Mid-Term Review: Regional Strategic Plan for Immunisation 2014-2020

The Regional Strategic Plan for Immunisation (RSPI) for the African region was adopted, in 2014, by the 64th session of the WHO Regional Committee for Africa with the goal of achieving universal immunisation coverage and reducing mortality and morbidity from vaccine preventable diseases (VPD) within the WHO African Region by the end of 2020. The plan was developed in line with the , approvedGlobal Vaccine Action Plan (GVAP) by the World Health Assembly in 2012, which aims to prevent millions of deaths by the end of the Decade of Vaccines in 2020.

In January 2017, Heads of State from across Africa endorsed the Addis Declaration on Immunisation (ADI). This commitment from the highest level of government to ensure that everyone in Africa, irrespective of where they live can access vaccines, provides much needed momentum to accelerate immunisation efforts in the region. The commitment is leveraged by implementing the declaration's roadmap and taking into account the current state of immunisation in the region.

Significant progress has been made in the region during the past three years particularly regarding the introduction of new vaccines. By end of 2016, all 47 countries in the region had introduced Hepatitis B and Haemophilus influenzae type b vaccines. Furthermore, 39 countries have introduced the pneumococcal conjugate vaccine (PCV); 32 countries have introduced the rotavirus vaccine; and 20 countries have introduced the rubella-containing vaccine in routine EPI services. All countries in the region met the set timelines for the global switch from trivalent to bivalent oral polio vaccine and, where supply allowed, introduced
inactivated polio vaccine, thus reducing the risk of vaccine-derived polioviruses (VDPV) and contributing to global efforts to eradicate polio. Despite this progress, immunisation coverage in the region remains below the expected target of 90% coverage at national level and one in five children in Africa still lacks access to all life-saving vaccines. The majority of the un- and under-immunised children live in three large countries: Nigeria, Ethiopia and the Democratic Republic of Congo (DRC) and immediate focused remedial actions are required there.

In October 2017, a mid-term review (MTR) panel appointed by WHO AFRO met in Brazzaville, Congo to review progress against the RSPI and provide recommendations aimed at supporting countries to achieve the 2020 regional objectives. The panel undertook a thorough desk review of progress and challenges experienced in the region, and provided the recommendations presented herein. The MTR panel assessed the data reported by countries to the WHO AFRO from 2014 to 2017.