‘Imagine, build African-led prevention’

The next phase of immunisation in Africa will require societies to think beyond vaccine delivery alone. This is the rallying call from Professor Charles Wiysonge, who delivered the Africa Day keynote address at the Faculty of Health Sciences (FHS) on 26 May. 

“For more than 50 years, immunisation has changed the trajectory of health and development across Africa. The next phase will require us to think toward resilient systems, trusted institutions, African leadership, and a broader vision of prevention,” he said at the event, hosted by the Pan African Health Sciences Forum at the University of Cape Town’s (UCT) FHS. 

Professor Wiysonge, a globally recognised public health physician and Africa Centres for Disease Control and Prevention (Africa CDC) immunisation leader, titled his talk “From Survival to Sovereignty: 50 Years of Immunisation in Africa and the Future of Prevention”. It began with an anecdote involving his mother. “She often talks about how measles used to invade villages in our kingdom every few years, exacting a terrible toll on families and communities. She also tells the story of late 1969 when she carried me on her back on a 50 km return journey to a hospital in the city so that I could receive a measles vaccination. That single shot protected me. I have never had measles,” he affirmed. “And when I reflect on immunisation today, I remember that behind every vaccination statistic, there is a human story.” 

Wiysonge reminded the audience that there was a world before vaccination when childhood survival was uncertain; when smallpox scarred and killed millions; when polio paralysed millions of children for life; and families lived in constant fear that a fever, cough or rash could become fatal. 

“Vaccination transformed this reality. For Africa, vaccination is not simply a biomedical intervention – it has become a foundation for child survival, social progress and national development. It has changed more than health outcomes. It helps children survive long enough to attend school, reduces disability and catastrophic illness, allows families and societies to become more productive, and contributes to economic growth and poverty reduction,” he said.  

Put differently, it is an investment in human capacity, national resilience, and development. However, as Wiysonge advanced, unfinished business remains. 

“Communities are not passive recipients of public health interventions.” 

“After decades of steady gains, vaccination coverage plateaued. Then came COVID-19 – a pandemic which disrupted routine services, weakened supply chains, diverted healthcare workers, and fuelled misinformation and mistrust. The challenge today is not primarily scientific. We know vaccines work; the challenge is whether our systems can deliver them equitably and consistently.”  

COVID-19, in particular, exposed deep structural inequities as Africa experiences major delays in vaccine access, exposed the shortcomings in depending on external manufacturers and stood as a stark reminder that health security cannot depend on external goodwill. 

“It showed us that trust matters as much as technology. As misinformation spread rapidly, communities questioned institutions and many health systems struggled to maintain continuity of essential services. One thing is clear, COVID-19 did not create inequity – it exposed that it had existed for decades.”  

“Today, Africa must think beyond survival alone. We must think about sovereignty, which does not mean isolation from the world. It means having capacity, capability and institutional strength to protect African populations through African leadership, African science, African manufacturing, African data systems, and resilient African public health institutions,” said Wiysonge.  

Investment is needed in Africa-based manufacturing, research and innovation, strong primary healthcare systems, sustainable domestic financing and high-quality surveillance and data systems, among others. “Most importantly, it means recognising that communities are not passive recipients of public health interventions – communities are partners. They are not simply delivery channels; they are co-producers of health. Public health succeeds when communities see themselves not as subjects of intervention, but as owners of solutions.” 

Led by Africans 

Wiysonge said the future of immunisation is exciting. “We are entering an era of life-course vaccination, digital health systems, precision public health and new vaccines against diseases. If we succeed, by 2030, we should see dramatically fewer zero-dose children, stronger and more resilient primary healthcare systems, trusted immunisation programmes and stronger manufacturing and innovation capacity. These targets are achievable, but only through deliberate political commitment, sustained investment, partnership, accountability, and if we act with urgency and equity at the centre.” 

He added: “The future of prevention in Africa must not be imported. It must increasingly be imagined, built, trusted and led by Africans.” 

The keynote was followed by a panel discussion where healthcare practitioners spoke about being proactive in the prevention space, the need for collective life skills and a vibrant conversation on what the current health sciences curriculum teaches … or does not.