The first annual progress report on the Strategic Framework for the Implementation of Immunization Agenda 2030 (IA2030) in the Eastern Mediterranean Region reveals both achievements and persistent challenges in vaccine equity and disease prevention. The framework supports countries in maintaining progress, recovering from COVID-19 disruptions, and strengthening immunization systems to ensure equitable access, especially in conflict-affected and hard-to-reach areas.
The report highlights that poliovirus has been eliminated in 20 of 22 countries, with Egypt joining Bahrain, Iran, and Oman in eliminating measles and rubella. However, outbreaks of cholera, measles, and vaccine-derived poliovirus have increased between 2019 and 2024, signaling setbacks in disease prevention. While 41 new vaccines have been introduced, including COVID-19 vaccines in all countries, the number of zero-dose children has risen from 2 million to 2.8 million, and overall vaccine coverage rates for DTP and other key immunizations have declined.
Progress under the seven strategic priorities of IA2030 shows mixed outcomes. Most countries now have national immunization advisory groups and strategies, but fewer are implementing social and behavioral initiatives to boost vaccine demand. Coverage and equity remain uneven, with fewer districts reaching target immunization rates. HPV vaccine introduction has expanded modestly, and while some countries have increased vaccine financing, reporting on outbreak responses remains weak. Encouragingly, more nations are developing research agendas to support immunization innovation.
Despite progress, the report identifies several critical barriers, including poor data quality, conflict-related access constraints, vaccine hesitancy, frequent outbreaks with delayed responses, and limited access to new vaccines in middle-income countries. WHO urges countries to intensify efforts to reach unvaccinated children, strengthen disease surveillance, respond rapidly to outbreaks, and leverage existing polio resources to enhance routine immunization.
As presented during the Seventy-second session of the WHO Regional Committee for the Eastern Mediterranean (RC72), the report emphasizes that while the region has demonstrated capacity for progress, immediate action is essential to close equity gaps and sustain gains against vaccine-preventable diseases.
