VOL. 6, ISSUE 4, FEBRUARY 2015 Immunization

Financing News

Quarterly news from the Sustainable Immunization Financing (SIF) Program

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A PRESIDENTIAL BOOST MOVES Dr. Ram Baran Yadav. On 31 October, President Yadav NEPAL CLOSER TO THE FINISH LINE hosted a briefing in his office to learn more about this work. Attending were Sabin Senior Program Officer Dr. This quarter, Nepal advanced further toward its Devendra Gnawali and, representing Rotary sustainable immunization financing goal. New International/Nepal, Rotarians Ram Prasad Bhandari, immunization legislation is nearing passage, Rabindra Jang Thapa, Gopal Pokhrel and Rishi Raj inaugurating a public-private immunization financing Adhikari.

arrangement. Four years in the making, the project Nepal's President, Hon. Dr. Ram Baran Yadav, with Sustainable recently received a boost from Nepal’s President, the Immunization Financing Senior Program Officer Devendra Honorable Dr. Ram Baran Yadav, who announced he Gnawali, and delegates from Rotary International/Nepal: Mr. was joining the growing network of supporters working District Governor Rtn. Rabindra Piya, Rtn. Ram Prasad Bhandari, on immunization financing solutions for the country. Rtn. Rabindra Jang Thapa, Rtn. Gopal Pokhrel and Rtn. Rishi Raj Adhikari. Like many lower income countries, Nepal’s economy is growing and revenues are increasing. But vaccine and delivery costs are rising faster. The country has already introduced inactivated polio vaccines in September 2014 and is on track to introduce pneumococcal and human papillomavirus in 2015, which will push immunization costs to well over US$30 per child- far more than the government can currently allocate to the program. The solution: establish two immunization funds, one governmental, and the other private. Backed by a new vaccine law, the public fund will guarantee a minimal vaccine budget safeguarded from budgetary shocks. It will be matched by a private fund, dubbed the Sustainable Immunization Financing Support Fund, which was launched by the country’s Rotary and Lions clubs in October 2012 [see related stories: Summary Digest, Vol 5, Issue 1, Immunization Financing News, The group discussed how new legislation will establish Vol 6, Issue 1]. Government officials are currently the funds and guide their administration. The Ministry of working on a provision granting tax benefits to induce Health and Population (MOHP) began the project in domestic firms to contribute to the private fund. May 2011. In April 2014, the Ministry of Finance

allocated an initial NPR 10 million (around These efforts to achieve sustainable immunization US$100,000) for the new fund. The prospects of financing caught the attention of Nepal’s President, Hon. enacting the supporting legislation dimmed when a

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constitutional crisis led to the dissolution of Parliament discussants analyzed technical issues of the national in July 2012. Undaunted, officials in the Ministries of immunization program, the immunization law and the Finance and Law and Justice turned to crafting immunization fund in detail. The Health Minister, H.E. regulations for the funds. Local governments and a range Khag Raj Adhikari, disclosed that the draft would be of non-governmental organizations, as well as WHO and registered into the parliament very soon, and the MPs UNICEF experts were consulted during this process. committed to pass the immunization bill.

At this writing, the National Immunization Law is now on the docket of the recently re-established Parliament and could be passed as early as March 2015.

“Now H.E. Khag Raj Adhikari, Minister of Health and Population, is calling for the immunization law”, reported Gnawali. “We are very close to the goal”, he concluded. Following Nigeria, Nepal now stands to be the second SIF country to enact legislation guaranteeing public financing for immunization.

SIF INSTITUTIONAL KNOWLEDGE CATALOGUE From Left to Right: Hon Ranju Kumari Jha, Chairperson of Women, Children, Senior Citizen and Social Welfare Committee of Parliament, Hon Khag Raj Adhikari, Minister of Health and Population, Mr. Shant Bahadur Shrestha, Secretary for Health, Dr. Krishna Poudel, Director of Child Health Division, Dr. Hendrikus Raaijmakers, Chief of Health, UNICEF and Dr. Rajendra Bohara, National Coordinator, WHO

The launching of the private fund by Rotarians and Lions Clubs in October 2012 added impetus to the government’s efforts. Former Minister of Health Hon. Vidyadhar Mallik guided the final government approval process, culminating in January 2014 with the publication of the fund regulations in the Nepal Gazette.

