April 2025 – April 2026

The Istanbul Call to Action
One Year After

In April 2025, Gavi, the Vaccine Alliance and the Global Health Advocacy Incubator (GHAI) convened 21 parliamentarians from 10 countries to a strategic forum in Türkiye's capital where they signed the Istanbul Call to Action for Immunization Financing. Here is what happened next.

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Countries
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Caucuses Launched
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MPs Now Engaged
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Vaccines save lives. It is the simplest equation in public health. Yet across Africa and Asia, the systems that deliver vaccines to children are under threat.

Global donor funding for immunization is declining. Countries that once received full support must shoulder more of the cost themselves. As nations transition from Gavi assistance, the share of vaccine costs covered by domestic budgets must grow. The question is stark: who pays when the donors scale back?

But a country is not an abstraction. It is legislators who interrogate national budgets. Health committee chairs who can question ministers. Elected officials who can turn political will into budget lines. This is the story of how 21 of them decided to act.

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14.5M
Zero-dose children worldwide who have never received a single vaccine
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8
Parliamentary immunization caucuses launched in one year to drive domestic financing
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Countries where MPs now lead the fight for domestic immunization financing
April 15-16, 2025

The Istanbul Moment

Twenty-one Members of Parliament from 10 countries gathered in Istanbul for a historic forum organized by Gavi and GHAI.

April 2025, Istanbul

The moment they signed

▶ Watch the Istanbul Forum Video on YouTube

The Five Commitments They Signed

Call on governments to rapidly adopt policies to mobilize domestic resources for immunization and primary health care

Urge governments to maintain and expand Gavi co-financing obligations and establish long-term sustainable financing mechanisms, including support for regional vaccine manufacturing

Call on international partners and donors to continue investing in immunization and support countries transitioning to domestic vaccine financing

Appeal to Gavi and partners to continue supporting civil society organizations and engage parliamentarians

Constitute an Africa-Asia Parliamentary Network to lead advocacy for increased domestic budget allocations for immunization

Read the Call to Action (English) Lire l'Appel (Français)
10 Countries. 8 Caucuses. Real Results.

One Year of Action

From the forum floor to the parliament floor. Here is what happened in each country.

☟ Click on each country tab below to see results

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Nigeria

Caucus Launched
13
MP champions in caucus
2x Bill
To double Basic Health Care Provision Fund
36
State health chairs engaged
VNDC
CSO partner driving advocacy

Nigeria delivered the most dramatic legislative action of any country in the network. Senator Ipalibo Harry Banigo, the caucus chair, championed a bill to double the Basic Health Care Provision Fund. It passed two Senate readings. The caucus organized a capacity strengthening summit that brought together health committee chairs from all 36 state assemblies.

The Vaccine Network for Disease Control (VNDC), GHAI's civil society partner in Nigeria, coordinated media advocacy that generated national coverage and supported the caucus throughout.

"Legislators are not just lawmakers. They are health champions whose decisions determine whether a child lives or dies."

Hon. Amos Magaji, Member, National Assembly, Nigeria

"We must also look within and strengthen our domestic resource mobilization, ensuring transparency and accountability so that every naira spent achieves its intended purpose."

Senator Ipalibo Harry Banigo, Chair, Parliamentary Immunization Caucus, Nigeria
Nigeria Parliamentary Immunization Caucus

Nigeria's Parliamentary Immunization Caucus

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Madagascar

Caucus Launched
15
MPs in Vaccination Coalition
131
Women mayors mobilized
HINA
CSO partner driving advocacy
WhatsApp
MPs coordinating via mobile

Madagascar's Parliamentary Vaccination Coalition is chaired by Hon. Rajaobelina Lova, president of the Health and Family Planning Committee. Even during a period of political transition, CSO and parliamentary champions ensured vaccines remained a priority. The coalition played a key role in enabling Gavi co-financing payments to continue uninterrupted.

When the Malagasy parliamentarians returned from Istanbul, their advocacy generated significant media coverage that raised the profile of immunization financing nationally. HINA, GHAI's civil society partner, supported caucus coordination and worked with journalists to sustain that momentum. The caucus used WhatsApp to organize MPs. A network of 131 women mayors became vocal advocates for immunization at the local level.

