On April 23, 2018, 43 parliamentarians, joined by government officials and partners, gathered in Kinshasa, Democratic Republic of Congo, for a briefing on sustainable immunization financing. Led by the Sabin Vaccine Institute, the briefing aimed to equip parliamentarians with the evidence they need to advocate within the government for domestic immunization financing.

As a low-income country, DRC receives significant support from Gavi, the Vaccine Alliance (Gavi), to purchase vaccines for its citizens. Gavi co-finances immunization programs in the poorest countries, but as countries’ economies grow, they are phased out of Gavi support, gradually taking on a greater and greater share of their immunization costs. As DRC’s economy has grown, the country has consistently struggled to meet its co-financing requirement to Gavi.  

Securing immunization financing within DRC’s budget is crucial to the success of the national immunization program. Without a strong, fully funded immunization program, families will not have access to vaccines, leaving them vulnerable to vaccine-preventable diseases and placing additional strains on the economy. Establishing country ownership of immunization is an imperative step toward developing secure and enduring health programs and, as a result, improving overall health.

Since 2009, Sabin has supported efforts to prepare DRC to independently finance its immunization program. During this time, Sabin has supported parliamentarians and officials in the ministries of health and finance in their work to gather financial and economic evidence as a tool for advocacy and budget transparency, with the goal of mobilizing domestic financing to cover an increasing share of national immunization program costs.

In 2012, Sabin helped parliamentarians establish the Congolese Parliamentary Network for Immunization Support (abbreviated in French as REPACAV). The network has advocated to increase the national immunization budget, protected against budget cuts, and engaged provincial officials to encourage them to establish budget lines and allocate sufficient funds. REPACAV has been immensely successful, winning and defending increases in immunization appropriations from 2012-2015, and growing the national immunization budget by more than 10 times.

Much of this funding is needed to meet the country’s Gavi co-financing requirement for vaccines. Over time, the country’s contribution increases, until eventually the country independently finances its entire immunization program. Over the past several years, DRC has not paid its co-financing requirement on time. At the time of the parliamentary briefing, the 2017 co-financing requirement had not been fully paid, leaving DRC without the new vaccines Gavi supports and putting the country at risk for outbreaks of rotavirus, yellow fever and polio.  

Sabin led a six-step advocacy exercise for parliamentarians as part of the briefing. Based on advocacy approaches Sabin has seen to be successful among REPACAV and other parliamentary immunization networks in SIF partner countries, the exercise highlighted the critical steps to create an effective advocacy strategy, from selecting the target audience to delivering a message and monitoring outcomes. 

The briefing equipped the parliamentarians with financial evidence and advocacy approaches important for long-term, predictable domestic financing for immunization. During the training, parliamentarians developed advocacy strategies to address chronically late disbursements from the Treasury to the immunization program. Already, REPACAV is using the skills and messages developed in the briefing to develop immunization advocacy materials with tailored messaging. The group plans to draft a memo to relevant national budgeting authorities urging them to release the funds needed to follow through on the country’s co-financing commitment to Gavi and secure the vaccines needed by the people of DRC.