularly those in regions affected by humanitarian crises and complex emergencies. These children have not received any shots, putting them at a higher risk of preventable diseases.

“We are scaling up routine immunization and reaching the estimated 14.3 million zero-dose children worldwide, recognizing that most polio cases are in subnational areas with the highest proportion of unvaccinated and under-vaccinated children,” Gavi representatives told the assembly.

Gavi’s 2021-2025 strategy focuses on reaching zero-dose children and missed communities who have not received any vaccinations. The organization aims to reduce the number of zero-dose children by 25% by 2025 and by 50% by 2030.

The World Health Organization reported a decline in the number of zero-dose children from 18.1 million in 2021 to 14.3 million in 2022, nearing the pre-pandemic level of 12.9 million in 2019. The percentage of children receiving their first dose of the measles vaccine increased from 81% in 2021 to 83% in 2022, still falling short of the 86% achieved in 2019.

During Committee A’s discussion on poliomyelitis, Gavi called on member states to integrate polio funding into existing national health systems to promote and accelerate essential polio and broader immunization functions.

Progress and challenges in the Eastern Mediterranean

Dr Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean, highlighted the region’s progress in ending poliovirus transmission but noted that the poliovirus persists in mobile, border, and migrant populations.

“To end polio, we must reach all children, keep strengthening surveillance, address community resistance and disinformation, and continue leveraging polio resources as we build a resilient health workforce across our region,” Balkhy said.

Iraq and Libya have taken full financial responsibility for sustaining polio essential functions, demonstrating what can be achieved when countries commit to transition. In Yemen, the WHO is negotiating with northern authorities to stop outbreaks of polio and other vaccine-preventable diseases this year.

Global efforts and country commitments

Australia pledged $43.5 million to bolster the Polio Eradication Strategy (2022-2026), underscoring the urgency to ramp up efforts to halt vaccine-derived transmission and concentrate on critical regions. The nation also backed routine immunization, emphasizing the importance of partnering with WHO, UNICEF, and Gavi to expedite advancements in achieving the Immunization Agenda 2030 objectives.

Countries spanning the globe, from Sudan and Chad to Guinea, Senegal, Pakistan, India, the Philippines, Kenya, Bangladesh, and Morocco, shared their initiatives, obstacles, and advancements in the fight against polio. All stressed the importance of integrated strategies, community involvement, targeting zero-dose children, and fortifying immunization systems.

African member states, having ended the wild poliovirus outbreak, remain uneasy about polio’s persistent status as a public health emergency of international concern. avi noted that “the 47 countries remain concerned by the ongoing transmission of circulatory poliovirus and by the low level of vaccination in areas that are difficult to access.” Vaccine supply problems and financial limitations were partly to blame for the type two poliomyelitis outbreaks.

African nations have started transition planning for poliomyelitis and post-certification activities, prioritizing indicators for monitoring and evaluation to uphold program quality. However, unstable health systems, coupled with political and economic challenges, may slow down several countries in the region from assuming complete technical and financial responsibility for all polio eradication functions.