NEWS - July 2003
Spending is up, but the finance gap is unfilled
GOVERNMENTS in low-income countries have significantly increased their own spending on immunization in the era of GAVI, says a report by the Financing Task Force (FTF). But although this increase is encouraging, future financing is vulnerable, particularly once the current support from the Vaccine Fund ends in three to five years' time. An analysis of the first eight countries whose financial sustainability plans are complete shows that they will need a total of $98 million per year, of which only $34 million (or 35%) is currently secured. The report says that "concerted and specific" actions by governments and each development partner are essential if improvements in immunization are to be sustained.
The FTF analysed complete data from Cambodia, Cote d'Ivoire, Ghana, Guyana, Kenya, the Lao PDR, Mali, and Rwanda. The early findings will be presented to the GAVI Board this month.
"The countries are beginning to work on filling the finance gap," says Steve Landry, co-chair of the FTF. "Now their action has to be matched by all the partners working together." Spending by the governments of the countries themselves has grown by about $4 million in aggregate, or 33%, compared with the pre-GAVI era. Some partners have also increased their support. Aggregate spending on immunization across the countries has increased from $34 million to $62 million, of which $15 million came from the Vaccine Fund, $7 million from multilateral and bilateral partners and the remainder from other sources. But, says the report, despite progress towards adequate and predictable funding, "managing the transition of financial responsibility from the Vaccine Fund to governments and their partners will be complex and is in no way assured at the present time".
Tore Godal, Executive Secretary of GAVI, says the success of GAVI depends largely on the partners' ability to tackle this major financing challenge. "This is not going to work if everyone looks at each other; each partner has to work out what it can do to help."
Although the financing gap may seem daunting, the absolute amounts of money involved are small compared with other global health initiatives or government health spending. On average across the countries, immunization programmes accounted for only 3.2% of total health expenditures and less than 0.2% of GDP.
Ruth Levine, who at the World Bank worked with GAVI on financial sustainability, says the increased spending will bring lasting health gains. "Countries are taking a major step to reduce disease burden, using some of the most cost-effective interventions available."
Immunization Focus July 2003 - Contents