The initiative, known as the Big Catch-Up and led by the World Health Organization, UNICEF and Gavi, the Vaccine Alliance, concluded in March after a three-year effort to restore immunization coverage disrupted by the pandemic.

By the end of December 2025, the campaign had reached an estimated 18.3 million children aged under five across 36 countries in Africa and Asia, delivering more than 100 million vaccine doses, according to a joint statement. Of those, around 12.3 million children had never received any prior vaccination, while 15 million had not previously been immunized against measles.

Health systems worldwide faced severe disruption during the COVID-19 crisis, leading to missed routine immunizations and a resurgence of preventable diseases including measles and polio. The agencies said the campaign also strengthened national immunization systems by improving their ability to identify children who had previously been missed.

Tedros Adhanom Ghebreyesus said the initiative had helped reverse one of the pandemic’s major health setbacks by reaching children who had been excluded due to service disruptions.However, officials warned that significant obstacles persist.

The agencies highlighted declining foreign aid and widening gaps in routine immunization, noting that measles outbreaks have increased globally, with approximately 11 million cases reported in 2024.Kate O’Brien said growing politicization of vaccines and health issues posed a serious concern, even as trust in frontline health workers remained relatively strong.

Sania Nishtar pointed to the role of social media in amplifying misinformation, saying digital platforms often incentivize the spread of misleading or false content about vaccines.

Ephrem Lemango added that algorithm-driven amplification of anti-vaccine narratives, combined with reductions in global health funding, could undermine progress and risk reversing gains made through the campaign.

The UNICEF Executive Board concluded its first regular session of 2026 with a warning that decades of progress in child survival could be reversed as funding constraints, conflict and systemic pressures weaken global health systems, according to statements delivered during the meeting.

The two-and-a-half day session reviewed a range of institutional priorities, including implementation of the United Nations’ UN80 reform initiative, UNICEF’s global evaluation plan for 2026–2029, and updates on the work of national committees engaged in fundraising and youth outreach. Financial oversight, programme delivery and governance issues were also examined as part of the Board’s agenda.

A central focus of the session was child health, highlighted during discussions on eight newly approved country programme documents covering Argentina, Cuba, Georgia, Malaysia, Mexico, Somalia, South Africa and Sudan. Board members and senior officials framed investment in primary healthcare as critical not only to survival outcomes but to broader human development and social stability.

Opening the session, Rein Tammsaar, President of the Board and Estonia’s Permanent Representative to the United Nations, emphasized inclusive governance as a priority for 2026. He also pointed to the potential role of artificial intelligence in expanding access to and improving the quality of education.

Tammsaar acknowledged UNICEF personnel working in high-risk environments, stating that their operational commitment underpins the organization’s credibility.In her introductory remarks, Catherine Russell cautioned that progress in reducing child mortality could stall for the first time in three decades.

She identified child and maternal health as core priorities and cited the establishment of a global Centre of Excellence in Nairobi aimed at strengthening technical capacity in health, nutrition and water, sanitation and hygiene services.Senior officials presented evidence of significant global gains, including a reduction in annual under-five deaths to below 5 million and an estimated 4.2 million child deaths prevented annually through immunization.

Maternal mortality has declined by roughly one third since 2000. However, speakers stressed that these achievements remain fragile.Douglas Noble, Associate Director of Health, said abrupt reductions in development funding are disrupting essential services and exposing structural weaknesses in health systems. He added that misinformation is undermining vaccine confidence, while conflict, climate-related shocks and economic instability are increasing displacement and limiting access to care.

Noble stated that survival alone is no longer an adequate benchmark for child development, arguing for integrated approaches that include mental health, psychosocial support and adolescent well-being alongside physical health services. He urged governments to prioritize primary healthcare in national budgets, protect health spending during fiscal pressures and invest in community-level health workers.

Panel discussions reflected concerns that setbacks are not confined to low-income countries. Participants noted declining vaccination rates in Argentina and signs of reversal in child survival indicators in South Africa. Rising mental health challenges among adolescents, including increased suicidal behaviour in Malaysia, were also highlighted.

Speakers from governments, international organizations, academia and civil society reiterated that access to healthcare should not be treated as a privilege. They stressed the need for age-appropriate services that address both communicable and noncommunicable conditions, supported by integrated systems spanning health, education and social protection.

Testimony from field representatives underscored the impact of conflict on health infrastructure. Ayoub Ibrahim Arabi Mohammed described conditions in Sudan, where ongoing violence has displaced populations and disrupted medical services. He reported shortages of fuel, medicine and basic supplies in hospitals, while some clinics have ceased operations entirely, leaving families without access to care.

