Vaccines are a public health success story. Routine childhood immunizations protect children from vaccine-preventable diseases, saving 2 to 3 million lives every year.

But climate change, conflict and COVID-19 are disrupting health systems worldwide, threatening to roll back decades of progess. In 2020, 23 million children missed out on basic vaccines through routine immunization services — an increase of 3.7 million from 2019. Most of those children — up to 17 million — did not receive a single vaccination, leaving them vulnerable to devastating but preventable diseases like measles, polio and meningitis.

UNICEF and partners like Gavi, the Vaccine Alliance are working hard to strengthen health systems to better reach the world’s children with lifesaving vaccines. Below, a look at some of the many places where UNICEF is making an impact.

Pakistan

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Once a terrifying diagnosis, polio is no longer a threat in most of the world. Since 1988, when UNICEF joined Rotary International and other partners to launch the Global Polio Eradication Initiative (GPEI), polio cases have decreased 99.9 percent. Today, the wild poliovirus is found in only two countries— Afghanistan and Pakistan — but polio workers won’t stop until every child is safe.

UNICEF works at the community level to share information about the safety and efficacy of vaccines, and to encourage families to vaccinate their children. Above, Izzat Begum, a polio worker, visits a family in Karachi. The parents were hesistant about vaccinating their two daughters, both under the age of 5. Begum listened to their concerns, assuaged their fears and convinced them to vaccinate their children. Polio primarily affects children under 5, though anyone who is unvaccinated is at risk. 

Afghanistan

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In Afghanistan, where only 50 to 60 percent of children are fully immunized, measles cases are on the rise. Between Jan. 1, 2021 and Feb. 6, 2022, 43,988 cases of measles —80 percent of them among children under 5 — and 232 measles-related deaths were reported across the country.

The disease is highly contagious; up to 90 percent of unvaccinated individuals who come into contact with a measles patient can become infected. Above, Paloma Escudero, Director of the UNICEF Division of Global Communication and Advocacy, talks to a young girl waiting with her little brother outside the immunization unit at Paktya Regional Hospital in Gardez, Afghanistan on April 16, 2022. UNICEF supports immunization, nutrition and newborn care units at the hospital. 

India

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Three-month-old Chumki sleeps in her mother’s arms after receiving her scheduled vaccinations in the state of Odisha in eastern India. Chumki and her family belong to a forest-dwelling tribe, the Dongria Kondh, who live in the Nyamgiri Hills. Electrical power is intermittent in the hard-to reach area, so UNICEF procured a solar direct-drive refrigerator for the village health center in Khambesi to keep vaccines at the optimal temperature. 

Guatemala

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In San Juan Melendrez, San Marcos, Guatemala, nurse Maria Elena Velásquez rolls down Ronald’s shirt sleeve after his COVID-19 vaccination at his grandparents’ home. With support from the Government of Japan, UNICEF delivered cold chain equipment including vaccine carrier boxes and a solar-powered refrigerator to the nearby Catalina health center, so vaccines could be stored and transported at the proper temperature. The equipment will be used to store not COVID-19 vaccines, but also routine vaccines for childhood immunizations, strengthening Guatemala’s health system.

“The last two years have taught us that a health care system that leaves some children exposed, is a health care system that leaves all children exposed,” said UNICEF Executive Director Catherine Russell. “The best way for the world to recover from this pandemic — and to prepare for future health emergencies — is to invest in stronger health systems, and immunization and health services for every child.” 

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Top photo: Mary Yandiru hugs her baby, Edgar, outside Dramba Health Center III in Uganda’s Yumbe district. Edgar receives his routine immunizations at the  health center, which is equipped with a solar-powered water pump system procured by UNICEF with support from the Government of Iceland. © UNICEF/UN0616904/Mugisha