A compendium of program inputs and observed outputs in nineteen At the request of Hon. Ranju Kumari Jha, Chairperson SIF countries nears publication. of the Women, Children, Senior Citizens & Social Welfare Committee, the Ministry of Health and Since 2009, the SIF Program has been working with an Population, WHO and SIF/Sabin jointly organized a array of countries to build the capacity of governmental "Symposium on Shared Responsibility for a Sustainable and domestic non-governmental counterparts to develop Immunization Program" for parliamentarians in and institutionalize their own innovative financing Kathmandu, Nepal. The Symposium was chaired by Mr. solutions. All but one of the original countries have Shanta Bahadur Shrestha, MOHP Secretary. The remained with the SIF program to this day, and three Chief Guest was Hon. Khag Raj Adhikari, Minister of more have joined since the program’s inception. Health and Population, and the Special Guest was Hon. Ranju Kumari Jha. Also attending were reporters, SIF has been operating on a unique international more than twenty MPs from the Women, Children, development frontier. The Program seeks to catalyze the Senior Citizens & Social Welfare Committee, and transition of national immunization systems from officials from the MOHP, EPI team, WHO, UNICEF, financial precariousness and dependency to self- and Sabin. Using the appreciative inquiry method, sustainability and country ownership. www.sabin.org/fr (en français) page 2 www.sabin.org/sif

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Little documentation exists on transitions of this nature, whether in the field of global health or elsewhere in international development. With six years of documentation to work from, SIF Program Coordinator Mr. Andrew Carlson recently produced the “SIF Institutional Knowledge Catalogue”. The Catalogue contains a monthly time-log of SIF Senior Program Officer activities linked to steps a country has taken toward one of five dimensions of financial sustainability:

 Legislation protecting federal immunization budgets against institutional, political, or economic shocks  An inter-institutional or parliamentary coalition to advocate for an increased immunization budget  A financing mechanism which ensures adequate, predictable domestic funding to the EPI program, such as a trust fund or a national immunization fund  The regular, independent use of resource tracking MP briefing between REPACAV representatives and Orientale tools by the appropriate government entity Province legislators, 8 October 2014. Photo courtesy of REPACAV.

 The integration of GVAP Strategic Objectives #1 and REPACAV’s President, Hon. Gregoire Lusenge, #5 into national immunization work plans established the coalition in May 2012. The REPACAV Charter states that, The five dimensions were derived from country presentations at the second SIF Colloquium (Dakar, In our country, children die every year from vaccine- August 2013). The catalogue will be updated monthly preventable diseases…an action by parliament would and is already being used for qualitative and quantitative allow the Democratic Republic of Congo to benefit from analyses. The catalogue will be available on the SIF autonomy over its immunization financing efforts, and website by April 2015. better organize its national immunization program.

REPACAV was created to “support vaccine-related MAJORITY OF DRC PROVINCES NOW activities through advocacy on the parliamentary level COMMITTED TO CO-FINANCE and sensitization campaigns on the community level.” IMMUNIZATION Hon. Lusenge, Hon. Louis Kaswende, Hon. Celestin DRC continues to increase immunization financing at Bondomiso, and Hon. Richard Makuba of REPACAV the provincial level. In October and December 2014, and SIF Senior Program Officer Dr. Helene Mambu- government authorities from three more provinces made Ma-Disu embarked on the first advocacy mission, to formal commitments to mobilize local funding and pass Bas Congo Province, on 11 December 2013 (see related legislation to support their immunization programs. In story, Immunization Financing News, 5(4)). This past all, six of DRC’s eleven provinces have begun December, three REPACAV members, Hon. Makuba, developing such solutions. Driving the process is the Hon. Yukula, and Mr. Muntuntete-Vanloy, paid a Réseau des Parlementaires Congolais pour l’Appui à la return visit to Bas Congo where they assisted the Vaccination (Congolese Parliamentary Network for provincial EPI team in preparing the program’s budget Immunization Support). Known as REPACAV, the for 2015. Network includes parliamentarians and government officials working together at federal and provincial On 5 & 7 May 2014, REPACAV members visited levels. Oriental and Kasai-Occidental provinces (see related story, Immunization Financing News, 6(2)). Among the www.sabin.org/fr (en français) page 3 www.sabin.org/sif

