Hafsa Zia

59628039200

Publications - 2

Global, regional, and national trends in routine childhood vaccination coverage from 1980 to 2023 with forecasts to 2030: a systematic analysis for the Global Burden of Disease Study 2023

Catherine Bisignano Ashley A. Harris Amanda E. Smith Paulina A. Lindstedt Simeon Okechukwu Ajakwe Olivia D. Nesbit Taylor Noyes Noga Shalev Latera Tesfaye Olana Catherine M. Antony Nancy Fullman Sharareh Eskandarieh Mushood Ahmed Naveed Ahmed Rana Kamal Abu Farha Kamoru Ademola Adedokun Nurudeen A. Adegoke Aanuoluwapo Adeyimika Afolabi Giuseppina Affinito Dolapo Emmanuel Ajala Reed J.D. Sorensen Eman Abu-Gharbieh Chun Wei Yuan Stein Emil Vollset Stephen S. Lim Jonathan F. Mosser Andy Stergachis Farbod Khosravi Sonali Kochhar Armita Abedi Usha Adiga Mitra Abbasifard Mohammad Amin Aalipour Faezeh Abbaspour Tomislav Mestrovic Ripon Kumar Adhikary Aqeel Ahmad Dariush Abtahi Mohd Adnan Simon I. Hay Abdollah Jafarzadeh Hana J. Abukhadijah Danish Ahmad Amin Sharifan Rotimi Felix Afolabi Saira Afzal Emad M. Abdallah Samar Abd Elhafeez Meqdad Saleh Ahmed Muktar Beshir Ahmed Syed Anees Ahmed Suneth Buddhika Agampodi Khurshid Ahmad Tauseef Ahmad Sepehr Aghajanian Ayman Ahmed Ramy Mohamed Ghazy Meriem Abdoun Salahdein Aburuz Lucas Guimarães Abreu Alireza Shakeri Sam Byrne Qorinah Estiningtyas Sakilah Adnani Emily Haeuser Jason Nguyen Catalina Raggi Susan A. McLaughlin Rana Kamal Abu Farha Dmitry Abramov Hedayat Abbastabar Sherief Abd-Elsalam Adam Abdullahi Faezeh Abbaspour Reda Abdel-Hameed Samar Abd ElHafeez Atef Abdelkader Deldar Morad Abdulah Haroon Ahmed Lisa C. Adams Constanza Elizabeth Aguilera Arriagada Mahsa Ahadi Rabbiya Ahmad Shoaib Ahmad Toufik Abdul-Rahman Asrat Agalu Abejew Abdu A. Adamu Juliana Bunmi Adetunji Kulmira Abdykerimova Rahim Abo Kasem Mohamed Abouzid Roberto Ariel Abeldaño Zuñiga Anirudh Balakrishna Acharya Juan Manuel Acuna Meshack Achore Ousman Adal Habeeb Abiodun Afolabi Arman Abdous Hasan Aalruz Auwal Abdullahi Bilyaminu Abubakar David Adedia Syed Hani Abidi Hassan Abolhassani Olumide Abiodun Richard Gyan Aboagye Ulric Sena Abonie Abdullahi Tunde Aborode Wakgari Mosisa Abdisa Oyelola A. Adegboye Mohammad Mahdi Bastan Dhiraj Motilal Agarwal Tajudeen Adesanmi Adebisi Oluwatobi E. Adegbile Olumide Thomas Adeleke Leticia Akua Adzigbli Hafsa Zia Gizachew Taddesse Akalu Molalegne Bitew Mache Tsadik Adhana Feven Sahle Gebre Alireza Mirkheshti Sohrab Salimi Seyed Mohammad Seyed Alshohadaei Jiawei He Prince Owusu Adoma Dorsa Salabat Mohamed Jalloh Vafa Rahimi-Movaghar Sina Shool Melika Jameie Jafar Karami Farzad Kompani Mohammad Ali Mansournia Abdolreza Mohammadi Amin Mohsenzadeh Aleksandr Y. Aravkin Omid Dadras Iman M. Talaat Ali H. Mokdad Xiaochen Dai Lalit Dandona Rakhi Dandona Fereshteh Baghizadeh Mahdis Bayat Minoo Heidari Almasi Ali Asghar Kolahi Ali Nikoobar Mohammad Mahdi Rashidi Firoozeh Madadi Mehdi Safari Mastooreh Sagharichi Maryam Shayan Zahra Siavashpour Mohsen Rezaeian Shakiba Ghasemi Assl Atakan Orscelik Yigit Can Senol Michael Zastrozhin Amin Azizan Nazila Rezaei Pegah Salimi Pormehr Amin Sedigh Farshad Shahkarami Kazem Ghaffari Georgia Smith Samuel James Herold Annie Haakenstad Christopher J.L. Murray Hannah Elizabeth Robinson-Oden Ghazal Arjmand Mahsa Asadi Anar Rasoul Ebrahimi Seyed Ataollah Madinezad Behnaz Niroomand Seyed Kiarash Sadat Rafiei Sara Bagheri Antonio Olivas-Martinez Williams Agyemang-Duah Nagah M. Abourashed