"59% of Madagascar's health financing comes from grants and loans. We must change this. Our children's health cannot depend on the generosity of others."

Hon. Fenohery, Member of Parliament, Madagascar
Madagascar Parliamentary Vaccination Coalition

Madagascar's Parliamentary Vaccination Coalition

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Zambia

Caucus Launched
19
MPs in immunization caucus
CDF
Constituency funds for health
CHAZ
CSO partner driving advocacy
1st
First caucus launched after Istanbul

Zambia was one of the first countries to launch its parliamentary immunization caucus after Istanbul. The caucus drove increases in both the national health budget and immunization-specific allocations. The Churches Health Association of Zambia (CHAZ), GHAI's civil society partner, supported the caucus formation and parliamentary engagement.

Hon. Christopher Kang'ombe championed an innovative approach: using Constituency Development Funds (CDF) for local immunization support. This model channels parliamentary constituency funds directly into health delivery and has drawn attention as a replicable financing mechanism across the network.

"This caucus broke party politics. We came together across party lines because children don't belong to political parties. Their health is everyone's responsibility."

Hon. Christopher Kang'ombe, Member of Parliament, Zambia
Hon Joseph Musanje with constituents discussing use of immunization funds

Immunization parliamentary champion Hon Joseph Musanje with constituents over use of funds

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Sierra Leone

Caucus Launched
27
MPs and officials engaged
2
MP champions leading caucus
Health Alert
CSO partner driving advocacy
MoH
Ministry held accountable

Sierra Leone's parliamentary immunization caucus is led by Hon. Bernadette Wuyatta Songa Lahai and Hon. Tamba Johnny. The caucus successfully advocated for immunization financing to be included in the national budget. The approved immunization budget increased significantly from 2025 to 2026.

Health Alert, GHAI's civil society partner in Sierra Leone, facilitated the caucus formation and generated media coverage in national newspapers including The Nationalist. The caucus immediately began holding the Ministry of Health accountable for immunization delivery targets.

Sierra Leone Parliamentary Immunization Caucus launch

Sierra Leone's Parliamentary Immunization Caucus

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Ghana

Caucus Launched
13
MP champions in caucus
Bipartisan
Cross-party caucus
HFFG
CSO partner driving advocacy
WHO
UNICEF collaboration

Ghana launched its parliamentary immunization caucus with a distinctive feature: it is explicitly bipartisan. MPs from the ruling party and opposition joined together, signaling that immunization financing transcends political competition. Hope for Future Generations (HFFG), GHAI's civil society partner in Ghana, supported the caucus formation.

The caucus collaborates directly with WHO and UNICEF country offices and is committed to advocating for immunization to be a "flagship priority" for the government.

Ghana Parliamentary Immunization Caucus launch

Ghana's bipartisan Parliamentary Immunization Caucus

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Kenya

Caucus Launched
16
MP champions in caucus
Health Ctte
Chair leads caucus effort
HENNET
CSO partner driving advocacy
Apr 29
2026 formal launch ceremony

Kenya's caucus was led by Hon. Kimani Kuria, chair of the Health Committee, and Hon. Irene Mayaka. The formal caucus launch ceremony is set for April 29, 2026. HENNET, GHAI's civil society partner in Kenya, supported parliamentary engagement and advocacy efforts.

Hon. Dr. James Nyikal, a medical doctor and MP, brought a deeply personal advocacy style. In parliament, he told the story of his household worker who left Kenya to seek vaccines in Uganda because they were unavailable locally. The story galvanized colleagues and made national news.

"My household worker left this country and went to Uganda to get her child vaccinated. That is the reality we are living with. We need our voices to be heard in the right place."

Hon. Dr. James Nyikal, Member of Parliament, Kenya
Kenya Parliamentary Immunization Caucus formation ceremony

Kenya Parliamentary Immunization Caucus formation ceremony, March 2026

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Côte d'Ivoire

Caucus Launched
15
Deputy champions in network
ASAPSU
CSO partner driving advocacy
1st
Dedicated vaccination caucus in parliament
Budget
Domestic vaccine cost share increased

Fifteen deputy champions form the parliamentary network, which is the first dedicated vaccination caucus in Côte d'Ivoire's parliamentary history. The government has significantly increased its domestic share of vaccination costs. ASAPSU, GHAI's civil society partner in Côte d'Ivoire, supported the parliamentary network formation.

