Fifty years of immunisation in Africa: the evolution of vaccine supply chains

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Abstract
Africa's vaccine supply chains have evolved over five decades from rudimentary systems to increasingly complex and resilient networks. This paper traces their development from the establishment of the Expanded Programme on Immunisation (EPI) in the 1970s through successive phases of expansion and innovation. Key milestones include the growth of cold chain infrastructure, procurement mechanisms, digital information systems, and the emergence of regional coordination and local manufacturing initiatives. Persistent challenges such as limited infrastructure, workforce capacity, and regulatory strength remain, yet, recent advances highlight Africa's capacity for adaptation. The COVID-19 pandemic exposed critical vulnerabilities but also accelerated progress. Understanding this evolution provides lessons for strengthening supply chains and advancing vaccine security, with artificial intelligence offering new opportunities for optimisation.

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