According to the federal Minister of Health, Prof. Isaac Adewole, Nigeria would need $738 million in vaccines procurement for the period spanning 2014 to 2018. The Nigeria National Immunisation programme for the year 2017 is somewhat behind us now, but how successful was its implementation remains the question on the lips of health watchers. In order to ascertain the extent of this, a data analysis was made public by Africa Health Budget Network in collaboration with Community Health and Research Initiative, Nigeria.
Thus taking into consideration all the necessarily indices, a scorecard was developed from secondary analysis of the 2017 appropriation act and relevant national surveys and reports including formal presentations during workshops and seminars with government officials. Experts’ opinion has been that the national programme on immunisation has for ages been bugged by so many factors leading to the persistent scourge of preventable diseases especially childhood diseases.
Experts believe that majorly, lack of transparency and accountability on the part of agencies of government in the cause of implementing the programme has been the bane of it, and not really the case of inadequate funding per se.
For the out gone year – 2017 for instance, the indicators show that out of the total national budget for the year being N7,441,175,486,758.00, the total health budget amounted to 308,464,276,782.00. From this figure N55, 609,880,120.00 was the total health capital budget. This therefore suggests that only 4.15 percent of the total National Budget was made available for health, whereas only N12, 519,276,232.00 was allocated for the purpose of immunisation in particular.
The irony of this is that Nigeria uses up to 169 million doses of vaccines annually, a figure, which is expected to increase to 210 million doses by 2020, experts say. In 2017 the country began a five-year accelerated exit transition phase of funding by the Global Vaccine Alliance (GAVI) for example. To this effect, Nigeria’s immunisation funding gap was expected to rise from N1b in 2016 to N40b by 2020, when arrangement with GAVI begins to run out.
But then the vaccine burden continues to rise; apart from lopsided and inefficient implementation style, the financial burden is tough on the country’s resources. But why spend such heavy amount of our lean foreign exchange earnings on continued importation of vaccines into the country? It certainly does not sound salutary for the continuous import dependency of the country for vaccines.
For the purpose of self sufficiency however, the country is making efforts in the right direction to achieve this. It is worthy of note that the federal government has put up plans in line with global best practices to resuscitate the vaccine laboratory/ plant in Yaba for instance – using a Public-Private Partnership arrangement.
The score card for the last few years clearly shows that Nigeria has not been able to fully fund its immunisation needs. This was largely attributed to dwindling national resources, rising cost of vaccine, inadequate yearly budgetary allocation and untimely release of dunds. According to Nigeria Immunisation Strategy Document, the government resource requirement for vaccine shows a continuous rise in monetary commitment by the federal government to the tune of about $1.035b, while subsidised funding from GAVI dwindles, and eventually exits by the year 2025 at a total commitment of about $320m.
Last year also the government signed a Memorandum of Understanding (MoU) through the FMoH with a local pharmaceutical company, May & Baker Nigeria Plc. And so everything being equal, Nigeria is expected to start local vaccine production by 2019. This will obviously go a long way towards adequately checking and possibly eradicate immunisation preventable diseases in the country in the very near future.
Obviously the allocation of funds for the purpose of immunisation has been grossly inadequate; this needs stepping up. Apart from this, there is need for the Nigerian government to be timelier on the release of immunisation funds. In the years to come government must be seen to have improved on these.