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With Nigeria’s immunisation crisis deepening amid donor funding shrinking and millions of children left with zero-dose immunisation and unprotected, Dr Itunu Dave-Agboola, Policy and Advocacy Coordinator, Boost Project at Save the Children International, in this interview with CHIOMA UMEHA warns that without urgent domestic resource mobilisation, vaccines may run dry, leaving tragic consequences for underfive mortality and vaccinepreventable diseases across Lagos, Kano, and beyond. Excerpts:
Vaccination status and barriers in Nigeria remain pressing issues. Could you explain what today’s discussion highlights?
The benefits of vaccines are best achieved when children receive all recommended doses on time. In Nigeria, government health facilities remain the primary centres for immunisation, yet service delivery is low and resources are inadequate. This has created significant barriers to coverage. Current figures reveal that only 57 percent of children are fully immunised, while more than 18 percent, about 2.1 million children, remain zerodose, highlighting the urgent need for stronger interventions.
Donor funding is shrinking. What should the government do differently?
That is why we are advocating for domestic resource mobilisation because donor funds are actually shrinking. According to the Abuja Declaration, where heads of states met and agreed that the federal government, which was cascaded to the state level, should dedicate 15 percent of the federal budget and the state budget to health. If states can actually be committed to that 15 percent, most federal government and state government, if they can be committed to that 15 percent and ensure that the 15 percent is allocated, released and effectively utilised, I think it will go a long way to help us. If that 15 percent is allocated, released and used, then we will know if it is sufficient or not. If it is not sufficient, then we can see how we can improve on it. But then when it is not being allocated, we won’t even know how far it can go.
What’s today’s meeting all about?
Today’s meeting is centered on orienting advocates on the effective use of advocacy briefs prepared for the BOOST project. At its heart, advocacy is about strategic action, deliberate efforts to influence decisionmakers in ways that can bring about policy shifts, secure funding, or strengthen systems. It relies on evidence, clear messaging, and meaningful engagement with stakeholders. The advocacy briefs being introduced serve as vital documents. They highlight progress made in routine immunisation, outline persistent challenges, and chart a way forward. A particular emphasis is placed on domestic resource mobilisation, which is critical for improving immunisation coverage among children in Lagos State. The BOOST project itself stands for “Better Opportunities for Optimising Systematic Immunisation.” Its mission is to reach zerodose and underimmunised children, ensuring that no child is left behind. Today’s meeting is therefore not just about orientation; it is about equipping advocates with the knowledge and tools to drive change, mobilise resources, and strengthen routine immunisation across communities.
What are the objectives of this meeting, and what would you say are the essential takeaways for participants?
The objectives of this meeting are both strategic and practical. At its core, the gathering is designed to bring policymakers and private sector leaders into the same conversation, ensuring that evidence from advocacy briefs is not only presented but actively used to shape decisions. Beyond that, the meeting seeks to mobilise public opinion and media support, while also establishing clear systems for tracking commitments and following up on them. This approach underscores the importance of accountability and sustained engagement. The stakeholders involved are diverse and influential. They include government officials at federal, state, and local government area levels, private sector partners, development agencies, media organisations, as well as traditional and religious leaders. Each group plays a vital role in advancing routine immunisation. The key takeaways are equally significant. Advocates are expected to leave with a deeper understanding of the BOOST project, which is focused on reducing the number of zerodose and underimmunised children. Participants will also learn how to deploy advocacy briefs effectively, engage targeted stakeholders, and conduct followup on commitments. Ultimately, the meeting aims to equip advocates with the tools to mobilise adequate resources and ensure routine immunisation becomes a sustainable priority.
From the scorecards that were distributed, can you summarise the main asks for Lagos State, Ikorodu, and Alimosho Local Government Areas?
The main ask is to improve domestic resource mobilisation in terms of funding, especially because we know that donor funds are reducing day by day. We need to learn how to stand on our own feet and ensure sustainability, even if donor funds disappear completely. Beyond funding, we also need human resources, material resources, and logistics to ensure that vaccines are available, alongside the cold chain and transport systems, so that they reach the grassroots and hard-toreach areas. We also need more healthcare facilities, because as we speak now in Lagos, there are some wards that still do not have health facilities attached to them.
Looking at Ikorodu and Alimosho LGAs compared to other Local Government Areas in Lagos State, why do they have such a large number of children? What are the factors?
One of the major factors is their population. Alimosho is the largest local government area in Lagos State, with six LCDAs within the same LGA. Ikorodu is equally another large local government. When calculating percentages, the more population you have, the more children you have, and the more children you have, the more candidates you have for immunisation. Given their population, the available healthcare resources are being stretched in those areas. Moreover, in Ikorodu and Alimosho LGAs, there are still some wards without healthcare facilities. In such wards, some mothers may not take their children for vaccination because of distance, as they do not have a healthcare facility close to them. That is why we are promoting outreach activities for routine immunisation in these projects.
What will you call the next steps?
Now that we have conducted immunisation and presented the advocacy brief, the next step is for advocates to begin engaging targeted stakeholders and securing their commitment, all towards the improvement of domestic resource mobilisation for routine immunisation. This mobilisation must encompass resources in terms of funding, human resources, material resources, and the establishment of more primary health care facilities.
Why domestic resource mobilisation for immunisation?
Domestic resource mobilisation for immunisation is essential to ensure the sustainability of immunisation programmes. External donor funding can reduce or even end over time. When countries fund immunisation themselves, programmes continue without interruption, vaccine supply remains stable, and long-term planning becomes possible. This approach helps to target underserved and hard-to-reach populations, addressing local barriers to immunisation and ensuring that no community is left behind.
This programme is being implemented in Lagos and Kano. Under what local governments in Kano?
The Nigeria component of the BOOST GSK-SCI partnership programme (2024–2027) is being rolled out in four Local Government Areas—two in Kano State and two in Lagos State. The initiative is designed to pilot innovative approaches that directly tackle vaccination barriers and reduce the number of zero-dose and missed vaccinations among children.The choice of project locations was not arbitrary. It was guided by a set of carefully considered criteria that highlight the urgency and importance of intervention in these areas. These include the prevailing development context, the high burden of zero-dose children, and the worrying rates of under-five and infant mortality. Additionally, the selected LGAs face a significant burden of vaccine-preventable diseases, which makes them priority zones for immunisation efforts. Another factor influencing the selection was the presence of other immunisation projects in these regions. This allows for synergy, coordination, and the possibility of building on existing structures rather than starting from scratch. Furthermore, the history of previous GSK-SCI partnership programmes in these areas provided a foundation of experience and lessons learned, which can now be leveraged to strengthen the current initiative. By focusing on these LGAs, the programme aims to demonstrate how targeted innovations can overcome entrenched barriers to vaccination. The ultimate goal is to ensure that children in underserved and hard-to-reach communities are not left behind, and that immunisation coverage becomes both sustainable and resilient in the face of dwindling donor support.
What happens if we do not get a positive response to the expected funding and resources?
What are the consequences for the number of unimmunised children we already have? We hope to achieve remarkable and significant improvement. However, if we do not secure the resources we need, with donor funds shrinking, we may face a situation where vaccines are not even available.
And what will be the implication?
The implication will be tragic. There will be an increase in the mortality rate among under-five children and a rise in deaths related to vaccine-preventable diseases.
