By Dr. Ciro de Quadros

We’ve achieved huge milestones in immunization over the last decade.  The global community has mounted a successful effort to increase vaccine coverage and to make improvements to other health interventions, which have saved the lives of more than 2 million children each year.[1]

But sustaining this progress requires equal partnership with a key stakeholder group: low- and lower-middle-income countries. Currently, development partners (such as GAVI Alliance, UNICEF, and others in civil society) finance more than 50 percent of routine immunization budgets – including the vaccines, infrastructure, delivery, training, public education and more – in these countries.

Meeting the ambitious goals of the Global Vaccine Action Plan requires a change to this paradigm.  Countries must increase their financial contributions to the immunization programs that protect their citizens and ensure the health of the next generation and reduce their dependence on external funding. 

To take on this responsibility, countries need to push for more collaboration and contributions from multiple players in government – from the leaders in the EPI (expanded programme on immunization) to the Ministry of Health, to the Ministry of Finance, to members of Parliament.

That’s the crux of the work for Sabin’s Sustainable Immunization Financing (SIF) program.  Their Second Colloquium on Sustainable Immunization Financing – held this year in Dakar, Senegal – convened more than 100 leaders from 17 countries who have pledged to work with development partners and domestic stakeholders to increase financing for their immunization programs.

Here’s a brief overview of just three of the (many) important steps that countries are looking to take to increase the sustainability of their immunization programs:

Enact New Laws

Creating new laws has been one way countries have successfully sustained their commitments to immunization.  At the first SIF Colloquium in 2011 most of the participating countries did not have laws in place to specifically deal with immunization; but less than two years later, the majority of countries shared that they had started this process and had drafted bills.  Though it is a challenge to move these draft bills through the political process (which involves education and advocacy with many members of Parliament), colloquium participants agreed that passing these bills into law is a critical next step.

Implement Budget Line Items

While many countries have increased their budgets for immunization, this commitment is not set in stone without a budgetary line item.  Many countries discussed their efforts to put this into place, as well as tools that will help make this possible, including better communication between the Ministries of Health and Finance, a strong case for investment on immunization that can be used to educate the Ministry of Finance and, in some cases, identifying new taxes or immunization funds to support the budgetary line item.

Improve Accounting and Data Management

If you want to increase the immunization budget, the first thing you need to know is how much it costs to run the program. Accurate data and accounting were major challenges for many countries attending this year’s colloquium.  In some cases, country delegates had difficulty determining how much funding was needed to run their programs.  In other cases, countries were unsure of why the EPI program did not receive all the money that was originally promised in the budgets.  To counter this, delegates discussed potential solutions including audits, better accounting tools and personnel and trainings.

Learn more about SIF’s Second Colloquium on Sustainable Immunization Financing by reading the official press release.


[1] The annual number of child deaths under five years of age fell from an estimated 9.6 million in 2000 to 7.6 million in 2010, despite an increase in the number of children born each year.