Publication Name: Lancet

Publication Date: 2025-07-19

Volume: 406

Issue: 10500

Page Range: 235-260

Description:

Background: Since its inception in 1974, the Essential Programme on Immunization (EPI) has achieved remarkable success, averting the deaths of an estimated 154 million children worldwide through routine childhood vaccination. However, more recent decades have seen persistent coverage inequities and stagnating progress, which have been further amplified by the COVID-19 pandemic. In 2019, WHO set ambitious goals for improving vaccine coverage globally through the Immunization Agenda 2030 (IA2030). Now halfway through the decade, understanding past and recent coverage trends can help inform and reorient strategies for approaching these aims in the next 5 years. Methods: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2023, this study provides updated global, regional, and national estimates of routine childhood vaccine coverage from 1980 to 2023 for 204 countries and territories for 11 vaccine-dose combinations recommended by WHO for all children globally. Employing advanced modelling techniques, this analysis accounts for data biases and heterogeneity and integrates new methodologies to model vaccine scale-up and COVID-19 pandemic-related disruptions. To contextualise historic coverage trends and gains still needed to achieve the IA2030 coverage targets, we supplement these results with several secondary analyses: (1) we assess the effect of the COVID-19 pandemic on vaccine coverage; (2) we forecast coverage of select life-course vaccines up to 2030; and (3) we analyse progress needed to reduce the number of zero-dose children by half between 2023 and 2030. Findings: Overall, global coverage for the original EPI vaccines against diphtheria, tetanus, and pertussis (first dose [DTP1] and third dose [DTP3]), measles (MCV1), polio (Pol3), and tuberculosis (BCG) nearly doubled from 1980 to 2023. However, this long-term trend masks recent challenges. Coverage gains slowed between 2010 and 2019 in many countries and territories, including declines in 21 of 36 high-income countries and territories for at least one of these vaccine doses (excluding BCG, which has been removed from routine immunisation schedules in some countries and territories). The COVID-19 pandemic exacerbated these challenges, with global rates for these vaccines declining sharply since 2020, and still not returning to pre-COVID-19 pandemic levels as of 2023. Coverage for newer vaccines developed and introduced in more recent years, such as immunisations against pneumococcal disease (PCV3) and rotavirus (complete series; RotaC) and a second dose of the measles vaccine (MCV2), saw continued increases globally during the COVID-19 pandemic due to ongoing introductions and scale-ups, but at slower rates than expected in the absence of the pandemic. Forecasts to 2030 for DTP3, PCV3, and MCV2 suggest that only DTP3 would reach the IA2030 target of 90% global coverage, and only under an optimistic scenario. The number of zero-dose children, proxied as children younger than 1 year who do not receive DTP1, decreased by 74·9% (95% uncertainty interval 72·1–77·3) globally between 1980 and 2019, with most of those declines reached during the 1980s and the 2000s. After 2019, counts of zero-dose children rose to a COVID 19-era peak of 18·6 million (17·6–20·0) in 2021. Most zero-dose children remain concentrated in conflict-affected regions and those with various constraints on resources available to put towards vaccination services, particularly sub-Saharan Africa. As of 2023, more than 50% of the 15·7 million (14·6–17·0) global zero-dose children resided in just eight countries (Nigeria, India, Democratic Republic of the Congo, Ethiopia, Somalia, Sudan, Indonesia, and Brazil), emphasising persistent inequities. Interpretation: Our estimates of current vaccine coverage and forecasts to 2030 suggest that achieving IA2030 targets, such as halving zero-dose children compared with 2019 levels and reaching 90% global coverage for life-course vaccines DTP3, PCV3, and MCV2, will require accelerated progress. Substantial increases in coverage are necessary in many countries and territories, with those in sub-Saharan Africa and south Asia facing the greatest challenges. Recent declines will need to be reversed to restore previous coverage levels in Latin America and the Caribbean, especially for DTP1, DTP3, and Pol3. These findings underscore the crucial need for targeted, equitable immunisation strategies. Strengthening primary health-care systems, addressing vaccine misinformation and hesitancy, and adapting to local contexts are essential to advancing coverage. COVID-19 pandemic recovery efforts, such as WHO's Big Catch-Up, as well as efforts to bolster routine services must prioritise reaching marginalised populations and target subnational geographies to regain lost ground and achieve global immunisation goals. Funding: The Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance.

