The first Ministerial Conference on Immunization in Africa was held this week in Addis Ababa, Ethiopia. The conference brought together government officials, advocates, religious leaders and partner organizations from across the continent, with ministry speakers from a dozen African countries. This conference presents an opportunity for African leaders in immunization to come together, celebrate their victories and prepare for the challenges that lie ahead.

Africa’s achievements are numerous. Nigeria, the last polio-endemic country in Africa, has not had a case of wild polio since 2014. Rwanda has made stunning progress, reducing its child mortality rate by 73 percent since 1990. The average rate for diphtheria-tetanus-pertussis (DTP3) coverage has increased more than 20 percent across Africa since the year 2000. However, at 80 percent, Africa’s routine immunization coverage is still the lowest of any region in the world.

Africa lags behind on Global Vaccine Action Plan (GVAP) goals. As of 2014, fewer than half of African countries had met the GVAP target to increase DTP3 coverage nationally above 90 percent. In fact, six African countries reported coverage less than 50 percent. The conference report, released by the World Health Organization (WHO), summarizes the current state of immunization on the African continent.

Immunization programs are also in a precarious state financially. According to a press release from the WHO and the African Union earlier this week, only 15 countries in Africa currently fund more than 50 percent of their national immunization expenditures, leaving them dependent on unpredictable donor funding. Speaking to conference attendees Wednesday via a video statement, Dr. Margaret Chan, Director-General of the WHO, stressed the importance of country ownership and encouraged governments to increase domestic investments in immunization for the sake of long-term sustainability.

Throughout the conference, one health minister after another echoed Dr. Chan’s message, speaking about the need to secure domestic financing for immunization. Government funding for immunization in Africa has increased in recent years, but there is still a long way to go. As economies grow and countries across the continent approach middle-income status, they will no longer be eligible for support from funders such as Gavi, the Vaccine Alliance. Additional funding will be essential to improve immunization rates and introduce new vaccines.