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Immunization Financing News VOL. 5, ISSUE 4, DECEMBER 2013 Immunization Financing News Quarterly news from the Sustainable Immunization Financing (SIF) Program J VOL. 5, ISSUE 4, DECEMBER 2013 SIERRA LEONE HOSTS A Over 40 MPs attended the briefing, which was opened by the Deputy Speaker of Parliament, Hon. SYMPOSIUM FOR Chernoh BAH. Peer exchangers from Liberia were PARLIAMENTARIANS ON also in attendance and shared their experiences SUSTAINABLE IMMUNIZATION establishing a Parliamentary Immunization Forum and drafting amendments related to immunization in FINANCING their Public Health Act. Sierra Leone’s parliamentarians (MPs) are driving progress on immunization goals within their country. Yet many MPs who were instrumental in defending immunization budgets and pushing forward legislation were not re-elected this year. To ensure continued progress, the Parliamentary Health and Sanitation Committee organized a parliamentary briefing on sustainable immunization financing and invited all MPs.new and old, to attend in order to learn more about immunization and the EPI Program. Dr Kenneh, Sierra Leone's new EPI Manager, describing Sierra Leone’s new EPI manager, Dr Mohammed the progress achieved in immunization at the Parliamentary Symposium. KENNEH, used the opportunity to brief the MPs on progress achieved by the country’s EPI program, the The UN country team also used the briefing as an newer vaccines that are being introduced and opportunity to acquaint the MPs with the vaccine coverage levels district by district. He commitments undertaken by Sierra Leone within the identified the program’s needs and asked the MPs to Global Vaccine Action Plan -- a framework be ready to defend the EPI budget for 2014, which approved by the World Health Assembly in May has recently been submitted for approval to 2012 to achieve a set of six strategic immunization parliament. objectives. www.sabin.org/fr (en français) page 1 www.sabin.org/sif VOL. 5, ISSUE 4, DECEMBER 2013 Many MPs are also physicians and members of the Parliamentary Health and Sanitation Committee and understood the issues well. One of the MPs described the difficulties he had faced when trying to vaccinate villagers in a remote part of the country earlier in his career. He stated that parents did not want to get their children vaccinated but after some information and outreach they became more comfortable with immunization. Dr. KENNEH and Dr. KAMARA answered the questions and provided more details on the issues raised. Left to right: Honorable Johnson Toe CHEA, one of the The MPs were also interested to learn about the Liberian MPs attending the Parliamentary Symposium, Global Vaccine Action Plan. They discussed how and two MPs from Sierra Leone leading Parliamentary much the immunization program would cost in the immunization efforts, Honorable Chernoh BAH and Honorable Mabinty FUNNA. future, based on the projected cost of newer vaccines. The MPs also discussed how they might The MPs agreed that passing immunization create a Parliamentary Forum on Immunization akin legislation is an important next step. Hon. Veronica to that of Liberia. Parliamentary Forums provide a SESSAY commented that the EPI staff would like to mechanism for maintaining a critical mass of MPs draft a series of bylaws to help regulate the Program, who are knowledgeable about immunization and the but they cannot do so until enabling immunization immunization program needs, so they can legislation is in place. The country is currently effectively defend budgets and advance legislation revising its Constitution, added Hon. SESSAY, so for immunization [see related story, Vol. 5 Issue 2]. the timing is good for developing new immunization The MPs discussed two options: Utilize a Tripartite legislation. Several MPs suggested drafting a Private Committee that has already been created (involving Member’s bill that would be backed by enough MPs Parliament, the Ministry of Health (MOH) and to be passed into law as an Act. Most of the MPs Ministry of Finance) or create a freestanding expressed their support. The EPI team and MPs Parliamentary Forum. agreed to continue exploring the best way to The MPs agreed that increasing the budget for proceed, whether through an Act drafted and immunization is an important goal. They pointed out submitted by the Ministry of Health or through a that, by law, parliament cannot increase the budget private member’s Bill (the strategy chosen by after it has been submitted by government. After a Uganda). budget has been submitted, parliament can make only small changes that do not have a significant impact. However, several parliamentary committees MALI POINTS THE WAY TO are involved in the drafting and formulation of the budget prior to submission. These parliamentary GVAP IMPLEMENTATION