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delegates were national immunization program UGANDA AND VIETNAM APPRAISE counterparts Dr. Guillaume Ngoie Mwamba, Dr. MONGOLIA’S IMMUNIZATION LAW AND Jacky Matondo and Mr. Benjamin Matata. Among FUND the MPs were Hon. Gregoire Lusenge, Hon. Célestin Bondomiso, Hon. Louis Kaswende, and Hon. Mubikayi, who represents Kananga, the capital city of Kasai-Occidental. Ministerial and parliamentary authorities in both provinces agreed to begin mapping the way towards sustainably financing their local immunization programs, reported SIF Senior Program Officer Dr. Mambu-Ma-Disu, who accompanied the delegates. The provincial officials, in turn, asked REPACAV to facilitate the disbursement of funds from federal level to their provinces.

These missions were soon followed by more. After their parliamentary summer recess, REPACAV members visited Bandundu (2-5 December) and Maniema

Provinces (23-27 December). The delegation was led by Hon. Henry Banyenzaki (Uganda) is welcomed by representatives former MP Hon. Hubert Masala and current MPs Hon. from Mongolia’s State Grand Khural (parliament). Photo courtesy Louis Kaswende, Hon. Lumeya and Hon. Koko. As in of State Grand Khural, Mongolia. their previous forays, the REPACAV delegates met with the provincial immunization coordinators, health An interesting event took place on 6-7 October in ministers, governors, provincial assemblies and civil Ulaanbaatar, Mongolia. The Government and State society leaders. Great Khural (parliament) of Mongolia, along with SIF, sponsored a peer exchange, the theme of which was Maniema Province, the country’s poorest, subsequently Sustainable immunization financing: The legal increased its proposed immunization budget by 66 landscape. Participating were parliamentarians and percent. senior government officials from Mongolia, Vietnam and Uganda. The purpose of the exchange was to learn To date, the Network has added six of DRC’s eleven how Mongolia created its immunization law and national provinces to the REPACAV network, creating immunization fund. subnational antennes for sustainable immunization financing: For the Ugandans, the visit was an obligatory study tour on behalf of their National Assembly. Before taking up a  December 2013: Bas-Congo similar bill, Uganda’s Speaker of the House had earlier  May 2014: Kasai-Oriental asked members of the Parliamentary Forum for  May 2014: Kasai-Occidental Immunization to learn from the experience of another  October 2014: Orientale country having had the same experience and to report  December 2014: Bandundu that experience back to parliament. This added evidence  December 2014: Maniema would make it easier for parliament to approve Uganda’s immunization bill, now three years in the making. Looking ahead, Hon. Lusenge and his colleagues are Ulaanbaatar-based Sabin Senior Program Officer Dr. envisioning an advocacy network with representation Khongorzul Dari was already planning another peer from all eleven provinces. exchange between Vietnam and Mongolia. Her

parliamentary and government counterparts agreed to alter the plan and host a joint Ugandan- Vietnamese visit.

