Millions of children remain unvaccinated in the Eastern Mediterranean, leaving them vulnerable to preventable diseases. This stark reality is revealed in the first annual progress report on the Immunization Agenda 2030 (IA2030) for the region, released on October 27, 2025. While the report highlights encouraging strides, it also exposes critical challenges that threaten to undermine hard-won gains in vaccine equity and disease prevention.
IA2030 paints a bold vision: a world where every person, everywhere, at every stage of life, enjoys the full benefits of vaccines for improved health and well-being. It aims to not only sustain existing immunization achievements but also recover from the setbacks caused by the COVID-19 pandemic, ensuring that no one is left behind. The Strategic Framework guiding this ambitious agenda focuses on strengthening immunization systems, expanding vaccine coverage, and promoting equity, particularly in conflict-affected and hard-to-reach areas.
But here’s where it gets controversial: despite the introduction of 41 new vaccines across the region since 2019, including COVID-19 vaccines in all countries, the number of children receiving zero doses of essential vaccines has risen from 2 million in 2019 to 2.8 million in 2024. This alarming trend raises questions about the effectiveness of current strategies and the persistence of systemic barriers to vaccine access.
The progress report sheds light on both successes and setbacks. On the positive side, poliovirus has been eliminated in 20 out of 22 countries and territories, and Egypt has joined the ranks of countries that have eliminated measles and rubella. However, the region has witnessed a surge in outbreaks of cholera, measles, and vaccine-derived poliovirus between 2019 and 2024, underscoring the fragility of progress in the face of ongoing challenges.
And this is the part most people miss: while high-income countries are leading in the introduction of vaccines like HPV, many middle-income countries face limited access to new vaccines, widening the equity gap. Routine immunization coverage for critical vaccines like DTP3 (diphtheria, tetanus, and pertussis) has declined from 84% in 2019 to 79% in 2024, leaving millions of children at risk.
The report tracks progress across seven strategic priorities (SPs) of IA2030, revealing a mixed picture. For instance, under SP1 (Immunization Programmes for Primary Health Care/UHC), all 22 countries now have national immunization technical advisory groups, but only 77% have a valid national immunization strategy. Under SP4 (Life Course and Integration), HPV vaccine introduction has increased, but primarily in high-income countries, leaving others behind.
Here’s a thought-provoking question: With rising vaccine hesitancy, particularly post-COVID-19, and increasing outbreak frequency, are we doing enough to address public mistrust and ensure timely responses to emergencies? The report highlights gaps in data quality, humanitarian access, and outbreak reporting, which hinder progress.
To stay on track, WHO calls for urgent action, including vaccinating all unvaccinated and partially vaccinated children up to 5 years of age, improving data reporting, and strengthening collaboration to respond to outbreaks. The region has demonstrated that progress is possible, but closing equity gaps and preventing backsliding on vaccine-preventable diseases requires sustained commitment and innovative solutions.
The full progress report, available at https://applications.emro.who.int/docs/IA-2030-eng.pdf, offers detailed data, country-specific insights, and strategic pathways forward.
What do you think? Are current efforts enough to achieve the ambitious goals of IA2030? How can we address the growing equity gaps and vaccine hesitancy? Share your thoughts in the comments below—let’s spark a conversation that drives change.
