Funding issues, failure to utilise data to blame for vaccine crisis

PS Medical Services, Ministry of Health Harry Kimtai before the Public Accounts Committee (PAC) for Examination of the Auditor General's report for the Financial Year ended 30th,June 2023 at Bunge Towers, Parliament, Nairobi. December 3rd, 2024 [Elvis Ogina, Standard] The shortage of infant vaccines in Kenya is not a new issue, yet it remains a persistent problem. This challenge is largely attributed to the government's failure to properly project population growth. Approximately one million babies are born in the country annually, with an estimated 300,000 missing immunisation. Currently, infants are at risk of contracting tuberculosis (TB) due to a significant shortage of Bacillus Calmette-Guerin (BCG), just six months after a similar shortage was reported in the country. "It is not the first time we have had a shortage of vaccines. This is a repeat of history. It is a cycle," says Eveline Kibuchi, the Stop TB Partnership Kenya Country Coordinator. "We need to get to the root cause of recurring vaccine stock-outs. For instance, in June, 2024 there was a stock-out, and six months before that, we faced the same issue. If we conducted a three-year trend analysis, we would realise that this is a cyclical problem. Understanding this cycle is critical to addressing the issue," says Dr Margaret Lubale, Director of Health NGOs Network (HENNET). Lubale notes that immunisation budgets are not supported by scientific and data projections, and that treasury allocations are disconnected from population growth trends. "Supplementary budgets are sometimes misused or reduced when funds are perceived as underutilised. The basis for resource allocation often lacks a scientific or data-driven approach, leading to inefficiencies," she says. Supply planning, she adds, is critical and involves analysing past consumption data and maintaining a three-month buffer stock. "This approach, combined with accurate population projections, ensures sufficient vaccine supply. Family planning programmes already use similar methodologies successfully to forecast and quantify needs," Lubale explains. Every year, the Ministry of Health seeks to vaccinate at least 1.5 million children against vaccine-preventable diseases, such as measles, polio, tuberculosis (TB), and pneumonia. Dr Lubale also highlights gaps in budgeting and planning. "Have we accounted for the number of zero-dose children? Do we understand the vaccine needs of the country based on population growth? For example, if annual population growth is projected at a certain percentage, vaccine supply planning must align with these projections. Unfortunately, this has not been done effectively," she explains. Lubale further notes the importance of co-financing obligations that must be addressed by the government. "Treasury needs to allocate funds for disbursement so that Gavi can issue an order to the United Chilren's Fund (Unicef) or other producers. The biggest challenge is meeting these obligations. Gavi has strict requirements, and any delays in payments can lead to halts in vaccine supply. Identifying the root cause is essential for finding a lasting solution," she says. She also points out that health sector advocates often encounter unexplained budget cuts. "Vaccination might request Sh3 billion, but only receive Sh1 billion, with no rationale provided. While resources are limited, we must prioritise their allocation and focus on areas with the greatest impact," she adds. The decision-making processes surrounding vaccine procurement, she observes, are often siloed, leading to inefficiencies. This comes as Kenya's vaccination programme gradually faces a reduction in budgetary allocation over the years.

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