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Representing Uganda were Hon. Henry Banyenzaki, forming global parliamentary network for immunization MP and State Minister for Economic Monitoring, Office at the next International Parliamentary Union meeting in of the President. He was joined by two other MPs active Geneva. Speaker Hon. Enkhbold Zandaakhuu agreed in the Network, Hon. John Amos Okot and Hon. Anne to support the proposal. Auru. The Vietnamese peer exchangers were Drs. Tran Hien Nguyen and Cong Luat Nguyen. Receiving the Reflecting on their experience, the Ugandan MPs delegations were Hon. Enkhbold Zandaakhuu, praised the Mongolians for their immunization financing Parliamentary Speaker, Hon. Battsogt Dogsom, work and resolved to push their own immunization bill Chairman of the Standing Committee on Social Policy, into law upon their return home. and Hon. Amarsanaa Jazaa, Vice Minister of Health. FRANCOPHONE AFRICAN PEERS Hon. Amarsanaa Jazaa moderated the inaugural EXCHANGE BEST PRACTICES IN KRIBI session. Representatives from the Mongolian Ministry of Health, Ministry of Finance and Tax Department Twenty-five parliamentarians and ministerial officials presented the history and structure of Mongolia’s from six French-speaking African countries assembled immunization law and fund. The fund, which was at Hotel Framontel, Kribi, on 4-6 December launched in 2000, is largely financed with mining to subject their institutional work in immunization revenues. Immunization expenditures were meager in legislation, resource tracking, and budget advocacy to the early years but, with the addition of newer vaccines, peer review. the fund is now disbursing over US$40 per surviving infant.1 In the next session, the visiting peers presented The Francophone Africa Peer Review Workshop on their own innovations for sustainable immunization Sustainable Immunization Financing was the second financing. Later, the peers visited the Tax Department, episode in a three-part sequel to the SIF Program’s where another innovation has been developing. Dr. Dari Second Colloquium on Sustainable Immunization and her Tax Department counterparts have been Financing, which took place in Dakar, Senegal on 5-6 coaching local government officials to begin reporting August 2013. The first post-Dakar peer review their local immunization expenditures to their publics workshop took place in Phnom Penh, Cambodia, on 21- (see related story, Immunization Financing News, 6 (2)). 23 July, 2014 where delegations from Cambodia, Nepal, Sri Lanka, Mongolia, Indonesia, and Vietnam On the second day of the visit, the peers met with scrutinized their respective financing innovations (see Mongolian Ministry of Health counterparts to compare Immunization Financing News, 6 (3)). their respective health systems and discuss immunization financing strategies. The final stop was Joining the Kribi workshop from DRC were Mr. Jules the House of Parliament, where the peers were received Baganda, Ministry of Budget Department Director, by Speaker of the House Hon. Enkhbold Zandaakhuu Hon. Gregoire Lusenge, National Assembly, Mr. and Hon. Battsogt Dogsom, two MPs with deep interest Benjamin Matata, EPI Financial Director and Dr. and experience in the health arena. The peers reviewed Audry Mulumba, EPI Manager, Ministry of Health. their observations and the recommendations they would Representing were Ms. Noeline Victoire take home to their own governments and parliaments. Raveloarijao, Ministry of Finance and Budget, Dr. Aro Decision makers would be urged to adopt or amend laws Tafohasina Rajoelina, Health Projects Director, that make immunizations universal and sustainably Ministry of Public Health, and Dr. Lova Herizo financed. Secondly, subnational governments would be Rajaobelina, National Assembly Health Committee asked to dedicate a budget line item to cover operational Chair. Representing the Republic of Congo were Dr. costs of immunization. Thirdly, MPs and government Hermann Boris Didi-Ngossaki, EPI Manager, Ministry counterparts will need to redouble their advocacy efforts of Health, and Mr. Jean Fenelon Kanda, Budget, & for increased government expenditures on Public Portfolio, Ministry of Finance. Representing immunization. Hon. Henry Banyenzaki then proposed Senegal were Dr. Ousseynou Badiane, EPI Manager and Dr. Alimata Naco Diallo, both of the Ministry of Public Health & Hygiene, and Hon. Elene Tine, of the 1 Source: WHO/UNICEF Joint Reporting Form – Mongolia. www.sabin.org/fr (en français) page 5 www.sabin.org/sif

