- Domestic advocacy network established and institutionalized
- Private fund and public fund for immunization under development
- Draft legislation under development
Expanded Program on Immunization (EPI)
The Cameroonian EPI is its own division within the Ministry of Health (MOH).
Government Spending on Immunization
Over the period 2006-2013, Cameroon’s Gross National Income increased from US$960 to US$1,270 per capita, increasing 32 percent in eight years. According to the WHO/UNICEF Joint Reporting Form (JRF), the Cameroonian government spent $6 on routine immunization per surviving infant in 2006. By 2013, this figure had fallen to $5, decreasing by 17 percent. In addition, the government share of total routine immunization expenditures dropped from 57 percent to 16 percent from 2006-2013. Cameroon has reported complete and consistent financial data to the JRF. The data show that Cameroon has not progressed towards country ownership of its immunization program.
Vaccination Financing Mechanism
The Parliamentary Health Committee and MOH established the immunization fund Steering Committee in April 2011. The following July, the working government officials finished the draft Immunization Fund Decree, and established a Working Committee to review the draft decree in September.
In November 2011, the MOH merged the National Immunization Trust Fund with the National Fund for Health Emergencies proposals. The merged fund proposal included EPI financing provisions and was submitted to the MOH Cabinet and Prime Minister. The MPs finalized the draft decree for the new fund in March 2012.
In 2013, the Working Committee began drafting regulations for the Health Support Fund that would be included in the Health Law.
The working peers reoriented their approach in November 2014, when MOF and MOH officials decided to construct an immunization fund around a stand-alone immunization & Anti-Retroviral (ARV) law.
Legislation for Sustainability
The Constitution of Cameroon, Part X (Articles 55–62), states that 10 semi-autonomous regions, ruled by regional councils, have responsibility for “economic, social, health, educational, cultural and sports development”.
In June/August 2012, the Legislative Working Committee was established and began drafting the immunization law. The Committee incorporated amendments recommended by fellow peers from Francophone Africa later that year.
At the beginning of 2013, the Prime Minister signed an act officially recognizing the expansion of the Working Committee to be a Multi-Institutional Working Committee in order to optimize multi-sectoral contributions to the draft law.
The Committee worked on the draft law throughout 2014 and presented it to a widespread set of stakeholders in August. The following November, the MOH and MOF working peers decided to expand the scope of the law to address ARV. They further committed to conduct a study tour to survey a country with an adopted immunization law before integrating lessons learned into the final draft immunization & ARV law.
Domestic Advocacy Network
Parliamentarians and female members of the Cameroonian Association of Mayors attended an advocacy training in August 2014. The female mayors learned how to build an advocacy case to deputize subnational authorities as advocates for immunization legislation and resource mobilization. The goal here is to create a Parliamentary Network for Immunization from this initiative. The MOH defended an EPI budget increase to all government stakeholders the following December.
Tracking Expenditure Flows
Government officials first filled out the SIF Budget Process Tool in November 2012. In September 2014, the NGO Immunization Platform and EPI team filled out the country Multi-Year Plan (cMYP) costing tool.
Global Vaccine Action Plan (GVAP) Implementation
In September 2014, MOF, MOH, Parliament and CSOs finalized the streamlining of relevant GVAP metrics into Cameroon’s cMYP. The following December, the national peers completed the cMYP’s financial section and inserted advocacy activities for sustainable immunization financing into the document.
Major SIF Program Efforts
- December 2014: Senior Program Officers from Cameroon and DRC co-organize the Francophone Africa Peer Review Workshop on Sustainable Immunization Financing. Government peers from DRC, Congo-Brazzaville, Madagascar, Cameroon, Mali, and Senegal participate.
- December 2014: Senior Program Officer co-organizes workshop where government peers complete the cMYP’s financial and advocacy sections.
- November 2014: Senior Program Officer holds a consultative workshop with twenty-five government peers where participants reoriented the approach for developing the immunization law and fund.
- September 2014: Senior Program Officer held a workshop where representatives Ministries of Health and Finance, parliament, and CSOs finalized the streamlining of relevant GVAP metrics into the cMYP.
- September 2014: Senior Program Officer convene the NGO Immunization Platform and EPI team for a follow-up workshop where the working peers finalized the CMYP costing tool.
- August 2014: Senior Program Officer, WHO, and UNICEF co-organize two advocacy trainings with MPs and female members of the Association of Mayors.
- July 2014: Senior Program Officer facilitates small group work in WHO/UNICEF/AMP/Gavi cMYP workshop.
- May 2014: Senior Program Officer organizes consultative workshop to address co-financing issues.
- April 2014: Senior Program Officer participates in financing workshop organized by the MOH Director of Cooperation. The government peers elaborated upon the Health Support Fund.
- December 2014 & January 2014: Senior Program Officer participates in two MOH-organized EPI Annual Work Plan (AWP) workshops.
- October/November 2013: Senior Program Officer participates in a MOH/UNICEF-organized workshop where working peers developed the EPI Communications and Advocacy Work Plan.
- September 2013: Senior Program Officer participates in a training workshop on rotavirus introduction in Cameroon.
- July 2013: Senior Program Officer participates in the first Cameroon Inter-Ministerial Committee Workshop on Sustainable Health Financing.
- June 2013: Senior Program Officer participates in the EPI budget monitoring workshop.
- March 2013: Senior Program Officer participates in a Health Systems Strengthening (HSS) planning and budget workshop as well as one on EPI budget monitoring for Fiscal Year 2013.
- February 2013: Senior Program Officer and Cameroon EPI manager participate in Central Africa EPI managers meeting.
- November 2012: Senior Program Officers from Cameroon and DRC co-organize the SIF francophone Africa legislative peer review. Government officials from Cameroon, Mali, Senegal, DRC, Congo-Brazzaville, and Madagascar participated.
- May 2012: Senior Program Officers from Cameroon and DRC, WHO, UNICEF, and AMP co-organize a cMYP workshop for Central African Countries in Cameroon.
- May 2012: Senior Program Officer holds a legislative workshop.
- July 2011: Senior Program Officer, WHO, UNICEF, and Helen Keller International (HKI) co-organize a workshop to revise the cMYP and elaborate upon the National Immunization Fund framework.
- June & July 2011: Senior Program Officer holds parliamentary briefings.
- September 2010: Senior Program Officers from Cameroon and DRC co-organize a financing peer exchange to design a protocol for establishing a National Immunization Fund in both Cameroon and DRC.
- July 2010: Senior Program Officer participates in the annual EPI planning meeting.
- December 2009: Senior Program Officer holds sub-regional parliamentary briefing on immunization financing, in which nine peer exchangers from MOH, MOF and parliament participate.
- August 2009: Senior Program Officer holds first parliamentary briefing.
- October 2008: Senior Program Officer and Program Director conduct introductory briefings with MOH officials and MPs.