committees will be responsible for ensuring that adequate budgets are allocated to immunization in The West African country of Mali recently offered a the future. (This is not the case in Liberia, where glimpse of how one country is implementing the Parliament has the constitutional power to increase Global Vaccine Action Plan (GVAP). Following a budgets after submission.) drop in immunization spending last year due to political unrest, the Government increased its 2013 immunization budget request. A parliamentary forum on immunization was formed in March. A draft immunization law is expected to be approved www.sabin.org/fr (en français) page 2 www.sabin.org/sif VOL. 5, ISSUE 4, DECEMBER 2013 by mid-2014. Government and parliamentary Evaluation/Accountability Framework, according to counterparts recently met for a week-long which ministers of health will annually present their immunization program review and planning progress toward the GVAP objectives, beginning meeting. Sabin Senior Program Officer Jonas with the May 2014 World Health Assembly. MBWANGUE and Program Associate Alice ABOU Meeting those GVAP objectives will require NADER attended. improving current program financing, management and reporting practices and probably developing The review was timely. According to recent reports new ones. After questions and answers, the from the Overseas Development Institute and participants broke into two working groups. One African Development Bank, Mali is one of the top group considered how to integrate the GVAP twenty Millennium Development Goal achievers. strategies into the cMYP. The other group inserted Yet child mortality remains stubbornly high, due specific GVAP indicators into the 2014 mainly to malaria. Measles deaths are increasingly immunization work plan. rare, thanks to the country’s routine immunization program. The introduction of pneumococcal vaccine On the second day, Sabin’s NADER suggested ways last year promises further mortality reductions. countries might integrate resource tracking strategies into their annual EPI work plans. She demonstrated Whether these mortality impacts occur in time to how SIF countries are using a standard approach to meet the 2015 MDG4 objective will depend in part analyze their immunization program budget flows. on immunization program performance. According Performed annually, the method shows whether to WHO reports, Mali ranks in the middle range of budget performance improved or deteriorated. Two the AFRO Region’s 47 countries in terms of vaccine small groups were again formed. One group coverage and surveillance system indicators. considered how best to perform the 2013 Improvements are needed, especially to reduce immunization budget flow analysis, while the other vaccination dropout rates and to double cold chain group applied the GVAP principles and objectives capacity for rotavirus vaccine introduction, slated to Mali’s draft immunization law. for 2014. A strong investment case will be required. The work continued through the week, culminating The review took place on December 13-17th in with participants forming a Ministry of Health Koulikoro, a government training center 90 committee to follow up GVAP implementation. kilometers from the capitol Bamako. As articulated by the Ministry of Health Division of Prevention and Disease Control, the main objective of the CAMEROON: PROGRAM REVIEW review was to integrate the six GVAP strategic objectives into the country’s 2012-2016 AND WORKSHOP POINT THE comprehensive Multi-Year Plan (cMYP) for WAY TO SUSTAINABLE immunization. A second objective was to review and revise Mali’s draft immunization law. UNICEF IMMUNIZATION FINANCING and World Health Organization counterparts and On 8 November 2013, regional immunization Sabin’s MBWANGUE and ABOU NADER managers gathered in Yaounde, Cameroon to hear facilitated the work. the results of an external review of the country’s immunization program. Yaoundé-based Sabin To kick off the first working session, WHO Senior Program Officer Jonas MBWANGUE Immunization Advisor Dr. Baba TOUNKARA attended and sent this report. outlined the GVAP objectives. MBWANGUE then presented the GVAP Monitoring and www.sabin.org/fr (en français) page 3 www.sabin.org/sif VOL. 5, ISSUE 4, DECEMBER 2013 In recent years, Cameroon’s vaccine coverage levels expenditures. This is one of the sustainable have hovered around 85%. However, in 2012-13, immunization financing priorities identified by the the country reported measles incidence levels above Cameroonian delegates in the August 2013 Dakar the average for Central African countries. In SIF Colloquium. October, four cases of wild poliovirus were confirmed- the first since 2009. The external review These and other issues were addressed in a focused mainly on
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