Dr. Ben Anyene has the daunting job of helping the Nigerian government find ways to pay for the immunization of the 5.3 million children born in the country each year. Dr. Anyene, a microbiologist and chairman of the National Immunization Financing Task Team (NIFT) in Nigeria, has been a valuable partner to Sabin’s Sustainable Immunization Financing (SIF) Program since 2009. He speaks with government officials like the Vice President and the Minister of Finance to increase political will for domestic immunization financing. In 2014, the Nigerian Parliament passed the National Health Act, which included a provision guaranteeing public vaccine financing. Dr. Anyene and NIFT are now building upon that work by writing legislation to establish sustainable solutions for immunization financing. This includes an immunization trust fund to secure permanent funding for vaccines within the national budget.

Currently, Gavi, the Vaccine Alliance, finances the majority of Nigeria’s immunization program, with the national government paying for 40 percent of the routine immunization program. As Nigeria’s economy grows, the country will enter a transition phase where the government will be expected to co-finance a larger portion of the immunization program. Nigeria will then graduate from Gavi funding and must fully self-finance their immunization. This will be a moment of sink or swim for Nigeria, but Dr. Anyene is determined they will swim. The economic case for immunization is convincing. “You commit one dollar investment in immunization and the minimum return is $16. In some places, it's as high as $34 or $44 dollars,” says Anyene. Because Nigeria does not have a social health insurance plan, the vast majority of health expenditures are out-of-pocket. That means that without a dependable immunization program, families experience high treatment costs for children suffering from vaccine-preventable diseases, placing additional strain on the entire economy. Investing in immunization strengthens future economic security, because, as Anyene points out, an immunized child “will be healthier to go to school, be better educated, be a better person, not just for his family but for the country.”

Sabin supports efforts to prepare for Gavi graduation through the creation of sustainable immunization financing mechanisms. Sabin has worked with Dr. Anyene and other advocates to lay the groundwork for immunization financing in Nigeria. Through the SIF Program, Sabin hosts international colloquia and facilitates peer-to-peer learning, providing opportunities for countries to share ideas and have discussions that Dr. Anyene feels are “critical” for program improvements.

Every country must follow a different path to success. For Dr. Anyene and Nigeria, co-financing with states is essential, as the country is made up of 36 states and a central government, all with separate budgets and priorities. Headway is being made on this front, and Anyene is hopeful this progress will continue. “We have broken a lot of ground, critical ground that now even the state governors are talking about immunization. They were not doing that in 2012.”

Dr. Anyene sees local vaccine production as another key to Nigeria's success. "People don't see that as immunization funding," he says, "but we see it as a big chunk of immunization financing because if we are producing quality vaccines in Nigeria, it saves us a lot of costs, but it also expands our scope and also we can use it to export to other countries."

Dr. Anyene will continue to work with dedicated advocates from across the Nigerian government and the private sector to strengthen Nigeria’s health system. A more independent immunization program will improve the country’s ability to respond quickly to outbreaks and prevent child deaths. Nigeria is among many lower-middle income countries navigating the transition to domestic immunization financing, and Dr. Anyene is one of many immunization champions thinking outside the box to catalyze change. He believes that, “because people like me believe our country can pay for the health of our people,” sustainable immunization financing goals are within reach.