He emphasized the role of frontline health workers as critical to sustaining services in conflict settings and called for their protection. He also warned that children are dying due to the inability of healthcare systems to function effectively under prolonged instability.Across discussions, a consistent theme emerged that sustaining progress in child survival requires resilient primary healthcare systems capable of withstanding external shocks.

UNICEF outlined key policy areas for governments, including strengthening primary care, restoring trust in immunization programmes, addressing underlying determinants such as malnutrition and sanitation, and integrating mental health and noncommunicable disease responses into health strategies.

Mental health featured prominently in the session, with officials noting that one in seven adolescents aged 10 to 19 is living with a mental health condition. Data presented indicated that one in four children has a caregiver experiencing mental health challenges, highlighting broader social implications.

Officials also cited global estimates suggesting that a young person dies by suicide every 11 minutes, underscoring the scale of the issue.Meylan Alejandra Ramos Espejel, speaking on behalf of young people, linked mental health challenges to wider global pressures including migration, conflict and climate-related disruptions.

She called for greater inclusion of youth perspectives in policymaking and emphasized the need for tangible support mechanisms.Noncommunicable diseases were identified as another growing concern, affecting more than 2 billion individuals under the age of 20 through direct conditions or exposure to risk factors.

Officials noted that these diseases disproportionately affect children in lower-income settings, challenging the perception that they are confined to wealthier populations.The Board also reviewed progress on international policy commitments.

A political declaration adopted by heads of state in September 2025 on noncommunicable diseases and mental health was cited as a milestone, with references to children and youth included multiple times, reflecting increased global attention to these issues.Despite broad agreement on key priorities, the Board did not reach consensus on all agenda items, with some decisions requiring formal votes.

By the end of the session, seven decisions were adopted, covering areas including governance, financial oversight, evaluation frameworks and fundraising strategies.The Board approved eight country programmes and extended a subregional programme for the Gulf Area.

These programmes are intended to guide interventions across sectors including health, education, nutrition and child protection, reflecting an integrated approach to humanitarian and development challenges.In closing remarks, Russell said the approved programmes provide operational frameworks for delivering measurable outcomes, while acknowledging the absence of consensus on certain items.

Tammsaar expressed concern over divisions within the Board, stating that consensus-based decisions strengthen institutional unity and effectiveness.The next annual session of the Executive Board is scheduled to take place from June 16 to 19, 2026.

The campaign, led by the health ministry with support from UNICEF, the World Health Organization and Gavi, the Vaccine Alliance, has been rolled out across 18 high-risk districts, according to a joint statement.

Government data shows 17 confirmed deaths linked to measles so far, alongside 113 suspected fatalities and more than 7,500 suspected infections across the country. The outbreak has now spread to 56 of Bangladesh’s 64 districts, raising concerns over further transmission.

Authorities said the vaccination drive is prioritising children aged between six months and five years, particularly those who missed routine immunisation and are at higher risk of severe complications. Health officials described the campaign as a critical intervention to address immunity gaps exposed by the surge in infections.

UNICEF representative Rana Flowers said the agency was alarmed by the sharp rise in cases, warning that thousands of children, especially the youngest and most vulnerable, face heightened risk.

She said the resurgence underscored significant gaps in population immunity.Hospitals in several high-burden areas are operating beyond capacity, with limited resources to manage the influx of patients, officials said, adding to concerns about the outbreak’s trajectory.

The World Health Organization said the outbreak is likely to continue spreading in the coming days but could be brought under control following the large-scale vaccination effort. WHO representative Dr Ahmed Jamsheed Mohamed said the campaign would be key to preventing further child deaths.

Officials said the emergency drive is intended to complement existing routine immunisation programmes as authorities work to contain the outbreak and stabilise public health conditions.

Zuwaira Hanafi stood outside a healthcare facility in Kaita, in Nigeria’s northern Katsina state, as medical staff hurried into a ward where her eight-month-old daughter lay semiconscious, underscoring the urgency confronting health workers in a region grappling with rising levels of severe malnutrition.

At the entrance, clinicians used colour-coded measuring tapes to assess the mid-upper arm circumference of children, a standard method for diagnosing malnutrition.

A steady flow of mothers, including teenagers, arrived with infants in critical condition, reflecting what humanitarian agencies describe as a deepening hunger crisis affecting large parts of the country.The International Federation of Red Cross and Red Crescent Societies has warned that as many as 33 million Nigerians could face severe hunger in 2026, a record level.

