East Timor, also known as Timor-Leste, shares its island with Indonesia in Southeast Asia. Despite possessing substantial oil and gas reserves, the European Commission classifies it as a Least Developed Country due to insufficient infrastructure and frequent food insecurity. The majority of Timor-Leste’s population relies on small-scale agriculture in rural areas, complicating vaccination efforts due to challenges in reaching these communities. Nevertheless, the country has made significant progress in immunizing its population against common, once-life-threatening diseases like polio and smallpox.

Challenges to Immunization in Timor-Leste

In East Timor, 75% of the population engages in small-scale farming in rural areas, making vaccination efforts challenging due to the sparse distribution of communities. The lack of robust infrastructure—from transportation to educational facilities—further complicates immunization initiatives. The COVID-19 pandemic significantly disrupted education, affecting 45% of East Timorese children. Moreover, the country’s inadequate infrastructure has left many areas difficult to access, hindering widespread vaccination coverage. Consequently, 8% of children in East Timor are ‘zero dose children,’ meaning they have not received any vaccinations. This issue was intensified by school closures in 2020 during the pandemic.

Vaccination Efforts

The East Timorese government boasts a commendable record of vaccination achievements. In the 1980s, it successfully eradicated smallpox, followed by polio in the 1990s, diseases from which Timor-Leste remains free currently. More recently, the country eliminated measles in 2018 and rubella in 2023. Health care workers, including WHO consultants, have been pivotal in ensuring comprehensive immunization coverage. They often conduct door-to-door visits in communities to administer vaccines directly to children who have not been previously immunized. Many children in Timor-Leste miss vaccinations because community health centers are kilometers away, requiring parents to take time off work—a luxury many cannot afford. This approach effectively reduces the logistical burden on parents and ensures children receive essential life-saving vaccines.

HPV Vaccinations

Timor-Leste introduced the HPV vaccine in July 2024, marking a significant achievement in public health. The Ministry of Health, in collaboration with WHO, UNICEF and other organizations, efficiently managed the vaccine rollout. By the 23rd of Sept., just three weeks into the program, health care workers had vaccinated 90% of the target population of school-aged girls, totaling 56,350 out of the 62,000 targeted. The HPV vaccine is crucial for preventing cervical cancer by protecting against various types of human papillomavirus. In addition to administering the vaccine, health care workers also engaged in community education efforts to emphasize the importance of vaccinations for eradicating cervical cancer in Timor-Leste.

A Bright Future

Timor-Leste has made remarkable progress in vaccination, despite its status as a Least Developed Country struggling with poor infrastructure and connectivity. Effective leadership has enabled widespread immunization, significantly improving the health of the East Timorese people. With continued efforts from the government and support from organizations like WHO and UNICEF, Timor-Leste is well-positioned to enhance the well-being and happiness of its citizens.

– Callum Bennett

Callum is based in Colchester, Essex, UK and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr