The group emphasized that losing ground in established programmes could expose more people to preventable illness and damage public trust in vaccination services.
WHO immunisation director Dr Kate O’Brien explained that while governments now have access to an increasingly broad range of vaccines, budgets often cannot support every available product, even with assistance from the Gavi alliance.
Decisions regarding vaccine introductions must account for disease burden, community needs, fairness, and the practical ability to deliver shots. A new vaccine can compete for resources with reaching children who have already missed the basic schedule. O’Brien noted that more than 30 diseases are now preventable through vaccination, with around 13 to 14 vaccines recommended for every country.
Broadening the list of available vaccines gives policymakers additional choices, yet every new addition also entails logistical demands and a cost to buy the doses. The SAGE committee recommends that preserving the vaccines already part of a country’s routine schedule should remain the foremost objective, so that progress made is not lost.
Changing financing models
Both internal budget gaps and the limited resources of Gavi’s present strategy are prompting hard choices about priorities. Gavi is moving from a model where each vaccine proposal is submitted separately to one that allocates a single lump-sum budget to each nation for the 2026-2030 cycle.
The coalition explained that a fixed package of essential vaccines will receive assured financing, while additional, optional funds may fall short of covering every national requirement. It also highlighted that the total cash assistance will be lowered. This revamped framework aims to provide more predictable funding and shift greater decision-making authority to the recipient countries.
Evaluating local priorities
The scale of the delivery task is substantial. WHO reported in April that the Big Catch-Up initiative reached 18.3 million children across participating countries between 2023 and 2025. In Nigeria, two million previously zero-dose children received a first diphtheria-containing dose, alongside 3.4 million IPV doses.
