WHO Calls for Stronger Vaccination Coverage and Domestic Health Funding
ABUJA, Nigeria — The World Health Organisation (WHO) has warned that persistent gaps in routine immunisation are leaving Nigerian children vulnerable to preventable diseases, urging the Federal Government to increase domestic health financing, strengthen disease surveillance and improve preparedness for outbreaks.
The warning was raised by the WHO Representative in Nigeria, Pavel Ursu, on Tuesday, October 13, during the organisation’s Health Diplomacy Dialogue in Abuja. The meeting brought together diplomats and health officials to discuss public health security, disease outbreaks, healthcare financing and antimicrobial resistance.
According to a report by Premium Times published on October 13, Ursu said Nigeria continued to face difficulties controlling vaccine-preventable diseases, including measles and circulating vaccine-derived poliovirus, despite support from international partners.
The warning highlights a continuing challenge for Nigeria’s health system: ensuring that children in rural communities, underserved urban neighbourhoods and areas affected by insecurity can access vaccines and complete their recommended immunisation schedules.
Routine immunisation protects children against diseases that can cause severe illness, disability or death. However, protection depends on children receiving the appropriate vaccines at the recommended ages and on health services reaching communities that have historically been underserved.
The WHO has called for greater national investment to sustain progress, particularly as international health assistance and global development financing arrangements continue to change.
The concerns also reinforce the importance of strengthening primary healthcare facilities, improving the availability of vaccines and ensuring that parents and caregivers can obtain reliable information about immunisation.
Millions of Children Remain Unvaccinated
Nigeria continues to carry one of the world's largest burdens of children who have never received a routine vaccine.
UNICEF reported in April 2026 that an estimated 2.2 million Nigerian children had not received any routine vaccination. These children are commonly described as zero-dose children.
The figure illustrates the scale of the challenge facing health authorities and their partners. It also demonstrates why national vaccination campaigns must be supported by reliable, accessible routine services that reach children throughout the year.
A child may miss vaccination because the nearest health facility is too far away, a caregiver cannot afford transportation, a health worker is unavailable or a family does not know when vaccination services are provided. In other cases, misinformation, insecurity, population displacement or interruptions in healthcare delivery can prevent children from receiving the protection they need.
UNICEF has highlighted these barriers through its work with Nigerian authorities and international partners to identify and reach children who have missed vaccines.
In April, the agency announced a partnership with the Republic of Korea and the Nigerian government aimed at improving access to immunisation in six states: Lagos, Ogun, Kebbi, Bauchi, the Federal Capital Territory and Adamawa.
The programme is designed to strengthen routine vaccination services and reach children who have never been vaccinated, including those in underserved urban communities and remote areas.
The partnership illustrates how targeted interventions can complement broader national vaccination programmes. However, sustained progress requires health authorities to identify missed children, maintain reliable vaccine supplies, provide trained personnel and ensure that families can return for subsequent doses.
For Nigeria, the challenge is not simply to organise vaccination campaigns but to establish dependable services that protect children throughout infancy and early childhood.
Measles and Poliovirus Remain Public Health Concerns
The WHO's warning comes as Nigeria continues to contend with diseases that can spread when population immunity is insufficient.
Measles is a highly contagious viral disease that can cause serious complications, particularly among young children and people whose immune systems are weakened. Possible complications include pneumonia, severe dehydration and inflammation of the brain.
Vaccination remains one of the most effective ways to prevent measles outbreaks. When many children miss their recommended doses, susceptible groups can accumulate within communities, allowing transmission to continue.
Polio also remains a public health concern in Nigeria, despite the country's certification as free of indigenous wild poliovirus in 2020.
Circulating vaccine-derived poliovirus is distinct from wild poliovirus. It can emerge when a weakened virus used in oral polio vaccines circulates for an extended period in populations with insufficient immunity and undergoes genetic changes. In rare circumstances, the resulting virus can cause paralysis and spread among under-immunised communities.
The presence of circulating vaccine-derived poliovirus does not mean that routine vaccination should be avoided. Rather, high and equitable vaccination coverage is essential to stopping transmission and protecting children.
