Vaccines are not just medicine. They are mirrors. They show us who we are, what we value and whose lives we’re willing to protect.
Every year, Immunisation Week arrives as a gentle global reminder of the power of prevention — of the syringe over the scalpel, the clinic over the emergency room, the vaccine card over the death certificate. And yet this year, it comes cloaked in a darker tone.
For decades, the US led the world in public health innovation. But now, in a bitter twist of irony, it is becoming an empire of denial and disinformation, where political cynicism is putting infants and children in preventable danger.
In Washington, public health policy has been hijacked by political operatives who view science as a matter of partisan alignment rather than national survival. The Centers for Disease Control and Prevention (CDC) is underfunded, demoralised and treated with suspicion by segments of its own government.
Vaccine uptake, especially for routine childhood immunisations, has begun to slip — not just among fringe groups, but in suburban districts and heartland counties. Measles outbreaks, thought to be relics of the pre-modern age, are now surfacing in schools and churches across the country.
This decline is not happening in a vacuum. The global stage is watching. And what it sees is a superpower whose inability to manage its own public health messaging is exporting confusion and complacency across borders.
Crisis of credibility
Let us be clear, this is not merely a crisis of policy — it is a crisis of credibility. When US leaders equivocate on vaccines, when governors veto mandates in the name of “parental rights” and when presidential hopefuls court anti-vaccine extremists for political gain, the ripple effects go far beyond American shores.
For decades, US influence shaped global immunisation norms — from the smallpox eradication campaign to its governance and financial support for Gavi, the Vaccine Alliance. But now, that same influence is breeding scepticism. The US army admitted to spreading anti-vaccine sentiment in the Philippines. But even in the absence of a co-ordinated operation, public health officials around the world, from Nairobi to São Paulo, report an uptick in vaccine hesitancy that can be traced directly to the US-originated narratives.
This export of misinformation is especially insidious because it comes packaged in the language of freedom. The argument goes: “I have the right to refuse,” even when that refusal endangers others. This rhetoric, born from a misunderstanding of liberty, ignores a foundational truth of public health — that freedom without responsibility is chaos. And chaos, when it comes to disease, is deadly.
This American exceptionalism — this notion that US citizens can defy global health consensus while still claiming to lead the world — is not only intellectually dishonest. It is morally bankrupt. And the world is starting to look elsewhere.
African counter-narrative
While the US stumbles in its own backyard, Africa is charting a bold new course — one rooted in pragmatism, sovereignty and deep community engagement. Consider Rwanda, where the ministry of health, in collaboration with community health workers and local leaders, has achieved near-universal childhood vaccination coverage, including the human papillomavirus (HPV) vaccine, which remains politically contested in parts of the US.
Rwanda’s success is not accidental. It is a product of a number of strategic choices. Yes, outside support from private donors and the US government helped to bolster the country’s health system after the 1994 genocide, but the government also made a commitment to community-based health systems, where trained local workers deliver vaccines house to house.
Second, a political culture that frames health as a national security priority rather than a political wedge issue. Rwandan civil servants sign a binding contract in which they pledge imhigo (to deliver). Third, an investment in health education that treats citizens as partners, not problems.
The result? While American parents debate whether measles is “really that bad”, Rwandan health workers are eradicating vaccine-preventable diseases in remote villages, using solar-powered cold chains, digital tracking and decades of trust built through consistent delivery. While many African governments have condemned Rwanda’s human rights record, the country’s vaccination model remains a beacon for other nations — and an indictment of the dysfunction playing out in Washington.
When politics infect public health
To understand the collapse of vaccine leadership in the US, we must examine the rot within. Over the past decade, American public health has been steadily politicised — not by scientists or epidemiologists, but by opportunistic politicians who found that peddling doubt pays dividends at the ballot box.
The Covid-19 pandemic laid bare the extent of this decay. Public health guidance was not just questioned — it was mocked, subverted and, in some cases, criminalised. Governors in states such as Florida and Texas actively undermined vaccine campaigns, banned school mask mandates and defunded public health outreach programmes. Congressional hearings became platforms not for scientific debate but for conspiracy theatre, where virologists were forced to defend the germ theory of disease as if it were a political opinion.
The government’s response, while more restrained under the Biden administration, still failed to rise to the moment. Messaging around boosters was confused and inconsistent. The CDC’s credibility was further eroded by bureaucratic missteps and internal strife. And now, in the shadow of the 2024 elections, the spectre of anti-science governance looms large once again.
The numbers are stark: CDC data shows that routine childhood vaccination rates in the US are slipping for the first time in decades and this year’s case count (800) is the second highest recorded in 25 years.
Polio — once eradicated in the Americas — was detected in New York wastewater, which suggests the virus is circulating among the unvaccinated. This is not the profile of a global leader. It is the symptom of a state in retreat.
