WHO Urges Equity to Vaccinate Millions in South-East Asia

The World Health Organization (WHO) has issued a critical call for a renewed focus on equity to ensure that life-saving vaccines reach every individual in the South-East Asia Region. This comes as millions of children in the region remain either completely unvaccinated or have not received all recommended doses, despite five decades of remarkable progress in immunization efforts. The original article, published by the WHO on April 24, 2026, highlights that while vaccines have averted an estimated 154 million deaths globally over the last 50 years, with 38 million in the South-East Asia Region alone, significant disparities in access and coverage persist. The WHO's Expanded Programme on Immunization (EPI), launched in 1974, has been instrumental in expanding vaccination coverage across the South-East Asia Region, which is home to a quarter of the world's population. Historically, DTP-containing vaccine coverage has soared from a mere 5% in the early years of EPI to over 94% today. The region has also celebrated major public health achievements, including maintaining polio-free status since 2014 and eliminating maternal and neonatal tetanus since 2016. Furthermore, five countries have achieved measles elimination, and four have successfully controlled hepatitis B through immunization. These successes underscore the immense potential of sustained immunization programs. However, the ongoing challenge of vaccine equity threatens to undermine these gains. In 2024, globally, more than 14 million infants received no vaccines, and nearly 20 million missed at least one essential dose. Specifically, in the South-East Asia Region, more than two million infants remain completely unvaccinated, and an additional 650,000 do not receive all the necessary vaccines. As of 2023, approximately 3.4 million children in the region did not receive all the vaccines offered under the childhood immunization program, with 2.7 million of these receiving no vaccines at all. This leaves them highly vulnerable to preventable diseases and highlights critical gaps in service delivery and access, particularly for vulnerable and underserved populations. The COVID-19 pandemic significantly exacerbated these issues, severely disrupting essential immunization services in 2020 and 2021. DTP3 coverage, a key indicator of routine immunization, declined from 91% in 2019 to 85% in 2020 and further to 82% in 2021. This disruption led to a doubling of unvaccinated children in the region, from 2 million in 2019 to 4.6 million by 2021. While there has been a recovery in coverage in many countries, current figures for DTP1 (92%) and DTP3 (90%) in 2023 still fall short of pre-pandemic levels. The decline in first-dose measles vaccine coverage from 94% in 2019 to 91% in 2023 further illustrates the backsliding. Dr. Catharina Boehme, Officer-in-Charge, WHO South-East Asia Region, emphasized that while vaccines are among the most powerful and cost-effective health investments, their maximum impact hinges on reaching everyone, everywhere. The continued existence of gaps in immunization coverage poses a serious risk of disease outbreaks, as evidenced by the ongoing measles situation in Bangladesh. In response, the Bangladeshi government, with partner support, is scaling up a nationwide measles and rubella vaccination campaign targeting 18.03 million children. Addressing vaccine inequity requires tailored, country-specific approaches, with a focus on identifying and reaching high-risk areas and zero-dose children. The WHO South-East Asia Region has outlined strategic priorities, including strengthening health systems, improving vaccine equity, and advancing countries towards their immunization targets. This aligns with the global Immunization Agenda 2030 (IA2030) and the regional Strategic Framework for South-East Asia Regional Vaccine Action Plan 2022-2030, which aims for a region where everyone, everywhere, and at every age fully benefits from vaccines. These plans emphasize increasing equitable access, pursuing elimination goals for vaccine-preventable diseases, and reducing overall mortality and morbidity across the life course. Challenges remain, including the strain on global health financing and evolving donor priorities. Countries are urged to mobilize greater domestic resources for immunization and strengthen collaboration with development partners, the private sector, and civil society organizations. India, being a significant vaccine producer globally, with approximately 46% of the world's supply, plays a crucial role in these efforts, demonstrating the region's capacity while also facing its share of unvaccinated children. The collective commitment to equitable vaccination is not just a moral imperative but a public health necessity to prevent future outbreaks and safeguard the health and well-being of populations across the South-East Asia Region and beyond. The WHO continues to underscore that targeted research, particularly operational research, is essential to understand barriers to vaccination, improve supply chains, enhance data systems, and ensure equitable access, especially in underserved communities. The Regional Vaccine Implementation Plan (RVIP) 2022-2026 focuses on strengthening resilient systems and improving vaccine equity, with initial activities concentrating on COVID-19 vaccination rollout and recovery of immunization services. These concerted efforts are vital to ensure that no child is left behind and to achieve the ambitious immunization goals for a healthier future.

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