Supply, demand and use of economic evidence in vaccine policymaking in Africa: A scoping review

2026, Africa, Algeria, BCG, Benin, Burkina Faso, Burundi, Capacity building, Central African Republic, Chad, Cholera, Comoros, cost-effectiveness, Costing, DRC, Egypt, English, Enhancing the use of Economic Evidence in Vaccine Policy Making in Africa, Equatorial Guinea, ETEC, Ethiopia, Financing, Gabon, Gambia, Ghana, Global/multi-country, Guinea, Guinea-Bissau, Health technology assessment, Hepatitis, Hib, HIV, HPV, KEMRI-Wellcome Trust Research Programme, Kenya, Liberia, Libya, Lund University, Malaria, Malawi, Mali, Measles, Meningitis, Morocco, Mozambique, Niger, Nigeria, Peer reviewed article, Penta, Pneumococcal, Polio, Prioritization, Review, Rotavirus, Routine schedule, RSV, Rwanda, Senegal, Shigella, Somalia, South Africa, South Sudan, Tanzania, TB, Tunisia, Typhoid, Uganda, University of Oxford, University of Washington, University of Zambia, Wellcome Trust, Zambia, Zimbabwe

Home > Supply, demand and use of economic evidence in vaccine policymaking in Africa: A scoping review

This scoping review, published in PLOS Global Public Health, examines the availability of economic evaluation evidence for childhood vaccines in Africa and how such evidence is used in policy decision-making.

The review followed PRISMA ScR guidance and synthesized peer-reviewed literature published in English between 2000 and July 2025, identified through searches of Medline, Embase, Web of Science, Scopus and EconLit Complete.

A total of 140 articles were included, comprising 129 economic evaluation studies and 11 studies examining the use of economic evidence in decision-making.

Key findings and insights

The literature on the economics of childhood vaccination in Africa is growing but remains sparse and concentrated in a few countries, led by Kenya and Uganda, then Malawi. Publications rose from two studies in 2000–2005 to 43 in 2021–2025.
Cost-effectiveness analysis was the dominant method, accounting for 90 of the 129 economic evaluation studies, followed by costing studies. Most analyses were national-level, relied on secondary data or published literature, and reported DALYs averted.
HPV, rotavirus, pneumonia, malaria and measles were the most frequently studied disease areas. Among cost-effectiveness studies, rotavirus vaccine was evaluated most often, followed by HPV, pneumococcal, malaria and hepatitis B vaccines.
Most first and last authors were affiliated with institutions outside Africa, mainly in the United States and United Kingdom. The Gates Foundation, Gavi, PATH, Wellcome Trust and WHO each funded multiple studies.
Evidence on how economic evidence is used in African decision-making was limited. In the 11 studies examining its use, it mainly informed costing, planning, resource mobilisation and scale-up. Gaps in research and policy capacity, data availability and institutional linkages were key barriers.

How can the findings be used?

The review highlights the need to strengthen both the production of locally relevant economic evidence and the institutional capacity to interpret and apply it in vaccine policy. Its findings can inform efforts to strengthen economic evaluation capacity, improve links between researchers and decision-makers, and integrate cost-effectiveness, budget impact and other economic considerations more systematically into vaccine prioritization, introduction, financing and sustainability decisions.

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