Vaccines remain one of the most cost-effective public health tools ever developed, preventing illness, saving millions of lives and creating healthier and more prosperous societies. From eradicating smallpox to pushing polio to the brink of eradication, vaccines have drastically reduced death from diseases such as measles, diphtheria and pneumonia. Yet, in many low- and middle-income countries (LMICs), the full promise of immunization is still far from being realized.
Achieving equitable vaccine coverage in LMICs is often hindered by logistical challenges, misinformation, weak community engagement and limited accountability. That’s why the role of institutions rooted in communities, with technical skills to support immunization and uphold accountability at every level is indispensable. Civil society organizations (CSOs) and Expanded Partners (EPs) have long played this role and their contribution is only growing.
Unpacking the Strategic Roles of Civil Society and Expanded Partners
CSOs and EPs are not just auxiliary players – they are foundational to the success of immunization programs worldwide. Operating at the heart of communities and with deep contextual country understanding, they possess an unparalleled ability to reach the under-reached in remote villages, urban poor communities, or conflict zones, where traditional health systems often falter. Their deep contextual knowledge allows them to bridge the gap between global guidance and country implementation fostering trust and sustaining demand and supply of vaccines among hard-to-reach populations.
Below are some of the core ways in which CSOs and EPs drive immunization forward:
- Increasing Access and Improving Delivery
Expanded Partners bolster national vaccine logistics and cold chain systems, facilitate last-mile delivery in hard-to-reach areas and adapt service models to local contexts through innovative outreach. Their agility and community presence fill systemic gaps and reduce bottlenecks in delivery. In many regions if they stopped working, vaccines would fail to reach millions of children.
- Making Immunization a Social Norm
CSOs’ deep community roots allow them to localize health messaging, normalize vaccine uptake and prepare the public for new vaccine introductions. Through interpersonal communication, behavior change campaigns and community dialogues, they make immunization a social norm, especially among under-reached groups. Without the involvement of CSOs, reaching many communities with vaccines would be extremely difficult – if not impossible – due to resistance, mistrust, and in some cases, hostility toward vaccinators.
- Strengthen Surveillance, Data and Accountability
CSOs are embedded within communities, enabling early outbreak detection, accurate data collection and continuous monitoring of vaccine-preventable diseases. They also promote transparency by highlighting service gaps, amplifying citizen feedback and holding health authorities accountable. This real-time intelligence supports more responsive and resilient immunization systems. This improves the quality of decision-making at all levels and enhances global health security.
- Shaping Policy and Strengthening Coordination
Through evidence-based advocacy, CSOs inform national and subnational immunization strategies, support planning and facilitate smooth vaccine rollouts. Their on-the-ground knowledge helps align global initiatives with local realities, making immunization strategies more inclusive, effective and sustainable.
- Building Local Capacity and Resilience
CSOs play a key role in training health workers, mentoring district teams and fostering country-to-country learning. Their work helps decentralize technical expertise and supports the long-term sustainability of immunization programs, especially in fragile settings.
Inclusion of Civil Society is a Necessity, Not a Luxury
Despite their pivotal role, CSOs and EPs often find themselves on the margins of planning and funding discussions. They are brought in too late or not at all and rarely receive the sustainable funding needed to maintain their impact. This weakens immunization programs, leaving systems vulnerable and undermining the very goals we aim to achieve.
If we are serious about securing the future of immunization, we must fully integrate CSOs and EPs into the core of global and national efforts. Their role must be recognized, resourced, and institutionalized—not treated as an afterthought.
This calls for decisive action from global health stakeholders, donors, and policymakers. We must prioritize:
- Dedicated Funding: Establishing sustainable, direct, and flexible financing mechanisms that support the long-term engagement of CSOs in immunization efforts.
- Capacity Building: Investing in the technical and organizational capacities of CSOs to meaningfully engage in planning, delivery, monitoring, and advocacy.
- Institutional Inclusion: Formalizing CSO participation in decision-making and technical assistance (TA) planning at all levels.
- Collaborative Learning: Supporting peer exchange and knowledge-sharing between CSOs and with governments—while respecting countries’ autonomy to work with the partners that best fit their needs.
Looking Ahead: A Shared Mission for a Healthier Tomorrow
Achieving equitable vaccine access requires collective commitment and collaboration—especially with civil society.
CSOs and EPs are not optional partners. Their proximity to communities, their trusted relationships, and their technical strength make them uniquely suited to drive immunization equity and resilience. The future of global immunization depends not just on investments in vaccines—but in the people and partnerships that bring them to life.
Now is the time to elevate civil society from the margins to the center of immunization efforts. Only then can we build a more resilient, inclusive and transformative immunization ecosystem—one that ensures no one is left behind.
The health of our children and communities depends on it.