(Ecofin Agency) – On the sidelines of a field visit to Benin at the end of 2024, Dr Colette Selman, director of strategies for main countries at GAVI, the Global Alliance for Vaccines and Immunization, shared with Ecofin Agency its perception of the challenges and successes of the deployment of vaccines in Africa. She presented a table of her team’s actions on the continent, particularly in Benin and Togo.
From the fight against vaccine hesitancy to the introduction of vaccines against malaria and human papillomavirus (HPV), including the initiative « Big Catch-Up » to make up for the vaccination delay caused by Covid-19, there are numerous projects.
Ecofin Agency: Can you tell us more about GAVI’s “Big Catch-Up” initiative? What are its objectives and what progress has been made so far?
Dr Colette Selman : The Big Catch-Up is the Alliance’s global response to the disruption caused by Covid-19. This involves identifying and vaccinating children who have missed vaccines during the pandemic, particularly those aged 1 to 5 years. In Benin for example, the government recently launched the 1re phase of this initiative with a preventive campaign focused on measles and rubella as the entry point.
Dr Colette Selman.
We have also allocated USD 17 million in funding to strengthen health systems and equity in priority districts in Benin, implementing strategies tailored to specific needs, whether addressing health issues access in remote areas or combat vaccine hesitancy in urban centers.
On a broader scale, GAVI has vaccinated 1 billion children over the past 20 years. We aim to replicate this success over the next decade.
AE: Vaccine hesitancy is a persistent problem, particularly after Covid-19 fueled disinformation and fake news. How is your organization facing this challenge?
CS : You are absolutely right. The spread of misinformation during the pandemic has had a significant impact on vaccine confidence. And our approach is multifaceted.
At the community level, we collaborate with trusted local leaders — religious figures, health workers, peers — to deconstruct myths and provide accurate information. At the national level, we work with civil society and parliamentarians to ensure clear messages reach a wide audience.
Globally, we work with organizations like WHO and UNICEF to combat misinformation on broader platforms. This requires ongoing effort, because rebuilding trust is not a one-time process.
AE: What milestones has GAVI set in Africa, and what are the long-term goals for the region?
CS : Since its creation, GAVI has contributed to the introduction of 9 vaccines in 40 African countries, reaching 400 million unique children and preventing nearly 9 million deaths on the continent. Of the 9 billion USD invested globally, 5.9 billion were allocated to African countries.
One of our key indicators is the DTP3 immunization rate (Diphtheria-Tetanus-Pertussis in 3 doses, Editor’s note), which guarantees that children complete the vaccination schedule. For example, in 2020 we reached over 25 million children with 3e dose of pentavalent vaccine.
The promises of the malaria vaccine…
AE: In terms of diseases, malaria remains a major cause of mortality among children under 5 years old in Africa. How is GAVI supporting the vaccine rollout against this condition?
CS : The malaria vaccine is a revolutionary tool, and we are proud to support its deployment. In recent years, 15 countries have introduced this vaccine, and more will follow.
Our role includes organizing the market to ensure vaccine availability, supporting the supply chain and cold chain, as well as training health workers and raising community awareness on the specifics of the vaccine.
This vaccine is part of a broader strategy to combat malaria, including the use of treated mosquito nets and other tools. For 2025, we hope to gather more information to continue to optimize the program’s impact and strengthen deployment efforts.
Local partnerships are at the heart of our work. 10% of our funding in each country is allocated to civil society organizations.
AE: How does GAVI collaborate with local communities and civil society organizations?
CS : Local partnerships are at the heart of our work. Community leaders and civil society organizations play a central role in raising awareness among families, supporting health care delivery and reducing gaps between health services and communities.
For example, 10% of our funding in each country is allocated to civil society organizations to support their essential efforts. This collaboration ensures messages are tailored and culturally relevant, building trust and increasing vaccine adherence.
AE: What are GAVI’s priorities for strengthening health systems in Africa?
CS : Our priorities remain focused on programmatic and financial sustainability, as well as resilience. By strengthening supply chains, training health workers and addressing vaccine hesitancy, we aim to integrate immunization programs with primary health care systems to contribute to universal health coverage.
Our visit was part of a joint mission with WHO, UNICEF and other stakeholders. We also prioritize partnerships with organizations like the African Union and the Africa CDC.
We are also prioritizing partnerships with organizations like the African Union and the Africa Center for Disease Control and Prevention (Africa CDC), to strengthen regional vaccine manufacturing capacity and achieve greater vaccine sovereignty.
On Benin and Togo
AE: Doctor Selman, Benin, which you recently visited, faces significant challenges in terms of vaccination coverage. In your opinion, what are the most effective levers to improve the situation, particularly in underserved and rural areas?
CS : Benin’s challenges reflect what we see in many African countries. Our visit was part of a joint mission with WHO, UNICEF and other stakeholders, to discuss key strategies with government, partners and civil society. To improve vaccination coverage, we have invested in vaccines, supply chains, cold chain management, health worker training and community engagement. We also recently launched the Big Catch-Up initiative to reach children up to 5 years old.
More recently, the Beninese government has begun to roll out a community health policy, assigning a key role and funding to local health workers. These identify children and families excluded from health services, and improve community health through an integrated approach, optimally connecting communities to services.
By involving religious leaders, local associations and trusted community figures, we aim to build trust and increase vaccination adherence. As I said, our job is not just to deliver vaccines, but to ensure they reach every child, especially in remote areas.
AE: Togo recently introduced the HPV vaccine. What are the objectives and how does this fit into GAVI’s wider public health strategy?
CS : Vaccination against human papillomavirus is essential to prevent cervical cancer, which is the 2e most common cancer among women in Togo. The HPV vaccine is safe, highly effective, and can prevent up to 90% of cases of cervical cancer.
In December 2023, with the support of GAVI, Togo launched its program with a dual approach: school vaccination campaigns for 9-year-old girls, and outreach programs for out-of-school girls, in collaboration with numerous stakeholders. and sectors. A catch-up campaign was also carried out to vaccinate girls aged 9 to 14.
We are working with the government to sustain these approaches and reach all girls, including by integrating this initiative into a broader cervical cancer elimination strategy, which focuses on prevention, diagnosis and treatment. treatment. Our goal is to ensure that all girls in Togo have access to this life-saving vaccine, enabling them to lead healthy and productive lives.
Interview conducted by Ayi Renaud Dossavi
Edited by Feriol Bewa
