CS blames vaccines shortage on outstanding debt

Health Cabinet Secretary Susan Nakhumicha. [Boniface Okendo, Standard]

The Ministry of Health has attributed the current shortage of childhood vaccines in the country to an outstanding claim.

Health Cabinet Secretary Susan Nakhumicha said the Ministry is liaising with the National Treasury, to ensure there is no gap in supply of the vaccines that are reported to be out of stock.

In an interview with the media, the CS revealed that the jabs given to newborns under the Kenya Expanded Programme on Immunisation (Kepi), are supplied by the United Nations International Children's’ Emergency Fund (UNICEF), and Gavi- the Vaccine Alliance.

“We have a challenge, but that challenge is being worked on,” said Nakhumicha.

“We had an outstanding claim, but this morning, we had a conversation with my colleague, CS, the National Treasure and Planning, and I discussed with PS Medical Services (Harry Kimtai), and we have agreed on what should be done to ensure the gap is filled,” she added.

The revelation comes in the wake of the measles outbreak in Garissa County.

Some of those reporting out of stock include Bacillus Calmette-Guérin (BCG), Measles, Polio, rotavirus and tetanus vaccines.

The jabs are given to newborns to prevent six killer childhood diseases; tuberculosis, polio, diphtheria, whooping cough, tetanus and measles.

During the shortage, Nakhumicha said, hospitals should order the vital jabs.

“The product (vaccines) may not be at the national level, but at the sub-national, the vaccines are there. It is just that we are being careful so that we do not run out completely," she said.

"Mechanisms have also been put in that if a facility has run out, there is a way they can check within the sub-national level where that vaccine is available, and what can be transferred from one facility to the other to ensure we do not have children who miss on their doses,” the CS added.

Nakhumicha’s admission came after health advocates under the umbrella of Health NGO Network (HENNET) and other health Civil Society Organisations - including Stop TB Partnership Kenya, raised concern over the vaccine shortage.

“We write to bring to your attention a matter of urgent concern regarding the potential outbreak of measles and reported vaccine stock-outs in various regions of Kenya,” reads a section of the letter written by Hennet, addressed to the Ministry of Health.

In the letter by the Executive Director of Hennet, Dr Margaret Lubale said vaccine shortages and stockouts are alarming.

“There have been alarming reports of vaccine stock-outs and shortage of some routine immunisation antigens such as BCG, Rota and Oral Polio Vaccine and measles in various health facilities,” notes the letter.

The vaccine stockout according to the health stakeholders may result in the spread of measles that has been reported in Garissa.

As a preventive measure, the stakeholders want the ministry to expedite the procurement and distribution of measles vaccines to replenish depleted stocks and ensure uninterrupted vaccination programmes.

Meanwhile, civil society organisations have opposed budget cuts on immunisation, citing disruption.

Under the 2023/24 budget, the National Treasury approved estimates for the period in review was Sh9.8 billion, but was revised to Sh9.4 billion in February.

"We are deeply concerned about the immunization budget reduction of Sh463,135,384 in the Supplementary budget FY 2023/2024 from Sh9,892,774,930 to Sh9,429,639,546," reads a section of a letter written to the National Assembly Health Committee.

The organisations further demanded an explanation from parliamentary health committees on why there is a budget cut.

“We call upon the National Assembly to increase the national budget for the national immunisation programme, as well as ring-fence funds allocated to the programme for sustained gains,” reads a section of the letter to parliament.

The document was also signed by Amref Health Africa, Path-Kenya, Waci-Health, Access to Medicines Kenya, TB Champions and Coalition for Health Research and Development (CHReaD).

According to the stakeholders' failure to allocate enough budget for immunisation will jeopardise the ability of the National Vaccine Immunization Program (NVIP) to timely and urgently procure vaccines, affecting the Ministry of Health's efforts to carry out any campaign.

“This (financial allocation) will also affect Kenya's co-financing payment to the Global Alliance for Vaccine Initiative -Gavi," added the organisation.

Additionally, the organisations are seeking the committee's indulgence to clarify the sustainability plan for Kenya to fully finance immunization through domestic resources as donor partners transition out, with an example of GAVI by 2028.

"Considering these developments, it is our request to the National Assembly Health Committee will take immediate action," the letter reads in part.

Between 2016/17 and 2018/19, the vaccine procurement budget remained constant at Sh703 million (USD 6.9 million).  

In the 2019/20 financial year, the vaccine budget was increased to Sh748 million (USD 7.3 million) followed by an 87 per cent increase to Sh1400 million (USD 13.4 million) in 2020/21 after Health Committee engagements with NVIP and non-state actors.

Under the 2022/23, the budget was increased to Sh1559.2 million (USD 15 million) in 2021/22, an allocation which remained constant in 2022/23.

The biting shotage comes at a time when Kenya is expected to source more local revenue to facilitate vaccination. The vaccination programme is heavily funded by Gavi and other partners.

"This also comes at a time when Kenya Country co-financing payments to Gavi in 2024 is US$ 11,655,533, while total Gavi support is US$ - 13,054,393," noted the stakeholders, adding that Kenya's co-payments are almost 50 per cent of all vaccines needs. 

The budget cuts, according to the stakeholders, will exacerbate the existing problem of low delivery of the immunisation programme, and make it difficult to meet the requirements of accelerated transition from Gavi funding.

Additionally, lack of budget, they said, will affect procurement of immunisation supplies, including injection devices and incinerators.

The Stop TB Partnership Kenya lead, Eveline Kibuchi, poked the government’s agenda on preventive health following the vaccine shortage.

“It is worrying that the government has prioritised preventive health, but we have stock out, which means we are likely to have disease outbreaks in children,” said Kibuchi.