Many different organizations were involved with immunizations brought together by The Task Force for Child Survival starting in 1984. But this coalition fell apart in the 1990s when the agency heads, who had been effective collaborators, turned over. They had to rebuild the coalition that had worked under the auspices of The Task Force.

One of the most challenging things for vaccinations is reaching those who live “at the end of the road”—those who are geographically isolated due to distance or living in hard to access regions. A well-functioning delivery system is one that reaches the patient at the point-of-care. Such a system is essential for adequate access to and availability of vaccines. But, while across Africa, governments and donors are investing billions of dollars to strengthen health systems and make affordable medicines available, government supply chains often struggle to get medicines and supplies through the last mile to the health facilities and to the people who need them most.