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Parliamentary Health Committee. Representing The National Assembly of the Congo Republic has also were: Mr. Mahamadou Sidibe, Health Focal Point, begun to organize a parliamentary network for Directorate-General for Budget, Ministry of Economy, immunization, reports Dr. Helene Mambu-Ma-Disu. Finance, & Budget, and Hon. Abdoulaye Dembele, Health Committee Member, National Assembly. The The next SIF peer review workshop is in preparation. It Cameroon delegation included: Dr. Marie Kobela, EPI will involve the six Anglophone African SIF countries: Manager, Ministry of Health; Mr. Cyrille Effila, Uganda, , Ethiopia, Sierra Leone, Liberia, and Nigeria. Budget Department, Ministry of Finance; Hon. Gaston Komba, Finance & Budget Committee Member, SIF WEBSITE UPDATE National Assembly and; Dr. Ngwen Ngangue, Ministry of Economy & Finance. Also attending were Interested readers can find a number of Sustainable representatives from UNICEF, Mr. Remy Mwamba, Immunization Financing Tools on our SIF Program Christophe Mvondo, and Folefack Medard. Attending website. from Sabin were Senior Program Officers Mr. Jonas Mbwangue and Dr. Helene Mambu-Ma-Disu. Two resource tracking tools, in English and French, are currently in use in several SIF countries. The Generic The workshop began with four rounds of small group Annual Work Plan and the SIF Budget Flow Analysis work in which each delegation presented its institutional tools both allow immunization managers to analyze their innovation- some new, creative approach or a new form budget performance and identify any bottlenecks. of collaboration- within one of three thematic areas: budgeting and resource tracking, legislation, and There are also tools for small group work using the advocacy strategies. The second half of the workshop nominal group technique. These guides are used in SIF featured a formal peer evaluation, where each delegate workshops to identify and analyze key problems as well scored the other countries’ innovations. UNICEF and as best immunization financing practices.

Sabin representatives served as facilitators. SEVENTY-FIVE SIF-SPONSORED PEER “The delegates interacted intensely in the small groups, the plenary sessions and in the formal peer evaluation EXCHANGERS FROM THIRTEEN exercise”, reported SIF Senior Program Officer Mr. COUNTRIES IN 2014 Jonas Mbwangue.

Workshop participants evaluated innovations in the other countries and received constructive feedback from their peers, which they will use to advance their own innovations.

Following the workshop, Senegalese delegate Hon. Elene Tine conferred with the Speaker of the National Assembly and the two announced the formation of a parliamentary network for immunization patterned on the DRC parliamentary network. In short order, the Senegalese parliamentary network numbered thirty MPs. Commented Hon. Tine: SIF Asian Peer Exchangers jointly identify problems and Next week, I plan to send a letter to the National Assembly facilitating factors associated with each country’s immunization President, calling for the official recognition of the financing prospects in small group work at the Asia Peer Review network as well as a General Constituent Assembly Workshop on Sustainable Immunization Financing, Phnom Penh, session at the Parliament level. This network will be linked Cambodia on 21-23 July, 2014. to an inclusive advocacy group soon to be established at the national level. Below are the names of individuals who participated in SIF-organized peer exchanges during 2014. Each has www.sabin.org/fr (en français) page 6 www.sabin.org/sif

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made, and continues to make, significant contributions  Mr. Entos Zainal, Head of Health Promotion and Nutrition to the cause of sustainable immunization financing in Community Sub-Directorate, National Development and their countries. Planning Agency

The SIF team salutes them for their work. Cambodia  H.E. Ouk Damry, Senior Advisor to the National Mongolia Assembly; General Secretary of CAPPD  Dr. Otgontuya Dari, Public Health Institute  H.E. Uy Visal, Director, International Relations  Mrs. Otgon Majaa, Standing Committee on Social Policy, Department, National Assembly of Cambodia Education, Culture, and Science; Parliament of Mongolia  Prof. Sann Chan Soeung, Advisor, National Immunization  Dr. Ganchimeg Ulziibayar, Ministry of Health Program, Ministry of Health  Hon. Enkhbold Zandaakhuu, Parliamentary Speaker  Dr. Chheng Morn, Deputy NIP Manager, Ministry of  Hon. Battsogt Dogsom, MP, Chairman of the Standing Health Committee on Social Policy  Mr. Hok Khiev, Director, Department of Legislation,  Hon. Amarsanaa Jazaa, Vice Health Minister Ministry of Health  Mr. Kim Phalla, Deputy Director General, Department of Nepal Finance and Public Policy, Ministry of Economy and  Mr. Komal Prasad Acharya, Under-Secretary, Legal Finance Department, Ministry of Health and Population  Mr. Sok Khorn, Department of Public Finance and Policy,  Mr. Shambhu Prasad Jnawali, EPI Manager, Ministry of Ministry of Economy and Finance Health and Population  Ms. Bola Kan, Health Economist, Budget Department,  Mr. Birendra Bahadur Karki, Secretary; Women, Children, Ministry of Economy and Finance Senior Citizen and Social Welfare Committee, Parliament  Hon. Mr. Uk Bun Chhoeun, Chairman of Commission 8, of Nepal Senator

