Nigeria Becomes First SIF Country to Pass New Vaccine Legislation
Nigeria, Africa’s most populous country, more than doubled its immunization budget from 2010-2012 and that budget continues to grow. In February 2014, the country took another step toward country ownership by passing a new National Health Bill in the Senate and House of Representatives. The bill includes a provision explicitly guaranteeing public immunization financing. This makes Nigeria the first of the original 15 Sustainable Immunization Financing (SIF) countries to pass such legislation.
The bill was passed thanks to the efforts of a handful of dedicated individuals, reports SIF Senior Program Officer Clifford Kamara, who has worked with the country since 2008. On the government side, the Minister of Health and the Executive Director, National Primary Health Care Development Agency and their officials provided technical input to the bill. In Parliament, the Senate and House of Representatives Health Committees played prominent roles in ensuring passage of the Bill. In the Senate, champions included the Chairman of the Health Committee, Senators Arthur Ifeanyi Okowa and Sefiu Adegbenga Kaka, who rallied support from their colleagues as well as the House of Representatives for final passage. In addition, a coalition of NGOs working in the health sector under the leadership of Health Reform Foundation of Nigeria (HERFON) provided technical input and kept discussions about the health bill on the front burner of public discourse.
Approval followed an arduous, two-year effort as would be expected for such a wide-ranging bill. The first reading took place in October 2012, and in a presentation to the August 2013 Dakar SIF Colloquium, Senator Kaka described the range of stakeholders who were vigorously debating how the government should deliver and finance curative as well as preventive services. The Senate Health Committee inserted the vaccine-specific language at the Third Reading.
Section 11(2)b of the law provides that:
20 percent of the [Basic Health Care Provision Fund] shall be used to provide essential drugs, vaccines, and consumables for eligible primary health care facilities.
This provision insulates the vaccine budget from political, economic or other shocks and ensures continuous vaccine financing.
With the passage of National Health Bill in 2014, Nigeria joins a host of countries, principally in Latin America, that now guarantee public vaccine financing.
Following passage, Senator Ifeanyi Okowa remarked, "We need to provide for vaccines…it will be a welcome affair that our people in the rural areas have somewhere they can call their own to attend when they have one ailment or the other, rather than going to the medicine vendors…”
Immunization financing arrangements are actually quite complex in highly decentralized Nigeria. This bill establishes a Basic Health Care Provision Fund, to be co-financed by federal revenues and defined contributions from state and local governments. Kamara and the Nigerian SIF champions will now shift their advocacy efforts to the 38 states whose participation in the fund will be crucial.