- Expenditure tracking nearly institutionalized at national level, operational at subnational level
- Parliamentary Network nearly institutionalized
- Draft legislation being conceptualized
Expanded Program on Immunization (EPI)
The DRC EPI is in the Disease Control Directorate, Ministry of Public Health (MOPH).
Government Spending on Immunization
Over the period 2006-2013, the country’s Gross National Income increased from US$230 to US$400 per capita, almost doubling in eight years. According to the WHO/UNICEF Joint Reporting Form (JRF), the government spent $1 on routine immunization per surviving infant in 2006. By 2013, this figure had risen to $2, a doubling of government contributions to routine immunization. While increasing in absolute terms, the government share of total routine immunization expenditures dropped from 9 percent to 7 percent from 2006-2013. Caveats: Reporting for JRF Indicator 6500 is incomplete but is consistent across the other JRF financial indicators. The data suggest that DRC has progressed towards country ownership of its immunization program.
Tracking Expenditure Flows
The EPI completed the SIF Budget Process Tool in August 2012 and May 2013. By November 2013, the EPI team was meeting independently on a monthly basis to update the Tool. The team met almost monthly until September 2014, when they updated the Tool for 2014. They updated it again in December.
DRC tracks immunization expenditures in the following manner as of December 2014:
- Every quarter, the Ministry of Budget (MOB) Budget Manager earmarks each budget line to monitor
- The MOPH Deputy Budget Manager and EPI track budget disbursement
- At the end of every trimester, financial inspectors conduct a budget accountability mission, the results from which are sent to the Court of Audits
- At the end of the year, the government conducts a mission surveying all EPI expenditures, the result from which is sent to parliament
- Provincial EPI teams use Form 6, a resource tracking tool used monthly
Domestic Advocacy Network
In May 2012, a parliamentary SIF champion completed the charter for the Parliamentary Network for Immunization. The charter sets guidelines for the Network’s structure, purpose, and recruitment procedures. Fifteen MPs joined the Network in June and resolved that its primary role is to conduct continued advocacy in parliament for adequate immunization financing. The Network’s first official meeting was in July and was attended by the EPI manager. In September 2013, the Network defended the proposed EPI budget in parliament. The Network conducted its regular field missions and ad-hoc advocacy initiatives independent of Sabin on three key occasions in December 2014.
As of January 2015, the Network is staffed by MPs, EPI staff, health professionals, officials from Ministries of Finance and Budget, EPI partners and civil society. Network representatives have deputized public and private provincial authorities from 6 of DRC’s 11 provinces to mobilize local resources for immunization financing:
- December 2013: Bas-Congo
- May 2014: Kasai-Oriental
- May 2014: Kasai-Occidental
- October 2014: Orientale
- December 2014: Bandundu
- December 2014: Maniema
Legislation for Sustainability
Section I, Articles 42 and 47 of the Constitution (2006) obliges the State to guarantee the health of every Congolese child.
Section VII, Article 204 of the Constitution empowers provinces to organize basic health services, including immunization campaigns.
The DRC government began preparing its draft immunization law by April 2012. The following May, the WHO and Economic Community of Central African States (ECCAS) co-issued an advocacy memo to the President to support the production of the immunization law. At a peer review workshop in November 2012, DRC government officials incorporated amendments recommended by government peers from Congo, Madagascar, Cameroon, Mali and Senegal.
In July 2013, the parliamentary law drafters finalized the first draft law and submitted it to parliament. The following November, the drafting MPs and EPI generated a second draft law per the Parliamentary Legal Advisor’s suggestions and relayed it back to the Advisor.
In June 2014, due to unforeseen circumstances, the law drafters began conceptualizing a general law on health which addresses immunization financing, instead of a stand-alone immunization law. As of November 2014, the MOHP is developing a proposal for the stand-alone law, which the Prime Minister will leverage to encourage parliament to make an exception for the law.
Global Vaccine Action Plan (GVAP) Implementation
In November 2014, representatives from the EPI, MOHP, Ministry of Finance (MOF), Ministry of Budget (MOB) and the Ministry of Planning (MOP) streamlined relevant GVAP criteria into the cMYP.
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 attends the Parliamentary Network mission to Maniema province.
- November 2014: Senior Program Officer participated in a cMYP workshop in which representatives from the EPI, MOHP, MOF, Ministry of Budget (MOB), and Ministry of Planning (MOP) participated.
- October 2014: Senior Program Officer attends the Parliamentary Network mission to Orientale province.
- May 2014: Senior Program Officer attends Parliamentary Network missions to Kasai-Occidental and Kasai-Oriental provinces.
- April 2014: Senior Program Officer participates in WHO/HQ & WHO/AFRO conference on oral cholera vaccine introduction in Central Africa.
- January 2014: Senior Program Officer participates in PATH/Gavi CSO advocacy training, which EPI and NGO representatives also attended.
- December 2013: Senior Program Officer attends the Parliamentary Network mission to Bas-Congo province.
- October 2013: Senior Program Officer attends the Parliamentary Network mission to the city of Kisangani.
- July 2013: Senior Program Officer co-facilitates provincial financial management workshop, in which EPI managers from multiple provinces participated.
- July 2013: Senior Program Officer participates in a PATH/Gavi consultative workshop on CSO advocacy.
- June 2013: Senior Program Officer organizes a legislative workshop where MPs and MOHP representatives improved the draft immunization law.
- May 2013: Senior Program Officer and peer exchangers from DRC and Congo participate in Gavi survey of Central African annual situation reports.
- May 2013: Senior Program Officer and representatives from MOH and CSOs participate in PATH/Gavi peer exchange on NGO advocacy experiences in DRC.
- April 2014: Senior Program Officer participates in Gavi Central & West African Subregional Working Group Meeting.
- February 2013: Senior Program Officer and MP Champion participate in the Central African EPI Manager’s Meeting in Cameroon.
- 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.
- August 2012: Senior Program Officer participates in the cMYP review workshop for 2011-2015.
- June 2012: Senior Program Officer accompanies DRC peer exchangers to a study tour of Madagascar’s draft law.
- May 2012: Senior Program Officer sponsors DRC peer exchangers to attend a Central African cMYP review workshop.
- August 2011: Senior Program Officer participates in the semi-annual immunization review.
- July 2010: Senior Program Officer and Program Director conduct subnational briefings on SIF in Katanga and Bas-Congo provinces.
- June 2010: Senior Program Officer and representatives from parliament as well as Ministries of Finance, Budget, and Planning participate in cMYP review workshop.
- June 2010: Senior Program Officer participates in Gavi Regional Working Group mission to DRC.
- June 2010: Senior Program Officer and WHO co-organize second parliamentary briefing with governors, parliamentarians, and Health Ministers from four of the country’s eleven provinces.
- March 2010: Senior Program Officer participates in a Global Fund/Gavi innovative immunization financing mission to DRC.
- November/December 2009: Senior Program Officer participates in the EPI annual planning meeting for 2010.
- September 2009: Senior Program Officer organizes the first SIF parliamentary briefing.
- June 2009: Senior Program Officer and Program Director conduct introductory briefings with DRC government officials.