Guinea's immunization costing and financing situation
Macroeconomic and health system context
While Guinea’s economy grew well at a rate of 4% during the 1990s, its economy has declined during the last three years due to changes in the terms of trade as well as unanticipated expenditures for security concerns due to conflicts in neighboring countries. As a result of high security expenditures, the country has not been able to implement its Poverty Reduction Strategy and the country’s external assistance is declining as well.
In 2001, per capita expenditures on health were $19.
Immunization programme objectives
According to the WHO and UNICEF estimates, the DTP3 coverage in 2001 was 71%. The national immunization programme objectives are to:
- attain a coverage level of 80% for all of the EPI antigens and in 80% of the health districts;
- introduce new vaccine against hepatitis B and haemophilus influenzae type b (Hib) in 2006;
- improve efficiency by reducing vaccine wastage and supply wastage rates;
- put in place a system of surveillance and control of vaccine-preventable disease, including polio by 2005;
- eliminate neonatal tetanus and control of measles by 2006; and
- develop plan for information, education and communication (IEC).
Immunization costs and financing
In 2001, the pre-GAVI Fund year, Guinea spent $2.3 million on programme-specific expenditures for routine immunization services and an additional $0.5 million on supplementary immunization services. The programme-specific spending on routine immunization service equated to about $9.5 per DTP3 vaccinated child or $0.25 per capita. Programme-specific spending on routine immunization increased by 23% in 2003, the second year of GAVI Fund support, due to the introduction of new vaccines. Total expenditures on the NIP in 2003 were $4.8 million.
The share of programme expenditures paid by the national government increased to 78% in 2003, due to an increase in expenditures on vaccines. The government pays mainly for vaccines, injection materials, salaries, social mobilization and maintenance and overheads, while donors pay for new vaccines, capital costs, monitoring and surveillance, and supplementary immunization activities. The main funding partners are the GAVI Fund, WHO, UNICEF, and USAID.
Routine immunization financing by source - 2003
Future resource requirements, financing and gaps
Resource requirements of the programme are projected to increase as expenditures on vaccines are projected to rise. The average annual resource requirements during 2004-2013 for the NIP are projected to be $7.6 million per year. About 90% of the funding is classified in the FSP as secure during these years. If funding classified as probable is included as well, 100% of needs are covered.
No annual gap will exist if both secure and probable funding is included ($0.9 million a year if probable funding is excluded) during the remaining GAVI Fund years. There is no post-GAVI Fund years reported. The FSP reports secured GAVI Funds for the entire 2004-2013 period.
Average annual funding gaps (millions of US$)
Financial sustainability strategies
Several strategies have been developed to improve financial sustainability of the NIP. These strategies include:
- increase government contributions for immunization;
- increase donor contribution for immunization; and
- improve programme efficiency through reduction of vaccine wastage and drop-out rates, improving the flow of funds to districts, and through improved monitoring and supervision of programme activities.