The WHO has repeatedly emphasised that missed vaccinations, limited access to healthcare and difficulties reaching children in insecure areas can complicate efforts to control outbreaks.
Health authorities therefore need to maintain routine immunisation while conducting targeted supplementary campaigns where surveillance identifies particular risks.
Strong disease surveillance is equally important because it allows health officials to identify suspected infections, investigate transmission and direct resources to communities where they are most urgently required.
Insecurity and Poor Sanitation Complicate Disease Prevention
Speaking during the Abuja dialogue, WHO emergencies adviser Alex Chimbaru identified weaknesses in immunisation coverage, disease surveillance and access to safe water and sanitation as factors contributing to Nigeria's continuing public health challenges.
These problems often overlap, placing additional pressure on communities already facing economic hardship or insecurity.
In conflict-affected areas, displacement can separate families from their usual healthcare facilities. Roads may become inaccessible, health workers may be unable to travel safely and vaccination records can be lost when households move repeatedly.
Mobile populations can also be difficult to track through conventional health records, particularly when families cross local government or state boundaries.
Such circumstances make it harder to determine which children have received their scheduled vaccines and which require additional doses.
Public health teams must therefore work with community leaders, local health workers and humanitarian organisations to identify vulnerable households and arrange appropriate services.
Water and sanitation problems create another set of risks. Diseases such as cholera can spread through contaminated water and food, especially where access to clean water, adequate toilets and hygiene facilities is limited.
Cholera prevention requires more than treatment at health facilities. It also depends on safe water supplies, sanitation infrastructure, community awareness, surveillance and timely outbreak response.
Where insecurity and displacement disrupt these services, outbreaks can become more difficult to contain.
The WHO's concerns underline the need for a coordinated approach that combines immunisation, disease monitoring, sanitation improvements and stronger local healthcare services.
Health Financing Becomes Increasingly Important
A central issue raised during the dialogue was the need for Nigeria to assume greater responsibility for financing essential healthcare.
International partners, including Gavi, the Vaccine Alliance, have supported vaccine procurement and immunisation programmes in Nigeria. Such assistance has helped countries expand access to vaccines and strengthen delivery systems.
However, continued progress requires predictable funding for the wider services that make vaccination possible.
These include cold-chain equipment for maintaining vaccine quality, transportation to remote communities, training for health workers, public information campaigns, disease surveillance and the operation of primary healthcare centres.
If funding is insufficient or unpredictable, even vaccines that have been procured may not reach every eligible child on time.
Ursu called for Nigeria to progressively increase domestic health financing and take greater responsibility for protecting its population.
The appeal comes amid changes in international health cooperation and concerns about declining development assistance for health. Countries that depend heavily on external support may need to adjust their budgets and programme arrangements as funding priorities evolve.
For Nigeria, stronger domestic financing could provide a more stable foundation for essential health services. However, additional funding must be accompanied by effective planning, transparent spending and accountability for results.
Government agencies also need to determine which communities remain underserved, identify gaps in staffing and infrastructure, and allocate resources according to public health needs.
The objective should be to ensure that children do not miss vaccines because services are unavailable, while maintaining the capacity to respond quickly when disease outbreaks occur.
Why Routine Immunisation Matters
Routine immunisation is designed to protect children at different stages of early life, beginning with vaccines provided around birth and continuing through subsequent scheduled visits.
Completing the recommended schedule is important because different vaccines protect against different diseases, and some require multiple doses to provide adequate protection.
A child who receives an initial dose but misses later appointments may not have the full protection intended by the vaccination programme.
Health workers therefore need to explain vaccination schedules clearly and help caregivers understand when to return.
Routine services also offer opportunities to identify children who have missed appointments, provide guidance on nutrition and child development, and connect families with other essential healthcare services.
When these services operate reliably, they can strengthen trust between communities and the health system.
Conversely, repeated cancellations, long waiting times, shortages of vaccines or inadequate communication can discourage families from returning.
Improving routine immunisation consequently requires attention to both the availability of vaccines and the experience of families using health services.
Local health authorities can help by publishing clear service schedules, providing accurate information about vaccine safety and ensuring that caregivers know where to obtain appropriate advice.
