The power of civil society to support new vaccine introductions

22 Jun The power of civil society to support new vaccine introductions

Posted at 10:39h in Article by Leith Greenslade

Something extraordinary has been happening for the children of Chad, Somalia, and South Sudan. An unprecedented period of child health progress with the introduction of new vaccines against pneumonia, diarrhea, and malaria.

Together, these three infections caused 86,000 deaths in 2021 – 45% of all deaths among children under five across the three countries and unlike for most other countries, deaths have declined very slowly – 15% over the last decade. Progress has not been even. While 32% fewer children are dying from diarrhea across the three countries, pneumonia deaths have declined by 11%, and malaria deaths by just 2%.

Despite the wide availability of powerful vaccines that can prevent pneumonia and diarrhea, children in Chad, Somalia, and South Sudan – the most vulnerable children in the world – have had to wait more than two decades for them. An estimated 1.5 million children have died from pneumonia and diarrhea in these three countries over this period.

But that reality is changing rapidly. In a world first, Chad introduced the pneumococcal conjugate vaccine (PCV) and the rotavirus vaccine in October 2024 along with the new malaria vaccine. This triple introduction of these three vaccines occurred within one year of the malaria vaccine approval by the World Health Organization (WHO). Beginning in April 2025, Somalia and South Sudan both introduced PCV and rotavirus vaccines; South Sudan alongside the malaria vaccines and Somalia with measles catch-up campaigns.

The impact will be measured in lives saved. When all three vaccines are operating at full coverage and reaching more than 90% of children across Chad, Somalia, and South Sudan, more than 16,000 children’s lives will be saved each year according to estimates from the Lives Saved Tool (LiST). This will enable each country to significantly close the wide gap that remains to reach the Sustainable Development Goal (SDG) for child survival target of less than 25 child deaths for every 1,000 births by 2030.

To achieve this historic milestone for child survival, health ministries across the three countries worked closely with Gavi, the Vaccine Alliance, the World Health Organization (WHO), UNICEF, and other global vaccine partners. But there was another powerful actor on the scene, a network of six civil society organizations joining forces under the banner, Promoting Rotavirus and Pneumococcal Conjugate Vaccine (PCV) for Enhanced Childhood Immunization and Safety (PRECISE). These included:

1. Action pour la Protection des Droits de l’Enfant (APDE), Chad
2. Somali Research and Development Institute (SORDI)
3. Y-PEER Somalia
4. South Sudanese Women in Medicine (SSWIM)
5. Impact Health Organization (IHO), South Sudan
6. Vaccine Network for Disease Control, Nigeria

With support from the New Venture Fund, the PRECISE partners ensured local communities were aware of the new vaccines prior to vaccine rollout, and ready to have their children vaccinated when the vaccines became available. Niyel Change Creators, a global health campaign, advocacy, and public affairs firm based in Senegal, was engaged to document the effort in Chad. The results are compelling and a testimony to the importance of ensuring CSOs trusted by the community are an essential part of any new vaccine introduction.

Chad

In October 2024, the rollout of pneumonia, malaria, and diarrhea vaccines in Chad was accompanied by a nation-wide community campaign led by local CSO APDE. APDE conducted community meetings in every region across Chad over a period of six months, engaging local religious leaders and drawing large audiences.

Commenting on the campaign, Mahamat Dabary, Founder and CEO of APDE, said that APDE’s team of 12 dedicated employees were able to reach thousands of people during these events, making it one of the largest community mobilizations ever undertaken by the organization. “We involved administrative, traditional, and religious authorities, as well as civil society and achieved high visibility by working with local and national media, including social media and national and community radio. Dr Dabary concluded that, “protecting the health of our children under five in Chad through vaccination against PCV, rotavirus, and malaria is investing in a healthy and promising future.”

Niyel Change Creators traveled to Chad to document this extraordinary effort. Valerie Traore, Founder and Executive Director of Niyel, said, “the candid conversation with families and health care workers highlighted the importance of rolling out the vaccines with sustained community engagement. Confidence in vaccines remains low for some families and requires door-to-door visits by health workers to ensure that the new vaccines become the norm for families. The commitment we saw from the government will benefit children and their families.” The 26 minute film titled, ‘Hope in a Vial,’ will be released at the Innovation and Action for Immunization and Child Survival Forum in Mozambique in July.

Commenting on the historic launch of the three vaccines, D. Abdelmadjid Abderahim, Minister of Public Health, said that the fight against the three diseases which caused so much infant death – pneumonia, diarrhea, and malaria – “must be fought with determination.”

Somalia

In 2024, to prepare for the introduction of pneumonia and diarrhea vaccines in Somalia, SORDI conducted a baseline survey to better understand community attitudes to the new vaccines. Dr Abdi Dalmar, President and CEO, explained that SORDI supported the introduction of PCV and rotavirus vaccines in Somalia by developing effective advocacy and communication mechanisms to enhance uptake. “We conducted a baseline survey to gauge the knowledge, attitudes, and perceptions of the community toward the new vaccines. Based on these results, we undertook community awareness and education to address any misconceptions and knowledge gaps towards vaccination safety and effectiveness.” Dr Dalmar concluded that SORDI’s work enhanced the uptake of these crucial vaccines, contributing ultimately to the health and wellbeing of Somali children in the future.

