Uganda must stop outsourcing its children’s immunity

What does a government owe its children when a preventable disease returns because the system meant to protect them has weakened?

That is the uncomfortable question raised by The Observer’s report on Uganda’s five-day measles-rubella vaccination campaign, which begins on October 1. The government hopes to reach 7.47 million children aged nine to 59 months after measles outbreaks were recorded in 66 districts in 2025 and another 18 districts this year.

The campaign is necessary. But its scale also exposes a deeper failure. Uganda is not confronting a mysterious new pathogen. It is racing to rebuild immunity lost when children missed routine vaccination because of COVID-19 disruptions, refugee inflows and declining donor support.

A mass campaign can close an immediate gap. It cannot substitute for a dependable health system. Parents should heed the ministry of Health’s advice. Every eligible child should receive the vaccine, even if previously immunized.

As Dr Michael Baganizi of the Uganda National Expanded Programme on immunization explains, “This campaign complements, rather than replaces, our routine immunization schedule administered at nine and 18 months.” That distinction matters.

Emergency drives attract funding, publicity and political attention. Routine services depend on less visible work: reliable vaccine supplies, functioning cold chains, trained health workers, accurate records and sustained community engagement.

When those foundations weaken, children disappear from the system until an outbreak makes them visible again. Measles exploits such neglect ruthlessly. One infected person can transmit the virus to as many as 18 others.

There is no specific antiviral treatment, and complications can include pneumonia, persistent diarrhoea, blindness and neurological impairment. Rubella carries another devastating danger: infection during early pregnancy can cause miscarriage or lifelong disabilities in unborn children.

Vaccine confidence is therefore as important as vaccine availability. Officials must answer parents’ concerns honestly, monitor adverse reactions and confront misinformation with evidence rather than contempt.

Dr Annet Kisakye of the World Health Organization advises caregivers to remain at vaccination sites for 30 minutes and seek medical attention if fever persists beyond three days.

Her warning against applying ice to injection sites is the kind of practical guidance every vaccination team should communicate clearly. The larger challenge is financial. The campaign’s Shs 21.8 billion cost is being shared by the government and international partners, including Gavi.

That support saves lives, but donor dependence leaves Uganda’s children vulnerable to decisions made in distant capitals. Parliament and the executive must progressively establish protected domestic financing for immunization, publish district-level coverage and expenditure data, strengthen follow-up for missed children and make routine vaccination accessible in underserved communities.

No country can credibly claim to value its future while treating childhood immunity as an emergency project financed at somebody else’s discretion. Uganda must make vaccination a permanent national obligation, not a recurring rescue mission.

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