Community health workers can also help identify children who have missed appointments and explain how families can catch up on recommended vaccinations.
Reaching Children in Remote and Underserved Communities
Nigeria's immunisation challenge is not distributed evenly across the country.
Some communities have relatively easy access to hospitals and primary healthcare centres, while others face long distances, transportation difficulties, insecurity or shortages of health workers.
Urban areas can also contain significant gaps, particularly in low-income neighbourhoods where families may live far from functioning facilities or struggle to access services during working hours.
These differences mean that a single approach may not be sufficient to reach every child.
Mobile vaccination teams and community outreach programmes can help extend services to locations that are difficult to reach through fixed health facilities alone.
Health workers can also collaborate with local leaders, community organisations and caregivers to identify children who have never received a vaccine or have failed to complete their schedules.
UNICEF's partnership with Nigeria and the Republic of Korea provides one example of an effort to target these gaps through existing health systems.
The programme's focus on Lagos, Ogun, Kebbi, Bauchi, the FCT and Adamawa reflects the need to address different barriers, ranging from urban disadvantage to remoteness, border mobility and insecurity.
However, outreach programmes need reliable supplies, adequate staffing and follow-up arrangements to be effective.
Vaccinating a child during a single campaign is important, but health authorities must also ensure that the child can return for subsequent doses when required.
Accurate records, appointment reminders and coordination between facilities can help reduce missed opportunities.
Tackling Misinformation Through Community Engagement
Misinformation and uncertainty about vaccines can also prevent children from receiving routine immunisation.
Some caregivers may have concerns about side effects, distrust official health messages or receive inaccurate information through informal networks and social media.
Others may not understand why a child who appears healthy needs vaccination or why several doses are necessary.
Health authorities must address these concerns through clear, respectful communication rather than assuming that every missed appointment reflects deliberate refusal.
Healthcare professionals can explain the benefits and possible side effects of vaccines, answer questions and advise caregivers about what to expect after immunisation.
Community leaders and trusted local voices can also help communicate accurate information, particularly where families have limited access to formal health education.
UNICEF has documented examples in Nigeria in which direct engagement by health workers helped caregivers overcome their concerns and bring previously unvaccinated children for services.
Such experiences demonstrate the value of combining vaccine availability with communication that responds to people's actual concerns.
Public information efforts should also make practical details easy to understand, including where vaccines are available, the ages at which children should receive them and what caregivers should do if a scheduled appointment is missed.
Reliable information can help families make informed decisions and reduce confusion that might otherwise interrupt vaccination schedules.
Strengthening Disease Surveillance and Emergency Preparedness
The WHO has also stressed the importance of stronger disease surveillance and outbreak preparedness.
Surveillance allows health authorities to monitor suspected infections, identify unusual patterns and investigate possible outbreaks before they spread further.
Effective systems require trained personnel, functioning laboratories, timely reporting and clear procedures for communicating information between local, state and national authorities.
When information arrives late or is incomplete, health officials may struggle to determine the scale of an outbreak or decide where to deploy resources.
Communities with weak routine immunisation may require particular attention because preventable diseases can spread more readily where many people lack immunity.
Emergency preparedness also involves maintaining supplies, training rapid-response teams, communicating risks to the public and coordinating the work of healthcare providers and partner organisations.
Cross-border cooperation is particularly important when people travel frequently between neighbouring countries for trade, work or family reasons.
Nigeria's health authorities must therefore work with neighbouring countries and regional partners to exchange relevant information and coordinate responses when infectious diseases threaten communities on both sides of a border.
Such cooperation can help ensure that public health threats are identified quickly and that appropriate interventions reach affected populations.
The Importance of Stronger Primary Healthcare
Primary healthcare centres are often the first point of contact between families and the health system.
They provide essential services, including routine immunisation, maternal and child healthcare, health education and referrals for more specialised treatment.
When these facilities are accessible and adequately staffed, they can help identify health problems early and prevent some conditions from becoming more severe.
However, a centre cannot provide reliable services without trained personnel, essential equipment, vaccines, transport arrangements and adequate funding.