Open Access: Yes

DOI: 10.1016/S0140-6736(25)01037-2

Mapping drivers of life expectancy change in Asia from 1990 to 2023

Bhaskaran Unnikrishnan Balachandar Vellingiri Dinesh Upadhya Ahmed Bilal Waqar Kazumasa Yamagishi Zhiyong Zou Y. Waheed Suowen Xu Abdul Rohim Tualeka Liqun Zhang Dakshitha Praneeth Wickramasinghe Ingan Ukur Tarigan Manoj Tanwar Ghazala Yunus Nuwan Darshana Wickramasinghe Lishun Xiao Yong Yu Dehui Yin Galal Yahya Karn Wijarnpreecha Saba Tariq Yunquan Zhang Shoban Babu Varthya Muhammad Umair Marcos Roberto Tovani-Palone Narayanaswamy Venketasubramanian Srikanth Umakanthan Gary Tse Haiqiang Yao Dong Keon Yon Amir Yarahmadi Xiaoyi Zhang Jibrin Sammani Usman Pascual R. Valdez Pengpeng Ye Ramna Thakur Anggi Lukman Wicaksana Naohiro Yonemoto Stefanos Tyrovolas Chuanhua Yu Bach Xuan Tran Mario Valenti Hong Xiao Yen Jun Wong Shu Wang Saeed Ullah Haosu Tang Nikhil Kenny Thomas Fei Long Wei Sojit Tomo Md Ismail Tareque Sok Cin Tye Reem Temsah Ghazal Zoghi Masayuki Teramoto Jay Tewari Mohammed Zuber Joe Varghese Angga Wilandika Jose M. Valderas Zhiqiang Zhang Abzal Zhumagaliuly Thang Huu Tran Nguyen Kieu Viet-Nhi Manish Vinayak Asokan Govindaraj Vaithinathan Magdalena Zielińska Asokan Govindaraj Vaithinathan Dongmiao Zhang Salih Mustafa Zebari Siyan Yi Jansje Henny Vera Ticoalu Muhammad Waqas Munkhtuya Tumurkhuu Quynh Thuy Huong Tran Jef Van den Eynde Yanzhong Wang Xiaoyue Xu Madi Tleshev Hafsa Zia Wanqing Xie Mingyang Xue Yuichiro Yano Claire Chenwen Zhong Zhijia Xia Jae Il Shin Gary Tse Yuichi Yasufuku Rekha Thapar Mohammed G. M Zeariya Claire Chenwen Zhong Dongmiao Zhang Nguyen Tran Minh Duc Casper J. P Zhang Ruixuan Wang Era Upadhyay Nicholas Steel Simona Villani Robert G. Weintraub Manjari Tripathi Simon I. Hay Paul Yip Mukesh Kumar Yadav Nihal Thomas

Publication Name: Nature

Publication Date: 2026-01-01

Volume: Unknown

Issue: Unknown

Page Range: Unknown

Description:

Life expectancy is a key indicator of population health and an important guide for health policy1,2. Although Asia represents approximately 60% of the global population, studies of longitudinal trends in life expectancy and their underlying drivers across Asian countries remain limited, with most previous research focused on western or high-income settings3, 4, 5–6. Here we provide a comprehensive analysis of life expectancy, cause-specific mortality and risk factors in 1990–2023 across 34 Asian countries and territories, utilizing data from the Global Burden of Disease Study 20231,7. Life expectancy increased in all countries and territories between 1990 and 2023, with the largest annual gains observed in South Asia and the smallest annual gains in high-income Asia Pacific countries and territories. Reductions in cardiovascular disease mortality were the primary contributors to life expectancy gains in Central Asia, East Asia and high-income Asia Pacific, whereas declines in diarrhoeal diseases and tuberculosis contributed most in South and Southeast Asia. In 2019–2023, life expectancy declined in several Asian regions, largely driven by the COVID-19 pandemic, with a nearly two-year loss in the first year of the pandemic. The causes of changes in life expectancy and the contributing risk factors varied across regions and countries/territories. Therefore, under the principles of proportional universalism, proactive and effective policies at both regional and national levels are essential to reduce premature mortality and reduce life expectancy inequalities across Asia.

Open Access: Yes

DOI: 10.1038/s41586-026-10739-6