When the 70th World Health Assembly (WHA) begins today in Geneva, Switzerland, it will be one of historic measure. Not only because the WHA be electing a new Director-General of the World Health Organization (WHO), but also because of its sheer scope. This year’s annual assembly is the longest to date, and will feature the most delegates, agenda items and documents. Featured among this year’s discussions are key considerations to one of the most significant undertakings in immunization history: the Global Vaccine Action Plan. 

The Global Vaccine Action Plan, or GVAP, was endorsed by the WHA in 2012 and aims to improve health worldwide through more equitable access to immunization. The plan is built around six strategic objectives, which together would avert hundreds of millions of cases and millions of future deaths from vaccine-preventable diseases by 2020, when the “Decade of Vaccines” concludes.

Progress towards achieving these goals, however, has been slow. In 2015, the Strategic Advisory Group of Experts (SAGE) on Immunization conducted a midterm review of GVAP, and the results sounded alarm throughout the global health community. Among the assessment report’s sobering findings were the facts that global average immunization coverage increased by only one percent since 2010, and 51 countries reported either no change in coverage levels or a net decrease in that time period. The findings left SAGE “gravely concerned” that progress toward key goals was too slow, and added urgency to leveraging support for immunization globally in order to achieve the GVAP goals by 2020.

At this year’s WHA, the nearly 4,000 delegates in attendance will review a summary of the midterm assessment report and consider recommendations for how Member States can help get progress back on course.

The recommendations put forward cover the spectrum of immunization issues, and include specific action items to promote sustainable country ownership of immunization programs, improve surveillance capacity and data, and remove barriers to vaccines in humanitarian crisis situations. Each of these components connect back to GVAP’s guiding principles and inform the plan’s overarching strategic objectives.

To achieve stronger leadership and governance of national immunization systems, SAGE calls on high-level officials to make “courageous decisions" and rise as vaccine champions. They are tasked with conveying the high return on investment and the value of sustaining immunization programs to national decision makers. SAGE’s resolution also calls on governments to enact legislation that guarantees access to immunization and ensures immunization programs have sufficient budgets to run effectively.

Sabin is working to bolster these efforts through its Sustainable Immunization Financing Program, which works with low- and lower-middle income countries to establish sustainable, predictable financing of their immunization programs and country ownership. Through this program, Sabin works with national officials to develop legislative roadmaps that support the sustainability of national immunization programs. Legislation is one of the most effective mechanisms that countries can use to maintain reliable access to immunization services, demonstrate political will and keep vaccination coverage rates high, especially when countries become more prosperous and become ineligible for external financial support. Since Sabin began this work, four of its partner countries have passed immunization legislation. Most recently, Sabin convened national leaders from Armenia, Georgia and Moldova for a legislative workshop that enabled policy makers to identify common challenges and discuss best practices for strengthening national immunization systems as their countries increasingly assume ownership for their immunization programs.

The recommendations also include guidance for immunization partners “resolve barriers to timely supply of affordable vaccines in humanitarian crises.” As the world has seen most recently in outbreaks of Zika and Ebola, emerging diseases pose significant threats to health and prosperity in every corner of the world, especially when vaccine candidates lag in the development pipeline. In order to ensure the “timely supply” of vaccines when they’re needed most, the global health community must invest in preparation.

The newly formed Coalition for Epidemic Preparedness Innovations (CEPI) is one initiative working to advance the development of safe, effective and affordable vaccines for epidemic threats. Established in January 2017 with an initial investment of $460 million from private, public and philanthropic organizations, CEPI aims to stop future epidemics by developing new vaccines for emerging infectious diseases. These efforts, combined with ongoing work to ensure that existing immunization programs are sustainable and supported by reliable surveillance data, will be vital in ensuring that the benefits of immunization are extended to everyone, everywhere.

As the WHO’s decision-making body, the WHA’s actions this week will be felt in communities around the world as they work towards achieving the GVAP’s goals by 2020. While it is widely anticipated that the WHA will endorse the recommendations, the success of their implementation will require committed action from both national decision makers as well as continued support from the global health community to ensure they have the tools they need to improve immunization equity for all.