Newborns at risk as vaccines shortage bites

Kenya is facing a vaccine shortage at a time when cases of measles outbreaks have been recorded.

Bacillus Calmette-Guérin (BCG), measles, polio, rotavirus and tetanus vaccines are out of stock in various facilities.

The vaccines are given to newborns under the Kenya Expanded Programme on Immunisation (KEPI) to provide immunisation against six killer diseases of childhood, namely tuberculosis, polio, diphtheria, whooping cough, tetanus and measles.

Health advocates under the umbrella of the Health NGO Network (Hennet) and other health Civil Society Organisations including stop TB Partnership Kenya have raised concerns over the vaccine shortage with the Ministry of Health. 

“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.

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In the letter, Hennet Executive Director Margaret Lubale said vaccine shortage and stock outs is 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,” reads the letter in part.

The vaccine stock out 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 an uninterrupted vaccination program.

Efforts by The Standard to get response from the head of Immunisation Dr Rose Jalang’o were futile.

A senior official at the Ministry of Health confirmed the shortage is “still persistent,” which he attributed to a cut in immunisation budget.

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 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 the letter to Parliament.

The letter 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 Immunisation 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)," said the organisations.

Additionally, the organisations are seeking the committee's indulgence to clarify on the sustainability plan for Kenya to fully finance immunisation through domestic resources as donor partners transition out, citing 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, vaccine procurement budget remained constant at Sh703 million (USD 6.9 million).  

In 2019/20 financial year, vaccine budget was increased to Sh748 million (USD 7.3 million) followed by the 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 shortage bites at a time when Kenya is expected to source for 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 the organisations said will affect the procurement of immunisation supplies for example injection devices and incinerators.

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

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