The death of a child brings a lot of sorrow to the family and community. This is the plight of thousands on Nigerian families as UNICEF report shows that about 2300 children under the age of five die every day in Nigeria. Regrettably, about 42% of deaths in children in this age group in Nigeria are due to vaccine preventable diseases. Vaccines work and save lives. The World Health organization, UNICEF and World Bank State of the World’s Vaccines and Immunization reports that about 2.5 million lives are saved globally every year due to immunization. Also, improved immunization coordination and program in Nigeria was key to her interruption of wild poliovirus transmission and delisting from the list of polio endemic countries in 2015.
Nigeria immunization faces a huge risk in the coming years with a progressively widening of a fund gap for her immunization program due to increasing birth cohort, cost of new vaccines, inadequate budgetary allocation following dwindling economy (falling price of crude oil which is Nigeria’s key revenue source) and loss of donor funding following Nigeria’s transition out of Gavi support. The country multiyear plan (cMYP) for immunization states that the government of Nigeria will require ($69 million) 13.7 billion naira in 2017, ($110 million) 21.9 billion naira in 2018, ($176 million) 35 billion naira in 2019 and ($205 million) 40.8 billion naira in 2020 to co-finance vaccines and devices alone for routine immunization. These values in naira were derived using a $1 to 199 naira exchange rate but this is likely to increase as the naira continue to fall against the US dollar. Achieving this co-financing appears unrealistic judging from federal government of Nigeria annual budgetary appropriation for vaccines and devices in the years of oil boom – 2.2 billion naira in 2010, 5 billion naira in 2011, 6 billion naira in 2012, 4.15 billion naira in 2013, 2.156 billion naira in 2014 and 2.615 billion naira in 2015. Certainly, Nigeria requires innovative ideas to fill these fund gaps so as not to lose the gains in her immunization program which will turn result to more deaths of her citizens.
The National Immunization financing task team (NIFT) which was mandated by the government of Nigeria to develop a sustainable vaccine financing advocacy strategy and roll out plan recommended the following if Nigeria is to meet its immunization finance needs; State government should support the federal government in funding the procurement of vaccines, local vaccine production and establishment of Nigerian Immunization Trust Fund (NIFT) that can draw support from individuals, the private and public sector for Nigerian immunization programs.
John F Kennedy during his inauguration as president of the United States on 20th January, 1961 said, “ask not what your country can do for you, ask what you can do for your country”. Is there anything Nigerians can do to support the government of Nigeria to fill this immunization fund gap? In answering this question, I would rather say that there is a whole lot Nigerians can do to help themselves and save more of their kids from dying from vaccine preventable diseases. Nigerians can talk less and save more kids from dying from vaccine preventable diseases. Data from the Nigerian communication commission website shows that as at November, 2015, there were 152,123,172 active mobile and fixed telephone lines in Nigeria. GSMA intelligence analysis in Nigeria revealed a 2012 and 2013 average revenue per user (ARPU) by subscriber of 15 US dollars. This means that an average subscriber in Nigeria spends 3000 naira (using an exchange rate of 1 US dollars = 200 naira) every month on telephone usage which translates to about 100 naira daily. If all telephone subscribers in Nigeria decides to talk less and contribute just a percent of this amount to the immunization trust fund, we would be generating over 150million naira daily which translates to over N54billion annually. This is even beyond government of Nigeria co-financing for 2020.
I am a mobile phone user in Nigeria, my telephone and internet browsing monthly cost is beyond that estimated by GSMA intelligence analysis and I believe that there are many Nigerian telephone users, like me, that are willing to sacrifice their 1 naira talk time everyday just to save a child from dying from vaccine preventable diseases. However, government must implement the recommendation of the National immunization financing task team (NIFT) and establish the Nigerian Immunization Trust Fund (NITF). With Nigerian history of trust funds, a strong legislation will be required to ensure that proceeds of this trust fund is not misappropriated but rather used solely for the intent of creation. 1 (one) naira can be donated by all subscribers in Nigeria upon making the 1st call of the day to save our kids from dying from vaccine preventable diseases and the proceed is paid into the immunization trust fund. Finally, only men of proven integrity must be appointed into the board that will manage this fund. The good news is that with an accountable and transparent immunization trust fund, local vaccine production and other innovative financing ideas, Nigeria will have enough to fund her planned immunization programs and also have some leftover funds to introduce anticipated “future vaccines” like that for malaria and HIV/AIDS – a key intervention that is needed if we must eradicate these two diseases that have remained a scourge in Nigeria.
Written by Dr. Obinna Ebirim Research Associate and Advocacy Consultant, Direct Consulting and Logistics & Consultant for International Vaccine Access Center (IVAC) projects in Nigeria. He can be reached at <firstname.lastname@example.org>