Immunization is one of the most cost-effective ways to save lives – preventing over 2 million child deaths each year. With the recent introduction of new vaccines, countries need to spend US$60 or more per infant to fully immunize, far more than what is traditionally spent on such programs in low-income countries. As vaccine science advances, nations must adapt their vaccine policies and mobilize more resources. The Sabin Vaccine Institute’s Sustainable Immunization Financing (SIF) program highlights the efforts of national institutions and lawmakers in this area. As they increase their domestic immunization budgets, the countries are reducing their dependence on external donors and taking financial ownership of their immunization programs.

SIF works with counterparts in 21 countries across Africa, Asia and Europe to facilitate their efforts to develop, implement and institutionalize solutions for sustainable immunization financing. An integral strategy for this advocacy work is peer-to-peer learning. The SIF Program arranges frequent peer exchanges, which bring together national counterparts to evaluate their current immunization programs and to foster momentum for necessary changes.

On 19-21 April 2016, delegates from five SIF countries convened in Abuja, Nigeria, for the second Anglophone Africa Peer Review Workshop on Sustainable Immunization Financing. The event was co-hosted by Sabin and the Nigeria Immunization Financing Task Team (NIFT) on behalf of the Nigerian Federal Ministry of Health. The workshop was a follow-up to a similar peer exchange workshop held in Nairobi, Kenya, in October 2015.

Among the 156 participants were delegates representing parliaments and ministries of health and finance in Nigeria, Uganda, Liberia, Sierra Leone and Kenya. They were joined by counterparts from Nigerian federal and state government ministries, non-governmental organizations and external agencies including WHO, UNICEF and Gavi, the Vaccine Alliance. While each of the five countries has increased its government spending on immunization since 2011, more funding will be necessary to reach the Global Vaccine Action Plan 2020 goal of country immunization program ownership. Currently, only 15 countries in Africa fund more than 50 percent of their national immunization expenditures.

The three-day workshop covered four overarching themes within sustainable immunization financing: financing arrangements, legislation, resource tracking and domestic advocacy. Participants discussed challenges in immunization legislation and resource tracking during a small group exercise. The groups followed the Nominal Group Technique wherein participants identify and rank challenges to taking ownership of their nations’ immunization programs. Facilitators then ask participants to propose realistic solutions, actions or steps to address each problem. For example, in a group discussion of financing arrangements, participants agreed that the problem of high donor dependency and inadequate government funding could be reduced by innovative financing solutions such as public-private partnerships, trust funds and tax funds.

The workshop culminated in a poster session where delegates assessed each other’s immunization financing innovations using a standard guide. Delegates shared their institutional innovations in the areas of immunization advocacy, financing and resource tracking. Uganda was ranked first by its peers in overall innovativeness, marking a momentous improvement from its previous ranking in Nairobi last October, where it came in last. The recent passage of the country’s Immunization Act, signed into law by Ugandan President Museveni in March 2016, no doubt contributed to this improvement.

The workshop provided an updated vision of obstacles to be overcome and strategies to be used to achieve the goal of country ownership in each of the five countries. Each delegation drafted action points that will help them secure the programmatic, financial, policy and legislative aspects of immunization financing. A comparison to the action points drafted at last year’s workshop shows that all five countries have made progress since October.

Workshops such as these motivate lawmakers to advocate for immunization legislation and budgeting in their respective countries. Nigerian Senator Mao Ohuanbunwa, who attended the workshop, tweeted, “As a health sector professional myself, I’ll legislate & support legislation that will ensure that vaccines are available to all. #SIFAfrica.” Following the workshop, Senator Ohuanbunwa held a twitter meeting, in which the public was free to ask questions on the topics discussed during this workshop.

The Abuja workshop, along with other recent regional peer review workshops, exemplifies SIF’s mission to catalyze greater domestic investment in national immunization programs. These meetings are building momentum which will culminate during the Sabin Vaccine Institute’s Third Colloquium on Sustainable Immunization Financing, to take place 19-21 July 2016 in Kathmandu, Nepal. At the Colloquium, the delegates from these five Anglophone African countries will convene with delegates from the other SIF countries to address immunization financing and chart a common path forward.

Read the full workshop report in English.