Bridging the Gap Between Research and Impact: Strengthening Global Vaccination Efforts

On the occasion of the World Vaccine Congress in Washington (April 21-24, 2025), where leading experts discuss current developments and challenges in vaccine research, production and distribution, we observe remarkable advances in vaccine development. The unprecedented speed with which effective COVID-19 vaccines were developed and deployed demonstrates research capabilities at their finest. Yet a striking disparity remains: WHO estimates indicate 1.5 million lives could be saved by improving global vaccination rates. This clearly shows that research breakthroughs alone are not enough to save lives. What, then, are the key factors for successful immunization programs in global health?

Efficacy Gaps in Practice: The Malaria Example

Laboratory efficacy and practical implementation can differ significantly. Malaria vaccines illustrate this challenge: the newer R21 vaccine is considerably more cost-effective than the conventional option (approximately 3 € vs. approx. 9 € per dose). Nevertheless, the transition is delayed by institutional barriers. Broader use of the R21 vaccine is hampered by lengthy international financing and procurement processes, as well as pending country-specific approvals that fail to keep pace with scientific innovation. More generally, limited production capacity, maintaining cold chains to the "last mile," logistical challenges in hard-to-reach areas, and availability of trained healthcare staff represent central challenges to successful vaccine delivery.

The higher cost-effectiveness of the newer R21 vaccine could save up to 800,000 additional children if actually deployed. This means that despite current scientific knowledge about the superior efficacy of certain vaccines, practical implementation of this knowledge is often signifi cantly delayed.

Political Direction and Social Acceptance: Keys to Vaccination Success

How can we make progress given these challenges? A key leverage is political decision-making. The COVID-19 pandemic demonstrated that scientific advances alone do not determine the success of health programs—political decisions and social acceptance are often decisive. Successful programs therefore utilize inclusive decision-making structures. The Global Fund serves as a model here: affected countries have equal say in decision-making. When local actors participate, local acceptance increases significantly—along with the program's overall chances of success.

Equally important is addressing social barriers and taking a holistic approach to vaccination access. Transportation costs, for example, often present a greater obstacle for families than the vaccine itself. Effective programs therefore invest in community education and remove practical barriers—whether through mobile teams or incentives such as free health checks or cash transfers in contexts with extremely low vaccination rates, as in Nigeria.

Sustainable Financing: The Foundation for Vaccination Success

A solid and sustainable financing base is crucial for successful immunization programs. Important global initiatives like Gavi and the Global Fund face signifi cant funding gaps that jeopardize progress. Germany must fulfill its global responsibility by closing these gaps, ideally with increased investments in these highly effective organizations. Especially in times when many global development programs face cuts, Germany should prioritize highly effective organizations.

Beyond traditional contributions, innovative fi nancing mechanisms can help:

• Advanced Market Commitments (AMCs) create strong incentives for vaccine development through binding purchase commitments from donors at guaranteed conditions. This significantly reduces investment risk for manufacturers and promotes capacity building, particularly for low-income countries.
• Results-Based Financing (RBF) directly rewards the achievement of vaccination targets. Payments are made only after success, creating incentives for eff ectiveness and stabilizing demand.
• With the Debt2Health mechanism, Germany converts forgiven debt into health investments through the Global Fund.

A combination of strong core contributions and targeted use of such innovative instruments is essential to create the fi nancial foundation for global vaccine equity.

From Research to Implementation: Securing Global Vaccination Success

Scientific breakthroughs are indispensable, but alone they do not save lives. To fully realize the life-saving potential of vaccines requires determined political decisions, inclusive local structures, and sustainable financing. Now more than ever, Germany must invest strategically in highly eff ective approaches and organizations like Gavi and the WHO Immunization Program —not only as a moral obligation but also as a strategic priority in the interest of global health security.