Immunization Financing Outlook: A Historical Perspective Being a paper presented at the NIFT one day workshop held on 13 th Feb 2017 at Top Galaxy Hotel Kaduna By Ganiyu Salau
Brief History of Immunization Financing in Nigeria Over the years, FGoN has been responsible for the procurement of traditional routine vaccines for the country. While other aspects of immunization activities are receive funding from both the three tiers of government and development partners, The existing sources of immunization financing in the country include: (a) Government sources Federal, States and LGAs annual budgetary appropriation (b) Donor Agencies sources GAVI Alliance WHO, UNICEF, BMGF, Rotary International, CHAI, etc. (c) Loan and grants The World Bank Buy-Down Grant, Japanese Agency for International Development (JICA), KFW, GAC, EU etc. 2003 US$28.7million World bank buy down grant - BMGF 2005 US$51.7million World bank buy down grant - BMGF 2008 US$50.0million World bank buy down grant - BMGF 2010 US$ 60million World bank buy down grant - BMGF 2013 US$95million World bank buy down grant - BMGF 2015 JPY8.285billion JICA loan 2015 US$200million World bank loan 2017 US$125million Proposed World bank loan
S / N YEA R Brief History of Immunization Financing in Nigeria cont RI Component of Capital Budget Non-polio SIA Polio SIA Component of Capital Budget Total 1 2012 6,000,000,000.00 4,485,000,000.00 10,485,000,000.00 2 2013 4,150,000,000.00 4,309,399,324.00 8,459,399,324.00 3 2014 2,156,300,000.00 3,650,775,386.00 5,807,075,386.00 4 2015 2,615,055,925.00 2,568,442,234.00 5,183,498,159.00 5 2016 1,094,468,554.00 1,963,879,269.00 9,821,331,311.00 12,879,679,134.00
Reasons for Funding Gaps & consequent vaccine stocks-out Experienced in the Past REASONS FOR RISING COSTS OF IMMUNIZATION It is important to understand the factors that seek to drive immunization costs during the planned period. They include: The planned Introduction of new and expensive vaccines in line with global trends in immunization service delivery and also to fulfill the save one million lives initiative by government. Such new vaccines planned for introduction (2014 2018) include: PCV (2 nd /3 rd stages), IPV, Rota, Men A, HPV, MR The recent rebasing of the nation s GDP and her subsequent reclassification as a medium income country makes it difficult to grants/funds from certain traditional donor sources. Graduation from GAVI financing GAVI graduation is calculated as 15% increase in GoN co-financing in 2015, and linear increase in co-financing obligation between 2015 co-financing price and the 2020 vaccine price. In 2020, the full market price occurs, and the GoN pays the full cost of vaccines and devices, and average freight; for new vaccines, the ramp-up is from the time of introduction to 5 years after introduction High cost of vaccines including freight and handling charges by procurement agent, Exchange rate instability
The Status of Finances for Immunization in Nigeria overview of Financial requirements of Routing immunization and polio eradication in Nigeria 2016-2020 Year Vaccine supply & logistics (routine only) billion Supplementary immunization Activities billion Total 2016 68 70 138 2017 67 80 147 2018 80 59 139 2019 101 28 129 2020 90 17 107 Total 406 254 660 Source: Nigeria cmyp 2016-2020 billion
2017 IMMUNIZATION FINANCING OUTLOOK S/N (a) (b) BUDGET LINE ROUTINE & NON-POLIO SUPPLEMENTARY VACCINES Sub-Total (Routine Vaccines & Devices) Sub-Total (SIA Vaccines & devices including OPV) Total (RI & Non-polio Supplementary Vaccines/Devices) Polio Eradication Initiative Sub-Total (PEI OPV + Operational Costs) TOTAL CAPITAL BUDGET PROPOSAL FOR 2017 FINANCIAL RESOURCE REQUIREMENTS (CONFIRMED/TENT ATIVE FUNDING) DONOR FUNDS OTHER DONORS (BMGF, EU, GAVI () GAC, KFW, UNICEFetc) 49,520,105,343.44 26,108,600,667.18 0 37,082,875,563.41 32,508,283,999.95 0 87,602,980,906.85 58,616,884,667.13 0 27,083,148,864.39 0 FUNDING SOURCES PROPOSED WBAF () 19,297,383,457.04 937,520,278.05 20,234,903,735.09 8,839,104,783.90 13,384,258,808.20 FGoN FUND GOVERNMENT (2017 BUDGET PROPOSAL) 4,114,122,844.37 3,637,071,285.19 8,751,194,129.56 4,859,785,272.29 113,686,129,771.24 58,616,884,667.13 8,839,104,783.90 33,619,162,543.29 13,610,979,401.85
lans by the Government to Bridge the Immunization Funding Gap in iew of Quantum Jump in Financial Requirement for Immunization in coming years In the recent past significant efforts have been made to bridge the funding gaps for immunization in the country. Some of the steps so far taken include: Presentations to the Budget Office for increased budgetary funding for immunization activities, Advocacy to the National Assembly for increased support for immunization financing, Advocacy to the Governors Forum for increased share states and LGAs budget for immunization services, Private Sector Health Alliance for immunization financing in the country, Individual foundations, Partnership with the National Health Insurance Scheme for increased funding for immunization, The National Health Act, and The establishment of National Vaccines Financing Task Force, etc. Establishment of immunization trust fund Encouraging local vaccine production in Nigeria