"By June, the network should be official so that the voice of 15 MPs can be heard with the important point: increasing the budget allocated to vaccination."

Hon. Berni Naman, Member of Parliament, Côte d'Ivoire
Cote d'Ivoire Parliamentary Immunization Caucus

Côte d'Ivoire's Parliamentary Vaccination Network

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Cameroon

Caucus Launched
20
MPs in parliamentary forum
PM
Prime Minister directive issued
SAILD
CSO partner driving advocacy
CRTV
National TV coverage

Cameroon's parliamentary caucus was formed under the leadership of Hon. Ngo Issi, who returned from Istanbul and immediately began organizing. The Prime Minister issued a directive reinforcing the government's commitment to immunization financing.

SAILD, GHAI's civil society partner in Cameroon, supported legislative engagement that generated coverage on CRTV, Cameroon's national broadcaster.

Cameroon Parliamentary Immunization Forum

Cameroon's Parliamentary Forum on Immunization Financing

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Lao PDR

Caucus In Formation
34
Parliamentarians engaged
1st Line
Push to codify immunization in budget
HPA
CSO partner driving advocacy
Only
Asian country in the network

Laos is the only Asian country in the network. Two landmark parliamentary workshops in Thalath and Vang Vieng transformed general support into precise fiscal commitments. Parliamentary advocacy secured a government commitment to nearly double the immunization budget by 2027.

Parliamentarians are now pushing to codify immunization as a "first-line charge" in the national budget, which would make it non-discretionary spending. Hon. Bounta Thepphavong, chair of the Committee on Social and Cultural Affairs, leads the parliamentary effort. Health Poverty Action (HPA), GHAI's civil society partner in Laos, embedded CSO voices in immunization financing processes. The caucus formalization process is navigating a February 2026 parliament transition.

"Our role as parliamentarians is to ensure that the national budget reflects the real needs of the people. Vaccination is one of the most cost-effective investments we can make in human capital and national prosperity."

Hon. Bounta Thepphavong, Chair, Committee on Social and Cultural Affairs, Lao National Assembly
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Liberia

Caucus In Formation
15
Parliamentarians engaged
PHIL
CSO partner driving advocacy
Health
Budget significantly increased
Forming
Caucus launch in formation

Liberia delivered one of the most dramatic budget increases in the network. The immunization budget and the broader health budget both increased significantly following the Istanbul commitments.

Due to the advocacy work of MP champions after Istanbul, the Liberian government strengthened its commitment to immunization financing, clearing pending obligations and making advance commitments. Public Health Initiative Liberia (PHIL), GHAI's civil society partner, supported parliamentary advocacy and engagement.

The caucus launch is in formation. While formal structures are still developing, the results demonstrate that the Istanbul commitments translated immediately into action.

The Numbers

Impact at a Glance

One year of parliamentary advocacy produced measurable results across every country in the network.

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MPs now engaged across 10 countries (from 21 signatories)
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Parliamentary caucuses launched in one year
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CSO partners supporting the movement
2
Continents connected through the Africa-Asia Parliamentary Network
Parliamentary Champions by Country
MPs and parliamentarians engaged in immunization financing advocacy
🇱🇦 Laos
0
MPs engaged
🇸🇱 Sierra Leone
0
MPs engaged
🇨🇲 Cameroon
0
MPs engaged
🇿🇲 Zambia
0
MPs engaged
🇰🇪 Kenya
0
MPs engaged
🇨🇮 Côte d'Ivoire
0
MPs engaged
🇲🇬 Madagascar
0
MPs engaged
🇱🇷 Liberia
0
MPs engaged
🇳🇬 Nigeria
0
MPs engaged
🇬🇭 Ghana
0
MPs engaged
Parliamentary Champions in Action
Kenya's Parliamentary Immunization Caucus formation ceremony, March 2026
Kenya Parliamentary Immunization Caucus formation ceremony
Caucus Launch Timeline
From the Istanbul forum to parliamentary action across two continents
Dec 2024🇿🇲 Zambia constitutes first MP caucus with GHAI/CHAZ support
2025🇲🇬 Madagascar Parliamentary Vaccination Coalition
2025🇳🇬 Nigeria Parliamentary Immunization Caucus
2025🇸🇱 Sierra Leone Parliamentary Caucus
2025🇨🇲 Cameroon Parliamentary Forum on Immunization
2026🇬🇭 Ghana Bipartisan Immunization Caucus
2026🇰🇪 Kenya Parliamentary Caucus (formal launch Apr 29)
2026🇨🇮 Côte d'Ivoire Parliamentary Vaccination Network
Coming🇱🇦 Laos & 🇱🇷 Liberia finalizing formation
In Their Own Words

