Vivianne Ihekweazu (Lead writer)
Seatbelts began as a simple safety feature, often dismissed at first as inconvenient. But over time, this innovation proved transformational. Countries that mandated its use saw road deaths decrease. According to the U.S. National Highway Traffic Safety Administration, seatbelts have saved over 374,000 lives in the U.S. alone since 1975. The UK halved its road fatalities within a decade of mandating them.
Like seatbelts, vaccines do not prevent all infections, but they do save lives, millions of them. According to the World Health Organisation (WHO), vaccines prevent 4 to 5 million deaths every year. The measles vaccine alone is estimated to have prevented over 56 million deaths globally between 2000 and 2021. Vaccines are, without question, the most effective public health intervention in history. Yet, they remain underappreciated.
Unlike seatbelts, the life-saving effect of vaccines is not immediate or visible. You do not hear about the pneumonia your child did not get or the measles outbreak that never happened, but you do hear about the measles outbreak when children are not vaccinated. This invisibility may be part of the reason why the value of vaccines does not resonate as powerfully as it should. If something works so well that it makes a crisis disappear, how do we keep valuing it?
A smart investment with proven returns
Financing vaccines is not just good for health; it makes economic sense. It is estimated that for every $1 spent on childhood immunisation returns $54 in economic benefits through reduced illness, lost productivity, and long-term health costs. That is a return no stock portfolio can match.
Recognising this, governments and global health institutions have invested heavily in immunisation. At the recently held Global Summit: Health and Prosperity through Immunisation in Brussels, co-hosted by the European Union and the Gates Foundation, countries renewed their commitment to Gavi, the Vaccine Alliance. The alliance has helped vaccinate over 1 billion children and saved more than 17 million lives. For the 2026–2030 funding period, Gavi raised $9 billion towards its broader replenishment target of $11.9 billion. The summit brought much-needed momentum, with pledges from around the world.
Among African countries, Uganda’s Minister of Health, Dr Jane Ruth Aceng, announced a $1 million commitment, citing that the commitment was a “signal of the importance” the Ugandan government placed on immunisation, but also a trust in Gavi the Vaccine Alliance, and a desire to inspire more domestic investment in health. Rwanda’s Health Minister, Dr Sabin Nsanzimana, reinforced his country’s ongoing co-financing of vaccines and pledged an additional $1 million over five years, underlining that building resilient health systems begins with immunisation.
Other significant pledges included $1.6 billion from the Gates Foundation. In his remarks, Bill Gates, Chair of the Gates Foundation, highlighted that “over the last 25 years, the reduction of under-5 deaths has been far faster than any time in history….from over 9 million to now half as many deaths taking place by children.”
In addition, the United Kingdom, made the largest single-country pledge of £1.25 billion, even though this represented a 24% decrease from its contribution during the Gavi 5.0 funding round (2021–2025). The European Commission also committed €360 million.
President of the European Commission Ursula von der Leyen in her remarks emphasised that “Vaccines have saved more live than any other medical breakthrough…Now more than 150 million lives have been saved because of vaccines over the last 50 years, and they remain our strongest shield against infectious disease”.
As the 4th International Conference on Financing for Development (FFD4) kicks off in Seville, the momentum to reshape global health financing, including vaccine access, has never been more urgent. FFD4 is a critical moment to champion country-led solutions that prioritise local needs, integrate the private sector, and ensure long-term sustainability of vaccine financing.
However, not all countries made pledges to Gavi. The United States (US) withheld its commitment, citing concerns about Gavi’s evidence-based vaccine recommendations. In 2024, former First Lady, Dr Jill Biden had announced a pledge of at least $1.58 billion on behalf of the US to support Gavi for the current replenishment. The announcement by Robert F. Kennedy, Health and Human Services Secretary was a surprising shift, especially considering that during the previous funding cycle (2019–2025), the US had committed $300 million each year to Gavi. This was a move that signalled the US government’s retreat from multilateralism at a time when global solidarity is needed most.
Vaccine access and the equity
Even as support continues, vaccine-preventable disease outbreaks remain an unfortunate reminder of deep global inequalities. The Lancet’s 2024 Global Burden of Disease Study revealed that 50% of the world’s 15.7 million zero-dose children are concentrated in just eight countries, including Nigeria, India, DR Congo, Ethiopia, Somalia, Sudan, Indonesia, and Brazil. Low immunisation coverage has led to the resurgence of diseases once under control. Diphtheria outbreaks in Nigeria, Pakistan, Bangladesh, Venezuela, and Yemen are stark warnings.
As is widely acknowledged, infectious diseases do not respect borders. So, when one country falls behind on vaccination, it puts other countries at risk. This is why the Gavi replenishment is about global health solidarity to strengthen our collective health security.
Gavi’s $1.2 billion commitment to the African Vaccine Manufacturing Accelerator (AVMA) is helping incentivise vaccine production on the continent, reducing dependency, and supporting regional ownership of health solutions.
The growing threat of misinformation
With efforts to increase funding and vaccine coverage rates, a growing threat is the spread of misinformation and disinformation, a major factor in the US decision to hold back on funding to Gavi. False claims and conspiracy theories about vaccines, amplified online are undermining years of progress in immunisation. From measles to COVID-19, public trust is being eroded, and many of gains made in reducing vaccine-preventable deaths are being reversed.
We must not take trust in vaccines for granted. This trust must be protected and putting a strong emphasis on letting the science guide public health decisions. Strengthening public communication and engaging trusted community voices must be core to every country’s vaccine strategy. Because no amount of financing or infrastructure will matter if confidence in vaccines continues to erode.
Transitioning from aid to ownership in Nigeria
Since 2001, Gavi has provided over $732 million to Nigeria for vaccine procurement, cold chain infrastructure, and health systems strengthening. Nigeria entered Gavi’s accelerated transition phase in 2018 and is expected to become fully self-financing by 2029 (extended from 2021 due to low coverage rates).
With an annual birth cohort of over 8 million and a fertility rate of 4.8, Nigeria’s immunisation needs are immense with coverage remaining below the national target of 85%. This makes vaccine financing a critical priority.
In Nigeria’s 2025 budget, ₦2.38 trillion (5.18% of the national budget) was allocated to health, a 58.5% increase from 2024, but still below the Abuja Declaration’s 15% target. Nigeria must ensure that vaccine financing becomes a first-line charge, disbursed promptly and not subjected to the whims of politicians or bureaucratic delays. The Nigeria Strategy for Immunisation and Primary Health Care System Strengthening (NSIPSS) provides a framework for this shift, targeting 84% immunisation coverage and sustainable health financing.
Country-led solutions that prioritise local needs, supported by both government and the private sector, must be at the heart of this transition. Vaccines should never be an afterthought in public finance. As Nigeria moves toward self-sufficiency, funding vaccines must be seen not as an expense, but as an investment in national security, economic stability, and strengthening the country’s human capital. Legislative reforms will be needed to institutionalise vaccine financing as a priority budget line. Nigeria’s leadership must also advocate for and invest in domestic manufacturing and supply chain resilience for vaccine delivery.
The seatbelt succeeded because people could see what it did. Fewer deaths from car accidents. Vaccines save just as many lives, most likely many more, but their “wins” are not always visible. This invisibility in the success of preventing vaccine-preventable deaths is the challenge we face. Investing in vaccines is the smartest investment for any economy to thrive. Now more than ever, we must protect and restore public trust and ensure vaccine financing is recognised for what it truly is, a strategic, and non-negotiable investment in stronger health systems and economic stability.