Five African countries have agreed on concrete measures to strengthen immunisation systems and reduce the number of children who have not received any routine vaccines, known as zero-dose children.Delegations from Senegal, Côte d’Ivoire, Gabon, Djibouti and The Gambia participated in a four-day regional benchmarking mission in Dakar, Senegal, from September 29 to October 2, 2026.Organised by Galien Africa in collaboration with Senegal’s Ministry of Health and Public Hygiene, the mission brought together representatives from the five countries, alongside academic, technical and financial partners including the World Health Organisation (WHO), UNICEF, Institut Pasteur de Dakar and the Gates Foundation.The initiative forms part of a regional effort launched during the Ministerial Dinner held on the sidelines of the 2025 Galien Forum Africa, with the goal of using peer learning to accelerate immunisation and sustainably reduce the number of zero-dose children.After four days of experience-sharing, field visits, analysis and joint planning, the five countries adopted national mini-roadmaps and identified common priorities for regional cooperation.Learning from each otherThe delegations first shared their respective challenges, innovations and good practices in immunisation and efforts to reach zero-dose children.They then visited Senegal’s Directorate of Prevention and Immunisation Division, as well as the Dakar Centre health district, to observe approaches to vaccine stock management, cold-chain monitoring, equipment management and vaccine distribution.The visits also highlighted the importance of human support in digital transformation. Following hands-on coaching, the proportion of active users of the Tracker system increased from 50 per cent to more than 90 per cent.At the Dakar Centre, mobile immunisation interventions conducted between 4:00 pm and 8:00 pm demonstrated how vaccination services can be adapted to the realities and schedules of families.Participants also examined community-based approaches such as the “Young Girls’ Round”, which uses peer engagement and trust to strengthen acceptance of HPV vaccination.Discussions during the final two days focused on how successful approaches could be adapted and scaled up within the different national contexts.Key issues included domestic and local financing, innovative resource mobilisation, community participation, reaching mobile and cross-border populations, and the professionalisation, motivation and financing of community health workers.Country-specific commitmentsSenegal, as host of the first regional mission, shared its experience in digitalisation, individual tracking of children and optimisation of vaccine distribution.Its roadmap includes advancing platform interoperability, expanding the individual vaccination registry, sustaining the OPTIVAC model through domestic financing, disseminating the EPI Good Practices Manual and strengthening the mapping of zero-dose children.Côte d’Ivoire highlighted its experience of working with pharmacies and private clinics to provide immunisation services.The country plans to strengthen integrated individual tracking, develop differentiated services adapted to community realities, mobilise more domestic and private resources, and consolidate multisectoral mechanisms for verifying vaccination status and providing catch-up vaccination.Gabon shared its experience in expanding community vaccination sites and its commitment to public financing.Its next steps include the progressive institutionalisation of “push” distribution, daily cold-chain monitoring, supportive supervision and remote coaching, the introduction of an individual registry and stronger domestic financing.The Gambia brought experience in combining geographic and immunisation data to better identify and trace zero-dose children.The country intends to strengthen its electronic system for tracking children lost to follow-up, increase domestic financing, consolidate the role of community health workers and improve access to immunisation in underserved areas.Djibouti contributed approaches targeting nomadic, mobile and cross-border populations, including the “vaccino-dromadaire”, or camel-based vaccine delivery, and the “Health Shield” initiative.Its plans include developing an electronic registry with a unique identifier, establishing a dedicated last-mile budget line, strengthening arrangements in border areas and creating a formal status for nomadic community health relays.Regional cooperationThe mission also identified areas where the countries can learn from one another.Gabon, Côte d’Ivoire and The Gambia expressed interest in Senegal’s experience with digital tools, while Senegal intends to draw on The Gambia’s approach to mapping zero-dose children.Gabon also offered to share its cold-chain maintenance manual once it has been validated.To sustain the commitments, a common regional matrix will be developed to document actions, responsible parties and indicators.A three-month review will assess implementation, while a six-month review will examine the impact of the measures on identifying zero-dose children, improving access to immunisation services and ensuring that children are vaccinated.Overall, the initiative is intended to transform regional benchmarking from a platform for simply sharing experiences into a practical mechanism for peer learning and adapting proven solutions to different national contexts.At the close of the four-day mission, the participating countries shared a common measure of success: the number of additional children effectively identified, reached, vaccinated and retained in the immunisation pathway.The five delegations identified 21 priority actions, with digital individual tracking of children and stronger domestic financing emerging as priorities across all the national roadmaps.