Voices of the Movement

Parliamentarians from 10 countries driving immunization financing across two continents.

“Since we got back from Istanbul, it’s not business as usual. We are pushing for a dedicated immunization budget line at the federal and state levels.”

Hon. Amos Magaji
Hon. Amos Magaji
Member, National Assembly, Nigeria

“We must strengthen our domestic resource mobilization for immunization. We cannot continue to depend on external support forever.”

Senator Ipalibo Harry Banigo
Senator Ipalibo Harry Banigo
Senator, National Assembly, Nigeria

“My household worker left this country and went to Uganda to get her child vaccinated. That is the reality we are living with. It’s humanly possible to fix this.”

Hon. Dr. James Nyikal
Hon. Dr. James Nyikal
Member of Parliament, Kenya

“This caucus broke party politics. We came together across party lines because children don’t belong to political parties. Their health is everyone’s responsibility.”

Hon. Christopher Kang’ombe
Hon. Christopher Kang’ombe
Member of Parliament, Zambia

“This parliamentary network on immunization is the first of its kind in Côte d’Ivoire. We are writing history.”

Hon. Berni Naman
Hon. Berni Naman
Member of Parliament, Côte d’Ivoire

“59% of Madagascar’s health financing comes from grants and loans. That is not sustainable. Parliament must act to increase domestic investment in health.”

Hon. Nirina Fenohery
Hon. Nirina Fenohery
Member of Parliament, Madagascar

“Immunization must be a flagship priority for this parliament. We owe it to every Ghanaian child to ensure no one is left behind because of where they were born.”

Hon. Charles Agbeve
Hon. Charles Agbeve
Member of Parliament, Ghana

“Our role as parliamentarians is to ensure that the national budget reflects the real needs of the people. Vaccination is one of the most cost-effective investments we can make.”

Hon. Bounta Thepphavong
Hon. Bounta Thepphavong
Chair, Committee on Social and Cultural Affairs, Lao National Assembly

“You know how many Cameroonians are dying of malaria or polio or other preventable diseases? Parliamentarians must lead on this.”

Hon. Tabot Lawson Bakia
Hon. Tabot Lawson Bakia
Member of Parliament, Cameroon

“We don’t just want to form the caucus and have it lying about. We want to be active. We want to push legislation. We want results.”

Hon. Bernadette Wuyatta Songa
Hon. Bernadette Wuyatta Songa
Member of Parliament, Sierra Leone

“Underinvestment weakens service delivery. If we don’t fund immunization properly, we are failing our children and our future.”

Hon. Julie Fartoma Wiah
Hon. Julie Fartoma Wiah
Member of Parliament, Liberia
Looking Ahead

The Road from Here

The Istanbul Call to Action set something in motion that no single event could contain. Eight caucuses in one year. 187 MPs engaged across two continents. Ten civil society partners driving advocacy on the ground. A movement that grew from 21 signatories to a network spanning Africa and Asia.

The work ahead is clear. Countries must continue increasing their domestic share of vaccine financing as they transition from donor support. Two more countries need caucuses launched. The Africa-Asia Parliamentary Network needs to convene and strengthen its collective voice. Every budget gain made this year must be defended in the next cycle.

What Istanbul proved is that when parliamentarians commit, budgets move. When civil society organizations equip them with evidence, politics yields to public health. The movement is no longer a promise. It is a record.

