By Ndidi Chukwu
African Ministers of Finance, Health and other relevant sectors would convene at Addis Ababa, Ethiopia between February 24 and 25, for the first-ever Ministerial Conference on Immunisation in Africa (MCIA). In this Interview with Health Reporters, Dr. Chizoba Wonodi, Country Lead, International Vaccine Assess Center (IVAC) shares her views on what is ahead of Nigeria and its Routine Immunisation Programs after 2022. Excerpt:
Routine Immunisation in Nigeria faces several funding challenges, and the country’s ministers are going to participate at the forthcoming African Ministers Conference in Addis Ababa on immunisation, what should be the expectation of Nigerians at the conference?
I think that within the immunisation space we already know what the challenges are, we know what the funding gap for Routine Immunisation is, but there are people outside the Routine Immunisation sector who have not really heard about it and do not really know what the issues are. We are hoping that with the momentum that will come during the ministerial summit, the awareness about what is facing us next year will begin to grow so that we can as a nation start having concrete plans and actions towards addressing the funding gap. We within the immunisation sector cannot solve the problems ourselves. We need to take this message to the Presidency, the Governors’ Forum, and the Private Sector; we have to know if they really care about the fact that without adequate funding immunisation program is at risk, because of the transition out of Global Alliance for Vaccine Initiative (GAVI) support.
We have seen scenarios where Nigeria is unable to meet up to its funding commitment of the GAVI agreement, now we are talking about the graduation process at a time that the issues around Routine Immunisation funding is not well understood by our policy makers, what should we be doing at this moment as a country?
Nigeria should really be clear of what it needs to do, and also know how much it should put on the table next year for Routine Immunisation which is about N12 billion. In this year’s budget, N4 billion was budgeted and next year we are going to require about N12 billion naira. So how are we going to move from N4 billion to N12 billion? But we are hopeful that people will review the budget and the National Primary Health Care Development Agency (NPHCDA) would be able to budget appropriately, they should request for the amount of money that is required. Then the role of the advocates is to say yes this is what we really need for children to get vaccinated, because the government is putting on new vaccines that will fight against the known killers of children, therefore as they are adding this new vaccines their cost is going to rise.
You keep saying the government should know, does it mean that they don’t know, or not making any plan ahead of 2022 the time the country is expected to self fund vaccine procurements?
It will be nice to see the plans in black and white to say this is how we are going to go, from 4billion to 12billion
Is the money not available yet?
I would like to see exactly what it is and what we are trying to help the government do. All the Civil Society Organisations are asking for this to ensure that those plans are in place.
Looking at the dwindling economy can Nigeria scale through its immunisation challenges?
That is a big question and that is why we have to look beyond government. I have laid out three options; increase budgets, state governments’ immunisation fund, contributions from public and private sectors.
What would be your recommendations on how to engage the Nigerian Private Sector?
One way they can come in is to dedicate a certain percentage of their corporate social responsibility into the fund. But in Nigeria private sector are sceptical about contributing money and it goes into a black hole so we need to set up a system where contributions are very transparent. So we have something like ‘go-fund-me’, where you can have a cause. For instance, if you want to raise N1million for IDPs in Borno state, you set up a go-fund-me, people will start contributing on that platform and you ensure that every kobo is recorded there, that platform generates the transparency that gives people the confidence that their money is not going in for something wrong. By the end of any month you see how much you have realise and a pronouncement that you raised N1million for IDPs and mention the day you are going to give it to the IDPs and people will see that there is accountability and transparency.
So we need to put in place such plans that will stir the public confidence to be able to donate for immunisation funds, of course you know that there are many individuals that you could ask to make donation and they would do it. Other ways to do it is through the telecoms, the cell phones, we have been talking about it for quite some time and there are different options, that you can systematically get these contributions from phone calls
CSOs participation during budget planning process could help in driving these good ideas you have shared, but there seems to be poor CSOs engagement when budgets are planned, does that imply that our policies makers are alien to accountability?
CSOs ought to actively participate in the budget development because they can play the watch dog function, to say for instance, these five health centres have been budgeted to be renovated and they work in those communities where these health centres have been identified. CSOs can track these renovations to say yes they were done, so that next year they will not have to be in the budget again because they have been renovated. Also they can track and say that they know that these health centres were to be renovated but they are not so they can demand that they are done. But if they don’t have that information they cannot play that role. So this is why it is important for CSOs to be brought in to be able to do accurate budget tracking, but then they have to be granted access to the data but many times they request for information and they met a brick wall. Bur the CSOs need to push harder because that is their job.