 Hon. Mr. Yan Sen, Chairman of Commission 1, Senator Vietnam  Hon. Mr. Chhit Kim Yeat, Vice-Chairman of Commission  Dr. Nguyen Van Cuong, Deputy EPI Manager, National 8, National Assembly Immunization Program,  Hon. Mrs. Pov Savoeun, Secretary of Commission 8,  Mr. Do Cong Thanh, Head of Budget Planning, Ministry National Assembly of Finance  Hon. Mrs. Krouch Sam An, Secretary, National Assembly  Dr. Nguyen Tran Hien, EPI Manager, National Institute of  H.E. Kob Maryas, National Assembly Hygiene and Epidemiology, Ministry of Health  H.E. Khim Hi, Advisor to the National Assembly  Dr. Cong Luat Nguyen, National Institute of Hygiene and Epidemiology, Ministry of Health  H.E. Mr. Kin Ratha, Advisor to the National Assembly  Mr. Kal Ketnin, Advisor to the National Assembly Sri Lanka  Mr. Sur Sovanpheach, Advisor to the National Assembly  Dr. Paba Palihadawana, Chief Epidemiologist,  Mr. Son Kakson, Advisor to the National Assembly Epidemiology Unit, Ministry of Health  Dr. Koam Sinoun, Deputy Director, Department of  Ms. Nandini Ranawaka Appuhamillage, Health Legislation, MOH Committee Staff, Parliament of Sri Lanka  Dr. Enheng Morn, Ministry of Health  Mr. W Arachchilage Don Dushantha Sameera  Mr. Thiep Chanthan, Senior Program Officer, Ministry of Wickramasinghe, Director, Budget Department, Ministry Health of Finance and Planning  Chhat C. Valthanak, Government of Cambodia  Mr. Phar, Government of Cambodia Indonesia  Mr. Maliki Arif Budianto, Head of Planning and State DRC Budget Subsection, Bureau of Planning & Budgeting,  Mr. Jules Baganda, Department Director, Ministry of Ministry of Health Budget  Dr. Diany Litasari, Immunization Sub-Directorate,  Hon. Gregoire Lusenge, Member of Parliament Ministry of Health  Mr. Benjamin Matata, EPI Financial Director  Dr. Audry Mulumba, EPI Manager

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Madagascar OTHER SIF HIGHLIGHTS  Ms. Noeline Victoire Raveloarijao, Health Projects Director, Ministry of Finance & Budget October  Dr. Aro Tafohasina Rajoelina, Ministry of Public Health  21-31 October, Tibilisi. SIF SPO Dr. Eka Paatashvili  Dr. Lova Herizo Rajaobelina, Health Committee Chair, assists in Georgia’s Gavi Graduation Assessment Mission.