Learn More About GHAI's Work Learn More About Gavi's Work
Questions & Answers

Understanding the Movement

The Istanbul Parliamentary Call to Action was signed on April 15-16, 2025 by 21 Members of Parliament from 10 countries at a forum organized by Gavi, the Vaccine Alliance and the Global Health Advocacy Incubator (GHAI). The parliamentarians committed to mobilize domestic resources for immunization, maintain Gavi co-financing obligations, support the Gavi 6.0 program for 2026-2030, engage civil society and constitute the Africa-Asia Parliamentary Network for immunization financing advocacy.
Countries are mobilizing domestic resources through parliamentary advocacy. In the year following the Istanbul Call to Action, 187 MPs across 10 countries are engaged in immunization financing advocacy. Countries with active caucuses saw significant increases in domestic immunization budgets. Parliamentary immunization caucuses in 8 countries now provide legislative oversight and hold governments accountable.
Parliamentarians serve as budget gatekeepers and policy champions. Through immunization caucuses, MPs advocate for increased domestic allocations, conduct oversight of health spending, question ministers on immunization gaps and use their legislative authority to influence national budgets. In Nigeria, Senator Banigo championed a bill to double the Basic Health Care Provision Fund. In Kenya, Hon. Kimani Kuria led formation of a bipartisan caucus. In Zambia, Hon. Kang'ombe pioneered using Constituency Development Funds for local immunization support.
African countries are preparing through parliamentary advocacy for increased domestic health budgets, establishing immunization caucuses for legislative oversight and developing sustainable financing mechanisms. Côte d'Ivoire significantly increased its domestic share of vaccination costs. Zambia's health budget grew substantially. Laos secured commitments to nearly double its immunization budget by 2027 and is advocating to codify immunization as a "first-line charge" in the national budget.
CSOs supported by GHAI conduct budget analysis, train parliamentarians, facilitate caucus formation, generate media coverage and engage communities. GHAI partners with 10 CSOs across the network: VNDC (Nigeria), HINA (Madagascar), CHAZ (Zambia), Health Alert (Sierra Leone), HFFG (Ghana), HENNET (Kenya), ASAPSU (Côte d'Ivoire), SAILD (Cameroon), Health Poverty Action (Laos) and PHIL (Liberia). In Nigeria, VNDC supported a 13-member caucus. In Madagascar, HINA mobilized 131 women mayors. In Laos, HPA embedded CSO voices in immunization financing processes.
Highly effective. In one year, 8 caucuses launched and the movement grew from 21 original signatories to 187 MPs engaged. Countries with active caucuses saw significant increases in domestic immunization financing. Caucuses provide structured mechanisms for MPs to question ministers, review budgets and ensure accountability for immunization delivery.
A cross-continental coalition of parliamentarians from 10 countries (9 African and 1 Asian) formed at the Istanbul forum. It connects MPs from Cameroon, Côte d'Ivoire, Ghana, Kenya, Laos, Liberia, Madagascar, Nigeria, Sierra Leone and Zambia to share advocacy strategies, coordinate legislative action and amplify their collective voice for domestic resource mobilization for immunization.
The Global Health Advocacy Incubator partners with CSOs in 10 countries, facilitates parliamentary engagement, organizes forums like the Istanbul Call to Action, provides technical assistance for budget advocacy and supports caucus formation. GHAI's approach combines legislative engagement with media advocacy, evidence-based policy briefs, podcast storytelling and community mobilization to create sustained political will for domestic immunization financing.
Gavi, the Vaccine Alliance is a global partnership that helps lower-income countries access and finance vaccines. Since 2000, Gavi has helped immunize over 1 billion children and prevented more than 17 million deaths. Gavi co-finances vaccine procurement with national governments, requiring countries to gradually increase their share as their economies grow. This co-financing model builds domestic ownership and prepares countries for full self-financing. As countries transition from Gavi support, they must increase domestic financing for vaccines. Gavi also supports health system strengthening, cold chain infrastructure and new vaccine introductions. The Istanbul Call to Action was co-organized by Gavi and GHAI to mobilize parliamentary support for these goals across Africa and Asia.