Data from the United Nations Office for the Coordination of Humanitarian Affairs indicates that approximately 6.4 million children in Nigeria are expected to be acutely malnourished by the end of the year, with the burden concentrated in northern regions such as Katsina.

Dr Soma Bahonan, head of the Nigeria mission for the Alliance for International Medical Action (Alima), which operates the Kaita facility in partnership with local authorities, said the crisis is expanding beyond children. Increasing numbers of mothers are also presenting with acute malnutrition, compounding the risks to infant health and survival.

Alima has expanded its operations to include mobile clinics designed to reach remote populations unable to travel to fixed facilities. These services include transport support for critical cases from surrounding communities.

However, Bahonan described the scale of need as exceeding operational capacity, particularly in Katsina, which has become a focal point of what aid workers describe as an intergenerational hunger crisis.Longstanding drivers of food insecurity, including climate variability and structural governance challenges, have been intensified by rising insecurity.

Attacks by jihadist groups and other non-state actors have disrupted farming activities and restricted access to agricultural land, further weakening household food production and income stability.The strain on the healthcare system is evident in workforce shortages. Nigeria’s doctor-to-patient ratio is estimated at roughly 1:9,000, significantly below the World Health Organization’s recommended ratio of 1:600.

Medical professionals continue to leave the country, citing delayed salary payments and limited career prospects, further reducing service capacity in already underserved areas.While digital health startups and private-sector partnerships have made progress in urban centres such as Lagos and Abuja, their reach remains limited in rural and conflict-affected regions due to infrastructure deficits and high inflation.

This uneven distribution of innovation has widened disparities in healthcare access.Analysts describe Nigeria’s current situation as a convergence of multiple crises. Joachim MacEbong, a senior analyst at Control Risks in Lagos, said the country faces overlapping economic, security, and human development challenges that reinforce one another.

He noted that these interconnected pressures are contributing to deteriorating health outcomes and weakening institutional response capacity.Humanitarian organisations have begun planning for the annual lean season, typically spanning June to September, when food stocks decline and malnutrition rates tend to rise.

The period is expected to place additional stress on already constrained health and nutrition services.Policy interventions have been introduced, though their impact remains uncertain.

In 2025, the Nigerian government partnered with the World Bank to implement the Accelerating Nutrition Results in Nigeria project, aimed at delivering basic nutrition services to vulnerable households.

A second phase of the programme is currently under way, but experts say broader structural reforms are required to improve food affordability and strengthen social protection systems.Supply chain inefficiencies continue to limit access to essential medicines and equipment.

Peter Bunor Jr, co-founder and head of growth at Field Intelligence, a health technology company focused on pharmaceutical logistics in Africa, said disruptions in global and domestic supply chains are contributing to shortages at the point of care.

Patients often travel long distances only to find that prescribed drugs are unavailable or replaced with alternatives, frequently at higher cost.Bunor said the impact of these shortages is amplified during a hunger crisis, as malnourished individuals are more susceptible to infections and require timely medical intervention.

He emphasised the need for better data integration and forecasting to prevent stockouts.In 2018, Field Intelligence launched the Nigeria Health Logistics Management Information System, a platform designed to track pharmaceutical supply data across public health programmes.

The system, now managed by the federal health ministry, has been expanded with support from UNICEF, and stakeholders are encouraging wider adoption among health agencies to improve coordination and anticipate shortages.Funding constraints remain a central concern.

Nigeria allocated approximately 5.2% of its 47.9 trillion naira national budget to the health sector, well below the 15% target set under the Abuja Declaration by African Union member states. Per capita health spending remains among the lowest on the continent.

In February, Health Minister Muhammad Ali Pate disclosed that of the 218 billion naira allocated for operations and capital projects under the ministry, only 36 million naira had been released. The figure, representing a small fraction of the approved budget, has raised concerns about implementation capacity and fiscal prioritisation.

MacEbong said the funding gap illustrates broader structural challenges in public finance management, noting that limited budget execution undermines service delivery even where allocations exist. He added that the scale of the crisis requires sustained government attention, particularly in sectors directly linked to human capital development.

Aid organisations continue to call for increased domestic investment in health and nutrition, alongside improved coordination with international partners.

As conditions in northern Nigeria worsen, frontline health workers face mounting pressure to manage a growing caseload with limited resources, highlighting systemic vulnerabilities in one of Africa’s largest economies.