In parts of the Eastern Mediterranean Region, whether a child receives a vaccine no longer depends solely on scientific progress, but also on whether it is safe to leave the house.
Conflicts are now casting a shadow over the daily lives of millions of families across the region. In Sudan, years of devastating war have left large numbers of children without protection from disease, amid the world’s largest displacement crisis. In Lebanon, bombardment and evacuation orders have uprooted a fifth of the population from their homes, schools, and clinics within weeks.
In Gaza, little remains of the health infrastructure but rubble, with systems on the brink of total collapse amid destruction and economic breakdown. Along the Afghanistan–Pakistan border, renewed violence is triggering new waves of displacement, compounded by natural disasters. In Yemen and Somalia, protracted crises continue to weaken already fragile health systems.
Vaccination requires stable primary health care, reliable cold chains, safe passage for health workers, and families able to access services. Conflict sweeps all of this away.
Even before the latest escalation, coverage was already declining. First-dose coverage of diphtheria, tetanus, and pertussis (DTP) vaccines fell from 89 percent in 2019 to 85 percent in 2024. Coverage of measles-containing vaccines dropped to 80 percent, far below the 95 percent needed to prevent outbreaks. An estimated 2.8 million children in the region received no vaccines at all in 2024. More than 12 million children have received no routine immunization since 2020.
These gaps are concentrated in conflict zones, among displaced families, in remote areas, and in underserved urban communities. When children repeatedly miss vaccinations, immunity gaps widen and outbreaks follow. In 2024 alone, nearly 4 million people did not receive their first dose of a measles vaccine. The poliovirus continues to lurk in under-immunized pockets, not due to a lack of tools, but because those tools have not consistently reached every child.
The predictable and preventable result is the resurgence of outbreaks, placing additional strain on already overstretched health systems and costing young lives.
Humanitarian access must be safe, sustained, and guaranteed. Medical supplies must flow without obstruction, and health workers must be able to reach communities freely. Services must be delivered to displaced families wherever they are. Immunization cannot depend on sporadic or fragmented opportunities; it requires continuity, even amid chaos.
Waiting for stability is not a realistic option. In many parts of the region, stability may remain out of reach for the foreseeable future, and children cannot wait. Immunization services must be protected during crises, not postponed. Delays create deeper and more costly immunity gaps and open the door to the return of preventable diseases.
Even under these harsh conditions, there remains a glimmer of hope, thanks to the courage of frontline health workers. They risk their lives to carry out catch-up campaigns that have reached millions of children, helping to repair the dangerous immunity gaps left by crises. These efforts must continue and be expanded.
At the midpoint of the Immunization Agenda 2030, countries have committed to halving the number of zero-dose children by 2030. Achieving this goal in the region will only be possible if immunization is treated as an essential service that does not stop during crises, supported by strong political will, secure financing, effective delivery systems, and community trust.
We are closer than ever to interrupting the transmission of polio. However, the virus will continue to find its way to children as long as they remain out of reach.
Strong immunization programs do more than prevent individual infections. They strengthen the resilience of health systems, protect populations from future shocks, and safeguard our collective health.
Vaccines have proven effective and saved millions of lives, but they can only fulfill their promise when they reach every child.
*Regional Director, WHO Eastern Mediterranean Region