Improving primary healthcare therefore remains an important part of the effort to close immunisation gaps.
Health authorities can strengthen services by monitoring facility performance, supporting health workers, maintaining supply chains and ensuring that facilities in underserved communities receive appropriate attention.
It is also important to integrate vaccination into broader child health services where appropriate. Families attending clinics for other essential services may benefit from checks to determine whether their children are due for routine vaccines.
Such integration can reduce missed opportunities and make more efficient use of available resources.
Nevertheless, programmes must retain accurate records and follow recommended vaccination schedules to ensure that children receive the appropriate doses.
What the Federal and State Governments Need to Do
The WHO's warning presents an opportunity for federal and state authorities to review the practical barriers preventing children from accessing immunisation.
First, governments need to provide predictable funding for routine vaccination and the health infrastructure supporting it.
Second, they need to ensure that vaccines are available at functioning facilities and that health workers have the training and equipment required to administer them safely.
Third, vaccination programmes should identify children who have missed doses and organise appropriate follow-up, particularly in remote, conflict-affected and underserved urban communities.
Fourth, disease surveillance should be strengthened so that health authorities can identify outbreaks and direct resources to areas where risks are increasing.
Fifth, public communication should address misinformation and provide families with clear guidance about recommended vaccines and available services.
Finally, government agencies and development partners should evaluate programmes using reliable information about vaccination coverage, service availability and the number of previously unvaccinated children reached.
These measures require coordination across government departments, healthcare facilities, communities and international partners.
Funding commitments alone will not guarantee better outcomes unless resources reach the people and facilities that need them most.
Likewise, vaccination campaigns will have limited long-term impact if routine services remain unreliable or families cannot complete their children's immunisation schedules.
A Shared Responsibility for Child Health
Protecting children against preventable diseases requires cooperation between governments, healthcare workers, caregivers, communities and development partners.
Public authorities have a responsibility to provide accessible services, maintain vaccine supplies and ensure that health programmes reach underserved populations.
Healthcare workers must provide accurate information, administer vaccines according to recommended guidance and help families understand the importance of completing vaccination schedules.
Caregivers can support these efforts by consulting qualified health professionals, keeping available vaccination records and following the recommended schedule for their children.
Community organisations can contribute by helping families find reliable information, encouraging participation in outreach programmes and identifying barriers that may prevent children from accessing care.
Development partners can continue supporting programmes that strengthen national systems, particularly where additional technical expertise, funding or logistical assistance is needed.
The long-term goal is to establish a health system in which a child's access to essential vaccines does not depend on household income, geographical location or whether a community is affected by insecurity.
Achieving that objective will require sustained investment and a commitment to reaching children who have repeatedly been missed by existing services.
What Happens Next?
The WHO's warning places renewed emphasis on Nigeria's responsibility to strengthen routine immunisation, increase domestic healthcare financing and improve its capacity to detect and respond to disease outbreaks.
The scale of the zero-dose population, alongside continuing concerns about measles and circulating vaccine-derived poliovirus, demonstrates the importance of sustained efforts beyond occasional vaccination campaigns.
The partnership involving UNICEF, the Republic of Korea and Nigerian authorities offers one route for improving access in selected states, while broader government programmes remain essential to achieving nationwide coverage.
The next steps will depend on how effectively authorities translate calls for investment into accessible services, reliable vaccine supplies, stronger surveillance and targeted outreach.
For families, the immediate priority is to obtain accurate advice from qualified healthcare professionals about the vaccines their children need and where those services are available.
For policymakers, the challenge is to ensure that routine immunisation becomes a dependable part of primary healthcare, including in communities where access has historically been difficult.
Nigeria's progress will ultimately depend on whether health services can reach children consistently, protect them against preventable diseases and maintain public confidence in vaccination.
Sources and further reading
Premium Times, October 13, 2026: WHO warns immunisation gaps leave Nigerian children vulnerable to disease.
The Daily Circular, October 13, 2026: WHO warns immunisation gaps leave Nigerian children exposed to disease.
UNICEF Nigeria, April 17, 2026: Nigeria, Republic of Korea and UNICEF partner to reach unvaccinated children.
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