A pediatrician’s perspective on waning global support for vaccination

As a doctor, how does it feel to see kids die of vaccine-preventable diseases?

It’s frustrating because these illnesses are preventable. We already have safe, effective vaccines that could stop so much suffering. When a child gasps for air due to diphtheria or coughs uncontrollably and stops breathing due to pertussis (whooping cough), it’s heart-breaking as a physician to know that a simple vaccine could have prevented it.

These diseases are cruel—they spread fast, hit the youngest and malnourished hardest, and can leave lifelong complications in those who survive. As a pediatrician, this suffering and death isn’t a failure of medicine; it’s a failure of access and equity. These children are suffering and dying unnecessarily.

Is there one patient in particular you’ve seen during your current assignment that you'll never forget?

There are too many patients with vaccine-preventable diseases to count. I’ve cared for children coughing forcefully for weeks from pertussis, to the point of exhaustion, and I’ve seen children with diphtheria struggling to keep their airways open as a thick membrane blocks them. I have treated children who are severely dehydrated from persistent diarrhea, their eyes sunken and skin loose.

I have taken care of patients who were once fully functional and have now lost the ability to walk or talk after meningitis. And I have seen children with tetanus, their muscles locked in painful spasms and backs arched from contractions. Many of these children are also severely malnourished, which makes their bodies even less able to fight infections, often leaving them battling more than one disease at a time. And as children edge closer to death, I’ve noticed many of them begin to stare off, their eyes listless and fixed somewhere far away. It’s as if they’re too tired to fight any longer.

What stays with me most are their parents—their worry, exhaustion, and disbelief at how quickly a mild illness can turn severe. One day their child has a fever or a cough, and the next, they are fighting for their life. The parents have done everything possible to reach care, often walking for hours or seeking traditional medicine. By the time they arrive, it’s sometimes too late. And in those moments, I never seem to find the right words for their parents. How do I tell a mother that her only child, the one she struggled for 10 years to conceive, is dying—and that there’s nothing more we can do? Those moments stay with you long after you leave the hospital.

How do you get parents on board with vaccination?  

Most parents I meet want the same thing as any parent anywhere: to keep their children healthy. The problem is rarely the refusal of vaccines; it’s access. Many families live far from clinics, face insecurity, or have missed vaccines because of conflict or funding gaps or not understanding the need. Some are hesitant because of misinformation or skepticism, but with time, listening, and explanation in their own language, trust grows quickly and they understand the value of vaccinating their child. These conversations remind me that vaccination isn’t just about science and medicine; it’s about communication, respect, and trust.

Is it concerning that governments across the world have reduced funding for vaccination? 

It’s deeply concerning because vaccination programs depend on consistent political and financial support. When that support stops, we quickly see the consequences: outbreaks of measles in over a hundred countries, the return of diphtheria in places where physicians haven’t ever seen it before in medical training, and even polio re-emerging in some areas.

Cutting vaccine funding isn’t just a local issue since diseases don’t respect borders. When wealthy nations pull back, it’s the poorest and most fragile communities that suffer first and most. It’s also incredibly short-sighted as vaccines are one of the best investments we can make. Every dollar spent on vaccination saves many more by preventing hospitalizations, long-term disability, and death.

Who is being hit the hardest by these political decisions to cut funds?

The hardest hit are children already living on the edge, like those caught in wars, living in refugee camps, displaced by crises, and those who are impoverished. More than half of unvaccinated children today live in conflict zones or humanitarian emergencies. These are children who already face hunger, unsafe water, and limited access to health care. Taking away vaccine support removes one of their last layers of protection. And when vaccination rates drop in these fragile settings, outbreaks overwhelm already-stretched health systems and can spread rapidly across borders. These political decisions—made in government offices and halls far away from the realities we see on the ground—have devastating consequences for the most vulnerable.

What can be done to prevent more deaths from vaccine-preventable diseases?

Gavi, the Vaccine Alliance, was set up more than 25 years ago to increase access to vaccines for the world's poorest countries. More than half of the vaccines that MSF uses in its projects come from ministries of health and are procured through Gavi. But now, Gavi is facing a $3 billion shortfall over the next five years. When the organization gathers this week to finalize funding decisions and set priorities for that period, its board members must step up and make sure vulnerable children all over the world are not forgotten.