Developing country governments join GAVI Alliance in "co-financing" scheme to immunise poor children
Geneva, 15 May 2007 - The GAVI Alliance and the World Health Organization announced today that the governments of Guyana, Ghana, and four of Africa's poorest nations, Madagascar, Malawi, Tanzania and Zambia, have begun to help pay the cost of providing new vaccines to their children. And they have done so more than a year before the Alliance would have required it as part of a new funding cycle. For their advanced contributions to the "co-financing" of vaccines, and for putting immunisation on the forefront of their development priorities, the five African countries and the South American nation of Guyana will be recognized during a special ceremony in the course of the World Health Assembly, currently meeting in Geneva.
GAVI Executive Secretary Julian Lob-Levyt congratulated representatives of the six nations on their contributions, noting that the Alliance is now encouraging countries to prepare for progressive national ownership of vaccination programmes. Four of the six nations to be honored today are among the "least-developed" countries, with a per capita income of less than US$1000 dollars a year and low levels of economic and social development.
"Today these six nations are demonstrating their foresight and leadership in immunisation financing." Lob-Levyt said. "These countries should be recognized for placing a priority on long-term sustainability to ensure the health of future generations."Lob-Levyt noted that countries such as Guyana, Ghana and Tanzania first started contributing to the cost of vaccines three to four years ago, then gradually increased their payments over time. .
"Ghana began in 2003, paying 15 percent; in 2006 the government's contribution surpassed 55 percent," Lob-Levyt said. "Guyana started paying 20 percent in 2004. By end 2006, the country was covering the entire cost of its programme."
"If something is free, no one really values it. The payment has helped to underline the value of immunisation at all levels, including the government," said Dr. Randriamanalina Bakolalao, Manager of Madagascar's Expanded Programme on Immunisation. Commenting on the co-financing scheme, she added: "This has helped understanding and ownership of the immunisation programme to increase dramatically."
Madagascar, one of the world's poorest countries, in 2006 paid 16 percent of the US$ 2,201,000 cost of a tetravalent vaccine, a combination vaccine that protects against diphtheria, tetanus and pertussis and hepatitis B (DTPHepB) Madagascar has an estimated birth cohort of about 555,000*.
Guyana covered the full cost of the pentavalent vaccine in 2006, the fifth year of GAVI support, and a year in which the country could have received full funding for purchase of the vaccine. The pentavalent vaccine contains the same antigens as the tetravalent vaccine, but also protects against Haemophilus influenzae type b. With an annual birth cohort of approximately 15,000, Guyana succeeded in immunising more than 14,800 children in 2006 against Hib, HepB, and diphtheria, tetanus and pertussis.
Malawi, another nation in the "least developed" group, immunised 534,000 children in 2006. It has an estimated birth cohort of about 555,000*. The government covered 9 percent of the US$10,340,000 cost of the pentavalent vaccine used to immunise the children born that year.
Tanzania: Since GAVI began supporting immunisation programmes in Tanzania, the under-five mortality rate has declined from 141 to 126, and coverage with basic vaccines has increased from 79 percent in 2000 to 90 percent in 2005. Coverage with DTP HepB vaccine in 2005 was 90 percent. Tanzania has started paying for the purchase of the tetravalent vaccine, contributing 1,212,000 doses in 2005, and 1,655,000 doses in 2006.
Zambia has increased the number of children vaccinated each year for the past 4 years. In 2005, 16,797 additional children were vaccinated with pentavalent vaccine than in 2004 (515,936 compared to 499,139 in 2004). The coverage achieved in 2004 was 94%. Zambia covered 14 percent of the cost of the pentavalent vaccine in 2006, costing the government a total of US$US$7,776,000.
Ghana, classified as one of the "intermediate country group," provided 56 percent of the US$11.337 million it cost to purchase its store of the pentavalent vaccine in 2006. In addition, the government covered 70 percent of the US$1,304,500 needed to buy the country's supply of vaccines against yellow fever.
"Ghana has in place strategies to increase financial sustainability," Lob-Levyt noted. "Those strategies include building close ties between the ministries of health and finance, and ensuring that immunisation becomes part of the poverty reduction strategy plan. The cost of vaccines becomes part of the Ministry of Health's procurement plan each year."
Speaking at the award ceremony, Lob-Levyt noted that the experience of these first six nations will be invaluable to GAVI and the other nations, as the Alliance begins to implement its co-financing policies. "It will be critical to engage the support of governments, particularly Ministries of Finance and national Parliaments. If vaccination programmes have the buy-in of a broad range of stake-holders, it is much more likely that long term funding for this public good will be sustained", he concluded.