Brazzaville — Rising diphtheria outbreaks across the WHO African Region are revealing serious gaps in routine immunization coverage. In response, countries are turning outbreak data into a tool for action, using evidence to target weaknesses, strengthen immunization systems and better protect vulnerable communities.

Weekly surveillance shows a further 10% increase in suspected diphtheria cases in eight countries—Algeria, Chad, Guinea, Mali, Mauritania, Niger, Nigeria and South Africa. Since 2023, more than 23,000 suspected cases have been reported, reflecting persistent immunity gaps, uneven recovery from COVID-19 disruptions, fragile primary health-care services and limited access in conflict-affected settings.

Against this backdrop, more than 100 participants from 11 countries met in Brazzaville from 8–12 December for a regional workshop focused on translating diphtheria response lessons into a roadmap for resilient immunization systems. The meeting emphasized that district-level data must guide decisions, investments and differentiated action.

With support from WHO countries analysed their own data—examining coverage trends, surveillance gaps, service-delivery bottlenecks, supply chain constraints and workforce challenges—to identify root causes and priority actions.

“A vision for resilient systems must go beyond emergency response. Countries must lead their own transformation using actionable evidence, innovation, and partnership to ensure equitable protection for every community,” said Dr Benido Impouma, Acting Director, Health Promotion, Disease Prevention and Control Cluster, WHO AFRO.

A key innovation introduced was the Immunization League Table, supported by a new Immunization Performance Index, which categorizes district performance to pinpoint vulnerabilities and guide targeted, resource-efficient interventions. Countries used the tool to develop 12-month, district-specific action plans and stressed the importance of combining administrative data with surveillance findings, field insights and community feedback.

“Turning outbreak lessons into stronger systems is not theoretical,” said Dr Albert Camara, EPI Guinea. “This approach allows countries to lead their own transformation using evidence.”

Discussions also highlighted tightening immunization financing and the need to “achieve more with less” by improving efficiency, integration and value for investment, in line with Immunization Agenda 2030 and the Addis Declaration.

The workshop resulted in district-focused workplans, strengthened multi-cluster collaboration, a regional roadmap for resilient immunization systems and the launch of the Africa Immunization Performance Forum to sustain learning and capacity building.

Looking ahead, countries committed to grounding decisions in real-time, subnational data to prevent future outbreaks and ensure equitable protection. WHO AFRO will support these efforts through regional collaboration, innovation and evidence-based action—helping build immunization systems that are resilient, adaptive and fit for future challenges.