Reflections on 50 years of immunisation programmes in the WHO African region: an impetus to build on the progress and address the unfinished immunisation business.

Immunisation is crucial to achieving the Sustainable Development Goals for maternal and child mortality reduction. As Africa marks the 50th anniversary of implementing immunisation programmes, it is imperative to review progress, address challenges and strategise for the future. Using available programme data, this article examines the progress made in achieving the immunisation milestones in the region, describes the success factors and lessons learnt and makes recommendations on how to immunise every African child in the coming years. The article concludes that despite significant improvements in childhood immunisation coverage, the region still falls short of global targets, with disparities across countries. Contributing factors include, among others, weak health systems, rapid population growth without corresponding increases in service delivery, vaccine hesitancy, inadequate sustainable financing and disruptions caused by the COVID-19 pandemic. Moving forward, efforts to attain the global immunisation coverage milestones should focus on building on the past progress, addressing the COVID-19 setbacks, leveraging new technologies and securing sustainable immunisation funding. This can be achieved by accelerating the implementation of the Immunization Agenda 2030 and the Addis Ababa Declaration on Immunization commitments. The support of all stakeholders including political leaders, public health professionals, the vaccine industry, regional organisations, academia, donors and healthcare workers is essential for this noble endeavour.