National Assembly November  7 & 14 November, Dakar and Bamako. SIF SPO Mr. Congo Jonas Mbwangue organizes parliamentary briefings in  Dr. Hermann Boris Didi-Ngossaki, EPI Manager Senegal and Mali.  Mr. Jean Fenelon Kanda, Ministry of Finance, Budget, & Public Portfolio  12 November, Dalanzadgad City. The Mongolian Tax Department, Department of Health and Parliamentary Senegal Standing Committee on Health, with assistance from SIF  Hon. Elene Tine, MP, Parliamentary Health Committee SPO Dr. Khongorzul Dari, brief Umnugobi District health Member and tax officials on local immunization expenditures.  Dr. Ousseynou Badiane, EPI Manager  12 November, Abuja. SIF SPO Dr. Clifford Kamara in Mali tandem with peers from Nigeria’s Senate Committee on  Mr. Mahamadou Sidibe, Health Focal Point, Directorate- Health, Ministry of Health, the NPHCDA and other General for Budget, Ministry of Economy, Finance, & international agency counterparts, moderates a panel at a Budget conference marking World Pneumonia Day, Sustaining  Hon. Abdoulaye Dembele, MP, National Assembly Health PCV Introduction in Nigeria. Committee Member  Dr. Alimata Naco Diallo, Ministry of Health & Public  13 November, Kampala. SIF Director Mike McQuestion Hygiene and SPO Ms. Diana Kizza Mugenzi host a SIF/Uganda Alumni Dinner attended by past SIF peer exchangers. Cameroon  Dr. Marie Kobela, EPI Manager  15-17 November, Kinshasa. Representatives from the  Mr. Cyrille Effila, Budget Department, Ministry of DRC’s EPI and Ministries of Finance, Budget and Finance Planning, with assistance from SIF SPO Dr. Helene  Hon. Gaston Komba, MP, National Assembly Finance & Mambu-Ma-Disu, integrate GVAP Objectives #1 and #5 Budget Committee Member into the country’s cMYP.  Dr. Ngwen Ngangue, Ministry of Economy & Finance December  Maina Djoulde, Government of Cameroon  9 December, Abuja. Nigerian President H.E. Goodluck  Amougou Mezang, Government of Cameroon Jonathan signs the National Health Bill into law.  Marie Epee, Government of Cameroon  Tina Sonia, Government of Cameroon  10-13 December, Kribi. Counterparts from the Cameroon  Lambiu Adamu, Government of Cameroon Ministry of Health, the Clinton Health Access  Flore Ekoulle Government of Cameroon International (CHAI), WHO, UNICEF, Agence de Médecine Préventive (AMP), Gavi, and SIF co-organize a Uganda cMYP workshop.  Hon. Henry Banyenzaki, Member of Parliament; Hon. John Amos Okot, Member of Parliament  Hon. Anne Auru, Member of Parliament

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Achieved Cumulative Milestone/Activity Details: this quarter (1.IX.09– 31.XII.14) Visits to field Congo (2), Senegal (2), Mali (2), Madagascar, 8 173 Countries Indonesia National Briefings 7 110 Cameroon (2), Nepal (2), Senegal, Mali, Uganda Sub-regional 6 25 DRC (4), Mongolia, Nepal briefings National Ebola Emergency Task Force, Sierra Leone (2) | EPI Technical Coordinating Committee (2) | World Pneumonia Day: Symposium on Sustainable Immunization Financing for PCV Introduction in Nigeria | Gavi/WHO Graduation Assessment, Congo | Second Annual Meeting of the Gavi Sub-regional Working Group for Eastern and Southern Africa, Madagascar | WHO/AFRO Working Group Meeting, Burkina Faso | National Health Forum, Cameroon | International Partners Gavi Proposal on Health Sector Strengthening (HSS) 16 105 Meetings Workshop, Cameroon | Health Budget 2015 Information Forum | Symposium on Building Vaccinology Expertise in Southeast Asia, Indonesia | Gavi/WHO Graduation Reassessment and Development of Graduation Action Plan Mission, Georgia | Middle-Income Country (MIC) Consultation Meeting, Turkey | Workshop on Immunization Financing and Graduation from Gavi Support, Turkey | Eighteenth Meeting of the European Regional Working Group for Gavi (RWG), Turkey Workshops/Capacity 2 28 DRC, Cameroon Building Meetings Peer Exchanges Countries involved: DRC, Congo, Madagascar, Involving SIF Target 2 65 Cameroon, Mali, Senegal, Uganda, Mongolia, Countries Vietnam Number of ICC Sierra Leone (2), Cameroon (2), Uganda (2), Sierra Meetings (measured 7 41 Leone since Jan 2013)

Sustainable Immunization Financing is an initiative of the Sabin Vaccine Institute.

SIF is funded by generous grants from the Bill & Melinda Gates Foundation and GAVI.

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