By Jackson Okata
Nairobi, Kenya: Health experts in the country are warning that limited funding for the National Vaccines and Immunization Program could easily plunge Kenya’s primary health sector into a crisis ahead of the 2029 scheduled exit by the Global Alliance of Vaccines and Immunization (GAVI), a major donor of the country’s vaccine and immunization programs.
Prof. Walter Jaoko, a lecturer at the University of Nairobi’s faculty of medicine says that the lack of adequate funding, blamed for the recent shortage of vaccines in the country, could erode gains made in the expanded immunization program.
Speaking in Nairobi during a science cafe organized for journalists by the Media for Environment, Science, Health, and Agriculture(MESHA), Prof Jaoko noted that the immunization program was the most important public health tool that should be handled as a priority.
“The immunization program has been one of the most effective public health interventions with a lot of benefits. The government should never allow the run out of stocks as witnessed recently. A shortage occasioned by a lack of funding is an indictment on the government’’ said Prof. Jaoko.
He added, “We risk reversing all the gains we have realized if we don’t handle immunization as a priority.”
Prof. Jaoko who is also the Director, of the KAVI Institute of Clinical Research, observed that it will be impossible to achieve herd immunity of vaccine-preventable infections and diseases if the country cannot meet its vaccine demand needs.
“With climate change, we are likely to see a rise in disease outbreaks across the globe and when we have a population that is not properly immunized then we are exposing them to more risks in times of pandemics’’ he said.
Battle against vaccine hesitancy
According to the Ministry of Health, routine immunization is one of Kenya’s most effective public health interventions for critical childhood diseases which has reduced the burden of vaccine-preventable diseases in Kenya by more than 70 percent in the last two decades.
Since its launch in 1980, the immunization Program has led to the elimination of Maternal Neonatal Tetanus, near eradication of Poliomyelitis marked control of measles, and a dramatic reduction in morbidity and mortality from several other illnesses. The Program currently provides 14 vaccines and five non-EPI vaccines (Hepatitis B, Anti-snake venom, Anti-rabies, Yellow Fever, and Typhoid vaccines).
Dr Christine Karanja, a pediatric infectious diseases specialist and lecturer at Kenyatta University warned that a shortage of vaccines could also lead to increased vaccine hesitancy in the country.
“Vaccine shortage is not only a health problem but also a social and economic issue. When a mother makes several trips to the hospital and her child fails to get immunized due to lack of vaccines, chances are she will give up and this will result in vaccine hesitancy’’ Dr. Karanja noted.
She added “We risk running into an increase in cases of infant mortality if we fail to combat vaccine-preventable diseases due to funding-related vaccine shortages’’.
Dr. Karanja wants the government to allocate enough funding to the immunization program to safeguard the lives of millions of children.
“When shortages persist, remember these children are growing older and are at a risk of getting diseases that could ruin their lives’ she said.
She cited diseases like measles which she says could lead to blindness and polio which leads to permanent disability and even death as some of the risks unimmunized children are exposed to.
Ending HIV/AIDS-related deaths in children
Doreen Moraa Moracha, a HIV/AIDS advocate says, interruptions in the immunization program will hamper Kenya’s goal to end HIV/AIDS-related deaths among children by 2027.
“Mothers with children born with HIV need these vaccines and as a country, we must be intentional about making these essential commodities available. All we need is political will to get enough funding for the immunization program’’ said Moracha.
Recently, health facilities across Kenya reported a shortage of critical vaccines blamed on procurement delays after the government defaulted on a Sh2 billion debt putting at risk the lives of at least 1.6 million infants, a similar number of pregnant women as well as 750,000 girls under the age of ten.
As of May 2024, the health ministry had not procured the DTP (Diphtheria, Tetanus, and Pertussis) vaccine for 10 months, while the BCG vaccine had not been procured for eight months. TB, polio, measles, rubella, pneumococcal conjugate vaccine (PCV), rotavirus, inactivated polio vaccine (IPV), measles-rubella (MR), human papillomavirus (HPV), and yellow fever vaccine were also reported to be out of stock for several months.
Between June and August 2023, eight cases of vaccine-derived poliovirus type 2 (cVDPV2) were recorded within the Dadaab refugee camp in Garissa County while 1444 cases of measles were recorded in Turkana County.
Limited funding
In the 2023/2024 financial year, the government slashed the vaccines budget from Sh2.6 billion to Sh1.2 billion while in the 2024/2025 budget estimates, the national treasury has proposed a Sh4.6 billion budgetary allocation for vaccines. In total, the health budget has been cut from Sh141.2 billion in the previous year to Sh127 billion in the 2024-2025 financial year.
With the country’s annual vaccine demand standing at between 16-25 million vaccines, Kenya spends an estimated Sh36 billion every year on immunization with Gavi and UNICEF contributing Sh32 billion while the Exchequer provides Sh4 billion. Gavi support includes funding for vaccines, immunization, and equipment.
With Kenya moving from a low-income to a lower-middle-income country, Gavi was set to end its funding in 2027, a deadline that was extended for two years after an agreement with the Kenyan government. The move was meant to allow Kenya Biovax Institute to build its capacity to start locally formulating and increasing volumes of imported vaccines, ready for use by 2029. The institute is putting up a plant in Embakasi and is expected to produce the first batch of locally packaged vaccines by 2029.
Dr Karanja says Kenya must seriously and intentionally invest in the facility to avert any future crisis by the time Gavi’s support ends.
“If we fail to effectively invest in our vaccine production capacity ahead of 2029, then we might end up witnessing even worse shortages than the ones we have ever witnessed,” Karanja said.
The World Bank has committed $120 million in funding for Kenya’s vaccine production facility which will have two filling lines. The Kenya Biovax Institute was established in 2020 in the wake of the COVID-19 pandemic and has been receiving technical and capacity-building support from Biofarma of Indonesia, Serum Institute of India, and SK Bioscience of South Korea
Apart from immunization, other heavily donor-funded programs expected to end under the GAVI funding include Tuberculosis (TB), family planning, and HIV/AIDS.
