At Local MD, we recognize that achieving global health equity is a critical pillar in sustaining healthy communities around the world. Central to this mission is the vital work of the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), two global institutions whose combined efforts underpin vaccine access to millions of people across continents. In this article, we explore in depth how WHO and UNICEF collaborate to expand vaccine access, why this mission remains urgent, where the key challenges lie, and what the future holds for equitable immunization.
Understanding the Imperative: Why Vaccine Access Matters
Vaccination has repeatedly proven one of the most cost-effective and life-saving interventions in public health. Vaccines protect individuals, families, communities and economies, creating ripple effects that extend far beyond immediate health outcomes. Despite this, in 2024 major gaps remained: while about 89 % of infants globally received at least one dose of the diphtheria-tetanus-pertussis (DTP) vaccine, roughly 14.3 million children received zero doses, according to WHO and UNICEF estimates.
Those “zero-dose” children predominantly live in fragile settings — conflict zones, underserved rural areas, or under-resourced health systems. The consequence: increased vulnerability to vaccine-preventable diseases, outbreaks, and long-term health burdens. Expanding vaccine access is therefore a global public-good issue, not just a national health system matter.
WHO’s Strategic Role in Vaccine Access
Standard-setting, surveillance and guidance
The WHO leads the development of global guidelines, technical standards and immunisation policies. By producing authoritative frameworks for vaccine schedules, cold-chain requirements, safety monitoring and outbreak response, WHO sets the foundation upon which national immunisation programmes rest. For instance, the WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) provide critical data on vaccine uptake trends in 189-191 countries.
Global coordination and leadership in emergencies
When new threats emerge — such as mpox, COVID-19 or other epidemics — WHO orchestrates global response mechanisms, declaring public health emergencies, issuing guidance, and mobilizing partner responses. Its convening role ensures that immunization efforts are aligned with broader disease surveillance and health system strengthening.
Technical support and capacity‐building
WHO supports countries in building immunisation infrastructure such as cold-chain systems, laboratory verification, surveillance networks and training of health workers. This behind-the-scenes work is critical for transforming vaccines into real-world protection.
UNICEF’s Unique Contribution to Vaccine Access
Procurement and supply chain management
UNICEF is often described as the world’s largest vaccine buyer. Its “pooled procurement” model aggregates demand across many countries, giving it greater negotiating power, securing better pricing and ensuring predictable supply for manufacturers.
Logistics, delivery and country-level support
Beyond buying vaccines, UNICEF manages the global logistics: transporting vaccines, managing ultra-cold-chain equipment, delivering to remote communities, and working directly with ministries of health. For example, in Bangladesh, UNICEF and WHO supported the delivery of 2.5 million Pfizer COVID-19 doses and 26 ultra-low-temperature freezers to expand national cold-chain capacity.
Advocacy, community engagement and equity
UNICEF works to elevate immunization as a rights issue for children, supporting demand generation, communication campaigns, engagement with local communities, and ensuring vulnerable groups are reached. The agency also often drives innovation in reaching marginalized populations.
The Powerful Synergy of WHO + UNICEF
When WHO and UNICEF work together, their complementary roles create a multiplier effect:
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WHO sets global standards, evidence-based guidance and surveillance frameworks.
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UNICEF delivers vaccines, builds supply chains, reaches children, especially in remote or fragile contexts.
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Together, they provide data, policy, procurement and operational delivery that many countries alone would struggle to manage.
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Many joint press releases highlight this collaboration; for example, their joint statement on global childhood vaccination coverage underscores both organizations’ roles.
This synergy allows for the development and implementation of initiatives such as the COVAX Facility (co-led by WHO and implemented with UNICEF) that aim for equitable access to vaccines for all countries regardless of income.
Major Achievements: What Has Been Accomplished
Increased procurement and deliveries
UNICEF reports that in 2023 it delivered nearly 10 million doses of COVID-19 vaccines to 80 countries, building on cumulative deliveries of 2 billion doses to 146 countries since 2021.
Additionally, the pooled procurement strategy expands access: UNICEF supplies vaccines to approximately 45 % of the world’s children under five years of age.
Improved immunization coverage in low-income countries
Through the support of WHO, UNICEF and partners, immunization coverage in many low-income countries has improved despite enormous challenges. The infrastructure, cold-chain capacity and community outreach have been strengthened in fragile contexts. For example, in Kyrgyzstan, UNICEF and WHO supported a review and improvement of national immunization programs, reaching 55,000 children in hard-to-reach areas.
Global formalizations and monitoring of immunization progress
The WUENIC dataset provides the largest global dataset on immunization coverage, enabling transparency, benchmarking and identification of gaps.
Persistent Challenges in Vaccine Access
Large numbers of unvaccinated or under-vaccinated children
Despite progress, more than 14 million children did not receive a single vaccine in 2024.
