The Government of the Republic of Angola places great importance on the provision of sound health care services to its population. The Expanded Program on Immunization is one of the Ministry of Health priority programs.
Angola experienced one of the worst periods in its recent history, which was characterized by two phases of armed conflicts that directly affected the entire population. The social sectors, particularly basic health services were most hit by the war. The massive destruction of infrastructures and the small scale investment in the health sector have all contributed to the state of poor health of the population.
This paper reviews the experience of the Global Alliance for Vaccines and Immunization (GAVI) in introducing hepatitis B and Haemophilus influenzae type b vaccines in the poorest countries, and explores how financing for immunization has changed since GAVI Fund resources were made available during its first wave of support between 2000 and 2006. The analysis of Financial Sustainability Plans in 50 countries allowed for some of the original funding assumptions of the GAVI approach to be tested against the realities in a wide set of countries, and to highlight implications for future immunization efforts. While the initial GAVI experience with financial sustainability has proved successful through the development of plans, and many countries have been able to both introduce new vaccines and mobilize additional financing for immunization, for future GAVI supported vaccine introduction, some country co-financing of these will be needed upfront for the approach to be more sustainable.
Immunization is one of the “best buys” in global health. However, for the poorest countries, even modest expenditures may be out of reach. The GAVI Alliance is a public-private partnership created to help the poorest countries introduce new vaccines. Since 2008 GAVI has required that countries cover a share of the cost of vaccines introduced with GAVI support. To determine how much countries can contribute to the cost of vaccines—without displacing spending on other essential programs—we analyzed their fiscal capacity to contribute to the purchase of vaccines over the coming decade. For low-income countries, external financing will be required to purchase vaccines supported by GAVI, so co-financing needs to be modest. Relatively better-off “intermediate” countries could support initially modest but gradually increasing co-financing levels. The countries soon to graduate from GAVI can generally afford to follow a rapid path to self-sufficiency. Co-financing for these countries needs to ramp up so that national budgets fully cover the costs of the new generation of vaccines once GAVI support ends.
Immunization is a critical intervention for achieving the Millennium Development Goal of reducing deaths among children less than five years of age (MDG4) by two-thirds. More than 100 million children are vaccinated each year, protecting them against life-threatening diseases (WHO and UNICEF, 2010). Immunization is considered to be one of the ‘best buys’ in public health (WHO and UNICEF, 2010; World Bank 2010). Traditional vaccines cost pennies per dose and provide health benefits not only for the immunized child, but also for the community in which a child lives through herd immunity. In addition, studies have shown that immunization extends life expectancy and the time spent on productive activity later in life, thereby contributing to economic growth. Given the public goods aspect of immunization and its potential returns for growth and poverty reduction, this is an intervention definitely worth investment by governments. While newer vaccines are more expensive on a per dose basis, they have been shown to be highly cost-effective investments. The purpose of this analysis is to summarize historical trends in immunization costs and financing, both for routine services and campaigns, as countries have introduced new vaccines. The main audience for this document is national, regional, and global technical staff working on national immunization programs.
The following report displays data and figures on the introduction status of Hib vaccine, pneumococcal conjugate vaccine (PCV) and rotavirus vaccine both globally and in 73 GAVI eligible countries. It uses information stored in the Vaccine Information Management System (VIMS) online database maintained by IVAC at the Johns Hopkins Bloomberg School of Public Health and supported by the GAVI Alliance. The images and text below describe: how many countries have introduced each vaccine or plan to in the future; global and GAVI rates of coverage and access; projected introduction dates for GAVI eligible countries; historical trends of the rate of introduction globally; and the introduction status of every country individually. The report concludes with a more detailed description of VIMS and its potential uses.
The purpose of this Guide is to stimulate interest in improving and sustaining high levels of immunisation coverage in all districts and to give health program managers (governmental and non-governmental), supervisors and health workers practical information about the RED approach. The Guide is intended for adaptation and use by national immunization programmes, as one of several resources that can be used to introduce district health teams and immunisation partners to the RED approach. Once adapted, it can also be used by district health teams and health workers as a quick reference to the five RED components and core monitoring indicators. Another important use for the Guide may be in explaining RED to local officials and other potential supporters of immunisation and PHC services.
This paper estimates and compares the costs and financing of a sample of 54 national immunization programs as reflected in comprehensive multi-year plans (cMYPs) submitted to the GAVI Alliance, for the period 2004 to 2015.
Substantial resources have been invested in increasing childhood immunisation coverage through global initiatives such as the Universal Childhood Immunisation (UCI) campaign and the Global Alliance on Vaccines and Immunisations (GAVI). There are longstanding concerns that target-oriented and performance-oriented initiatives such as UCI and GAVI's immunisation services support (ISS) might encourage over-reporting. We estimated the coverage of three doses of diphtheria, tetanus, and pertussis vaccine (DTP3) based on surveys using all available data.