At the same time Y-PEER Somalia hosted training sessions with health workers in several regions producing a report. Country Director, Abdikadir Dooy, said, “In Somalia, building public trust around new vaccines requires more than just medical facts – it needs grassroots engagement. Through our health worker training and community dialogue sessions, we empowered local leaders and caregivers with accurate, culturally relevant information. This helped us turn uncertainty into confidence, and hesitation into action. The power of civil society lies in our proximity to the people, we are the bridge between policy and practice.”

Eight months later when the vaccines were launched, communities were ready. At the official national launch in April 2025, Somalia’s Federal Minister of Health and Social Welfare, Dr Ali Haji Adam said, “the introduction of these two vaccines and the launch of the measles catch-up campaign marks a significant step forward in our national effort to reduce child deaths and build a healthier future for Somalia’s next generation.” He underscored the government’s commitment to investing in the health of children and strengthening immunization services in partnership with global and regional health partners.

South Sudan

To prepare for the introduction of pneumonia and diarrhea vaccines in South Sudan, South Sudanese Women In Medicine (SSWIM) has been at the forefront of demand creation efforts, speaking on nationwide radio shows, publishing editorials and media articles, and hosting a healthcare professionals’ symposium, among others, to maximize uptake of the vaccines.

SSWIM played a prominent role in the launch of the new vaccines in May 2025. Acknowledging the busy vaccine landscape in South Sudan with measles catch-up campaigns, the introduction of the new malaria vaccine, and a cholera outbreak, Dr Emmily Koiti, Co-founder and Executive Director of SSWIM, said, ”these overlapping public health challenges with attendant campaigns to which the launch of pneumonia and diarrhea vaccines is added, highlight the urgent need for enhanced strategic coordination, sustained public education, and capacity strengthening at all levels of care.” She added that, “crucially, the demand generated for all vaccines must be met with supplies sustained by prioritization of immunization within our national budget and planning processes beyond vaccine finance waiver periods. The health and future of our children must be a national investment, not a donor-dependent aspiration.”

Another CSO, Impact Health Organization, led by Dr Mwanje Jolem, has been advocating for the introduction of PCV and rotavirus since 2024 with calls to action, media articles, and stakeholder meetings. Commenting on the introduction of the vaccines, Dr Jolem said, “Immunization is one of the most cost-effective public health interventions. By investing in these vaccines, we can save lives, reduce healthcare costs, and build a healthier, more productive future for South Sudan.”

Anin Ngot Ngot Mou, Undersecretary in the Ministry of Health, described the rollout as a game changer for child mortality. “Today, we are taking a bold step forward in protecting the health and future of our children in South Sudan. Pneumococcal disease is the leading cause of pneumonia, meningitis, and sepsis, especially among children under five years old.”

Peer-to-peer CSO support

Activities in the three countries were further supported by the influential vaccine advocacy group, Vaccine Network for Disease Control and their dynamic CEO, Ms Chika Offor. They not only supported PCV and rotavirus vaccine introduction in South Sudan but extended their work to Guinea, which is yet to introduce both PCV and rotavirus vaccines, but is expected to do so in 2026.

Ms Offor said that by bringing CSOs from South Sudan and Guinea to Nigeria, Vaccine Network for Disease Control created a space to share firsthand experiences of how civil society advocacy contributed to Nigeria’s vaccine introduction. She said, “This peer-to-peer exchange not only inspired but also equipped the CSOs with practical insights to drive similar progress back home. It is a powerful reminder that when we learn from each other, we go further, faster, and together.”

Describing vaccination as one of the greatest inventions because it prevents deadly diseases from occurring and/or taking a life, Ms Offor said that Chad, South Sudan, and Somalia’s successful introduction of PCV and rotavirus vaccines is an incredible milestone in protecting the health of children.

To celebrate this historic effort and share learnings, the PRECISE partners will come together at the Innovation and Action for Immunization and Child Survival Forum in Mozambique in July 2025. With 60 countries off-track to achieving the child survival SDG and 45 in Africa, closing vaccination coverage gaps will accelerate the reductions in child mortality so urgently needed across the continent.

Many Gavi-supported African countries have gaps in vaccine coverage for children. Ten have coverage below 60% of PCV and/or rotavirus vaccines and some are yet to introduce either or both (e.g., Central African Republic, Comoros, and Guinea). Non-Gavi African countries including Egypt, Gabon, and Equatorial Guinea are also yet to introduce PCV and/or rotavirus vaccines. And although the rollout of the new malaria vaccines has been rapid, there are still malaria endemic countries yet to introduce.

The Forum is an opportunity for governments to make new commitments to ensure that by 2030 every African child lives in a country that offers pneumonia and diarrhea vaccines, and malaria vaccines where it is a major threat to children.

But with foreign aid budgets shrinking and many countries struggling with high debt burdens, it will be even more challenging for governments to finance coverage of the most lifesaving vaccines for children, and introduce new vaccines like the respiratory syncytial virus (RSV) vaccine, which WHO now recommends. New African-led approaches are needed. The recent 2025 report of the Lancet Countdown to 2030 for women’s, children’s, and adolescents’ health concluded that, “a major initiative focused on the health of women and children and led by regional institutions and countries with strong global support is needed.”

African CSOs can play a vital role in such an initiative. By ensuring that families take advantage of vaccines that prevent their children from getting sick, CSO engagement increases the cost-effectiveness of national vaccine programs. Governments and global health partners need to make local CSO engagement a routine part of new vaccine introduction and beyond to sustain high coverage.

We applaud the work of the PRECISE partners and encourage governments and global vaccine partners to sustain the partnership to maximize the community support needed to ensure high, sustained coverage of existing and new vaccines, because this is the key that enables vaccination to deliver on its lifesaving promise to children.