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

Economic evaluation offers policy makers a valuable tool for optimizing the use scarce healthcare resources. This scoping review aims to describe the existing scientific literature on economic evaluation and budget impact analysis of vaccine interventions, and the use of economic evidence in Africa. It highlights the current landscape and the challenges in using economic data to support vaccine policy on the continent. This study adapted and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We included peer-reviewed studies published in English between January 2000 and July 2025 that reported on cost and economic evaluations of vaccines administered to children and youth, or on the use of economic evidence for policy decision-making in Africa. A literature search was conducted across five electronic databases: Medline, Embase, Web of Science, and Scopus. The search yielded 4037 articles in total after deduction of duplication. A total of 140 articles were included in the study following title, abstract screening and full text review. The review identified a sparse but growing literature of economic evaluations related to vaccine interventions in Africa. Only a handful of countries are represented in the articles published, implying a very low production of (and likely a low demand for) economic evaluation evidence. Authorship of the articles is led mostly by researchers from institutions based outside Africa, mostly in North America and Europe. Funding of studies is mostly by Gates Foundation, Gavi, PATH, Wellcome Trust and World Health Organisation. Production and use of economic evaluation for vaccine policy in Africa have been hampered by capacity limitations in both research and policy institutions on the continent. The use of the evidence in decision making is limited. In the sphere of vaccine policy, economic evaluation is still a fledging enterprise requiring more investment.