Sustaining High and Equitable Vaccine Coverage

The Gavi Middle-Income Countries (MICs) Approach aims to prevent and mitigate backsliding and address the barriers to sustainable and equitable immunisation programme performance. The MICs Approach contributes to Gavi’s overall vision of leaving no one behind with immunisation, and the Gavi 5.0 strategy to achieve greater sustainability, equity, and resilience in immunisation globally.

The shock of the COVID-19 pandemic has caused immunisation coverage to decrease in many countries and has further increased the risk that in some of these countries, coverage may not recover fully or may take much longer to recover. While the COVID-19 pandemic did place immense pressures on health systems, some of the countries that are struggling to restore coverage levels often include those in which barriers to sustainable immunisation programme performance existed prior to the pandemic and were, therefore, already at higher risk of backsliding. In these countries, COVID-19 has further exacerbated existing inadequacies in the immunisation programme. Furthermore, the current prioritization of the COVID-19 vaccine and outbreaks of previously controlled vaccine preventable diseases threaten to erase some of the hard-won gains of routine immunisation programmes.

Linked facilitates cross-country learning among the 19 former-Gavi countries focused on common challenges related to strengthening immunisation programme performance and reaching zero-dose children. Thematic areas prioritized by country members have included Community Demand for and Confidence in Vaccines, Delivery of Immunisation through Primary Health Care Platforms, Human Resource Capacity and Performance, and Clearing Immunisation Backlogs and Building Back Better.

Click the buttons below to access network and partner resources and news related to strengthening immunisation programme performance and ensuring all children are reached with vaccines and immunisation services.

Many middle-income countries are missing critical, life-saving vaccines, which presents a threat to inter-country equity. Of the 19 countries that have transitioned from Gavi support, 13 have not yet introduced at least one of PCV, rotavirus, or HPV vaccines. And despite higher immunisation investments on average, a number of middle-income countries that have never been eligible for Gavi support are similarly lagging behind in introducing these vaccines relative to Gavi countries. Explore our resources that highlight good strategies and promising practices in new vaccine introduction.

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Gavi’s vision for a successful transition is one in which countries have expanded their national immunisation programmes with vaccines of public health importance and sustain these vaccines post-transition with high and equitable coverage of target populations, while having robust systems and decision-making processes in place to support the introduction of future vaccines. Explore our resources that highlight good strategies and promising practices for tackling challenges for transitioning countries.

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