This “zero-dose” group typically resides in countries or regions with conflict, instability, or weak health systems. The risk of outbreaks remains high.
Inequities and access-gaps
Access to vaccines remains deeply unequal. Many middle-income countries and high-income countries with pockets of low uptake are seeing stalling or declining coverage.
In conflict-affected or humanitarian contexts, supply chains and health service delivery are disrupted, making “last-mile” delivery difficult.
Supply chain and logistic limitations
Vaccine distribution demands robust cold-chain infrastructure, effective logistics, forecasting and storage. In many low-income settings this remains a bottleneck. The delivery of ultra-low-temperature freezers is one solution, but it is costly and complex.
Misinformation and vaccine hesitancy
Beyond physical access, social and behavioral barriers exist. Misinformation about vaccines undermines uptake and trust, even when supply exists.
Sustainable financing and domestic investment
Many immunization programs remain dependent on donor funding and global mechanisms. For long-term sustainability, domestic investment and resilient health systems are necessary. WHO has pointed out that drastic cuts in aid threaten decades of progress.
Key Strategies Employed by WHO & UNICEF to Expand Access
Pooled Procurement and Demand Aggregation
UNICEF’s approach of pooling demand across countries ensures competitive pricing, predictable supply contracts and larger manufacturing runs, which enable economies of scale.
WHO provides the technical review and approval, ensuring procurement aligns with global safety and efficacy standards.
Strengthening Cold-Chain and Logistics Infrastructure
WHO and UNICEF jointly support countries to modernise storage and transportation systems. The Bangladesh example of ultra-low-temp freezers demonstrates how such infrastructure expands access to advanced vaccines.
Country-level Integration and Health System Strengthening
Rather than standalone vaccine campaigns, WHO and UNICEF promote integration of immunization into routine health services, primary care and national health strategies. This creates sustainability and resilience.
Data, Monitoring & Transparency
With the WUENIC dataset and other monitoring tools, WHO and UNICEF track progress, identify gaps and support targeted interventions.
Equity-Focused Outreach and Humanitarian Response
Special efforts are made to reach zero-dose children, conflict-affected populations and marginalized groups using mobile teams, community engagement and remote delivery strategies. UNICEF’s work in Kyrgyzstan is one example.
Advocacy and Global Partnerships
WHO and UNICEF partner with regional agencies, the Gavi, the Vaccine Alliance, governments, manufacturers and donors. Initiatives like COVAX reflect this multi-stakeholder coordination.
What the Future Holds: Toward Immunization Agenda 2030
The global immunization community has set ambitious targets under the Immunization Agenda 2030 (IA2030). Key aims include reducing the number of zero-dose children to fewer than 6.5 million by 2030 and achieving at least 90 % coverage in all countries.
For WHO and UNICEF, this means scaling up the following:
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Accelerating innovation in vaccine development, manufacturing and delivery, including local production in low- and middle-income countries.
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Investing in resilient health systems that can integrate immunization with other primary care services.
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Strengthening surveillance, data systems and outbreak responsiveness.
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Addressing social determinants of immunization: gender, equity, education, poverty and conflict settings.
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Ensuring sustainable financing and domestic health investment to move away from dependence on external donors.
For instance, UNICEF’s procurement of the first commercial doses of the malaria vaccine — 6.2 million doses to seven African countries — is a concrete step toward expanding vaccine types and target populations.
Implications for Global Health, and Why It Matters to Us at Local MD
From a global health vantage point, strong immunization systems organized by WHO and implemented through UNICEF translate to:
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Fewer outbreaks and epidemics, meaning reduced burden on health systems.
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Lower mortality and morbidity among children and vulnerable populations.
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Healthier populations contributing to economic growth and stability.
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Improved health equity as every child, in every environment, gains access to life-saving vaccines.
For Local MD, though our direct service footprint may be local, the implications are global. When we train clinicians, develop protocols or write patient-facing materials, we reflect a world where vaccines are routinely available, trusted and equitably distributed. The work of WHO and UNICEF underpins the very foundations of public health from which our local practices draw.
Conclusion
In the grand endeavor of global health, the partnership and collective efforts of WHO and UNICEF stand as a cornerstone of vaccine access and immunization equity. Their roles — from setting policy and standards to procuring and delivering vaccines, from monitoring coverage to empowering communities — converge to bridge the gap between possibility and reality. While the challenges are formidable, the progress achieved to date is compelling. As we look toward 2030 and beyond, the path forward requires sustained commitment, innovation, investment and collaboration.
At Local MD, we affirm our support for initiatives that ensure everyone, everywhere, has access to life-saving vaccines. By aligning our practice with the values of universal health coverage and immunization equity, we contribute in our own way to the vision that WHO and UNICEF champion.