And yet, despite this unravelling, American leaders continue to see themselves as the stewards of global health. They issue statements. They attend summits. They pledge support for international vaccine efforts. But what credibility do those pledges carry when the home front is so compromised?
The silent reckoning
There is a silent reckoning under way — especially across the Global South. Quietly, thoughtfully and with increasing confidence, countries that were once dependent on the Global North for vaccines are building their own futures. Africa’s vaccine manufacturing movement is gaining ground, led by institutions such as the Pasteur Institute of Dakar in Senegal and Biovac in South Africa. In the wake of Covid-19, the AU has doubled down on its vision to manufacture 60% of its vaccines domestically by 2040.
This is not just about independence — it is about leadership. African nations are no longer waiting for the West to save them. They are investing in surveillance systems, regional manufacturing hubs, cross-border procurement strategies and robust public education campaigns. In Kenya, for example, the National Vaccines and Immunisation Programme has created school-based vaccination drives coupled with youth-targeted digital media outreach — strategies that many American states, paralysed by culture wars, can barely contemplate.
Even more importantly, these efforts are grounded in community trust. In many African countries, vaccine programmes succeed because they are not handed down from detached bureaucracies but co-created with traditional leaders, midwives and grassroots organisers. This model of participatory health governance is both more resilient and more just.
It is no coincidence that during the Covid-19 pandemic, African countries such as Senegal, Ghana and Nigeria outperformed many wealthier nations in components of their vaccine roll-out efficiency, despite structural inequalities, political will and supply chain barriers. What they lacked in cold storage, they made up for in coordination where they could. What they lacked in government funding, they delivered through clarity of purpose and proximity to their people.
A dangerous gap, a global threat
So where does this leave us? The most powerful country in the world is actively undermining its own public health infrastructure — through political negligence, strategic ignorance and deliberate sabotage. Meanwhile, some of the most promising immunisation programmes are emerging from regions that US policymakers have long dismissed as “recipients” rather than “leaders”.
This gap is not just morally troubling — it is geopolitically dangerous. When the US abdicates responsibility, misinformation fills the vacuum. Russian and Chinese state media have already begun amplifying vaccine scepticism in African countries, portraying Western science as unreliable and arrogant. The same forces that sowed chaos in American elections are now undermining global health from the inside out.
If we are not careful, we will enter an era of health fragmentation — where vaccine access, trust and innovation are dictated not by evidence, but by ideology. And that fragmentation will cost lives — millions of them.
The irony is that the tools to prevent this future are already in our hands. But the will to use them is not evenly distributed.
The case for a new immunisation vanguard
We are witnessing a pivotal shift in the architecture of global health leadership. And while much of the Western world is still obsessed with reclaiming lost influence, African nations are quietly building the scaffolding for a new public health order — one that is community-led, politically astute, technologically innovative and proudly sovereign.
It is time we stop calling this a “miracle”. It is not. African immunisation success is not a matter of luck; it is the result of deliberate policy, hard-won partnerships and the wisdom of communities long ignored by the global health elite. This is not a story of catching up. It is a story of leading forward.
For years, the world has defaulted to the US as the moral compass of science and medicine. But a compass that spins in confusion is no longer a guide — it is a liability. The global immunisation movement must now decentre US institutions as its north star and instead look toward the bold experimentation and grounded excellence emerging from the African continent.
Let us imagine a new kind of global leadership — one that does not rely on GDP but on collective dignity; one that does not measure progress by pharmaceutical exports but by lives saved in slums and villages; one where a health worker in Rwanda wields more influence over the future of humanity than a senator in Washington grandstanding about “parental rights” while children suffer.
History’s verdict
There will be a reckoning. Perhaps not next year. Perhaps not even in the next decade. But history will have its say. And when it does, it will not be kind to the rich nations that chose politics over protection, that used their platforms to stoke fear instead of building trust, that allowed preventable diseases to return, not because they could not stop them — but because they would not.
Children will die because of the choices being made today in American state legislatures, cable newsrooms and campaign war rooms. That is not hyperbole — it is epidemiological certainty. And yet those same children, in communities across Africa, might survive because a nurse on a motorbike reached them in time, because a village elder gave her blessing, because a government prioritised health over headlines.
This is the tragic, beautiful paradox of our era: as one empire declines, another rises — not in bombs or ballots, but in syringes and solidarity.
So as we mark this Immunisation Week, let us dispense with platitudes. The time for polite applause is over. We need to name the failure of US vaccine politics for what it is — a threat to global public health. And we must elevate and fund the systems that are working — many of them African, many of them ignored — to lead us into a safer, more dignified future.
Because vaccines are not just medicine. They are mirrors. They show us who we are, what we value and whose lives we’re willing to protect.
And, right now, the reflection coming out of the US is as dangerous as it is damning. But in Africa, we see something else. We see vision. We see courage. We see leadership.
The world should follow.
Tian Johnson is founder of the Pan-African nonprofit, the African Alliance.