Elevating immunization as a political and economic priority in Africa: Reflections from the continental consensus on Africa's continental immunization strategy in november 2025 in Kigali, Rwanda.

Africa's Continental Immunization Strategy convening from 11 to 13 November 2025 in Kigali, Rwanda, marked a defining political moment for immunization in Africa. Beyond a technical consultation, the process generated broad consensus among African Union Member States, led by Africa CDC, to reposition immunization as a driver of primary health care transformation, health security, and health sovereignty. The Kigali consensus recognized that immunization can no longer rely on fragmented, vertical, and donor-dependent approaches, but must transition toward integrated, resilient, and country-owned systems. Africa's rapidly expanding birth cohort continues to add millions of vaccine-eligible children annually, while health systems struggle to keep pace. At the same time, immunization schedules are expanding, external financing is declining, and nearly 99% of vaccines used on the continent remain imported, creating vulnerabilities in supply reliability and sustainability. These pressures expose structural weaknesses and call for a fundamental shift in immunization delivery and financing. The Continental Immunization Strategy responds directly to this reality. It is not another technical strategy, but a political and systems blueprint that places Member States at the centre of leadership, financing, and accountability, while positioning immunization as a life-course public good embedded within primary health care systems. This article argues that the Kigali consensus may represent an important turning point in efforts to elevate immunization as a political, economic, and systems priority for advancing health sovereignty and resilient health systems in Africa.