Kenya will have no crisis if it loses some donor funding for vaccines, a major financier has said.
Some donors are expected to withdraw support in about nine years, citing Kenyans’ rising incomes. This has sparked fears of a possible crisis.
But philanthropist couple Bill and Melinda Gates expressed confidence that the country is well prepared to handle the transition.
Melinda said different donors were working with all transitioning countries to ensure there is no disruption in vaccine and drugs supplies.
She said recipient countries always demonstrate their preparedness to co-finance each time they apply for donor funds.
“I don’t know if you know, but on Global Fund, when a country puts an application in, it has to explain exactly the logistics of how that’s going to move through its systems,” Melinda said.
Bill and Melinda spoke to the Star in a conference call last week, ahead of the World Economic Forum in Davos, Switzerland, this week.
The Bill and Melinda Gates Foundation is one of the largest donors to Gavi — the vaccine alliance. Currently, Kenya pays for 10 per cent of its entire vaccine budget, while Gavi pays 90 per cent — about Sh4 billion yearly.
Kenya rebased its economy three years ago, pushing the gross national income to Sh135,000 ($1,350 ) per capita.
When a country’s GNI exceeds the eligibility threshold, currently Sh158,000, it loses Gavi’s support and must pay for its vaccines.
Kenya began to transition out of Gavi support in 2017, and the 10-year process will particularly accelerate in 2022. Melinda urged Gavi, the Global Fund and the Global Financing Facility, which supports maternal and child health, to support countries for smooth transitions.
“These funds working in concert, as well as the way they’re doing the work around the world, is what’s going to help that transition,” she said.
Bill said the transition must be done carefully to avert a crisis.
“You want to make sure you don’t go backwards as you graduate. And you tend to graduate from all sorts of things: development banks, Gavi and the Global Fund at the same time. And particularly if it’s resource wealth that maybe goes up and down, trying to make sure there’s not a discontinuity that affects children’s health is very important,” he said.
Recently, humanitarian organisation Medecins Sans Frontiers asked Gavi to reconsider transition for Kenya and Nigeria, saying disease burden and poverty were still high and there was a high risk of reversing the gains made in health in the past years.
“GNI is not a significant predictor of health outcomes and ignores key factors such as universal health coverage and institutional capacity to deliver healthcare,” Kim West of the Medical Advocacy Advisor, MSF, said in Nairobi.
If Kenya follows the planned phased transition, it will be expected to fund the immunisation programme in its entirety by 2027. This is about a 700 per cent increase of what it currently pays.
A recent study estimated that after Kenya graduates from Gavi support, the cost of the pneumococcal conjugate vaccine for pneumonia alone will require an extra Sh1.56 billion annually, nearly doubling its current expenditure on vaccines.
Currently, the government procures vaccines for polio, tetanus, BCG and measles, while it pays Sh20 per dose to co-finance Gavi support for pentavalent, PCV10, rotavirus and yellow fever vaccines.
Gavi has supported the introduction of the following vaccines: yellow fever (introduced in 2001 ), pentavalent ( 2001 ), PCV ( 2010 ), rotavirus ( 2014 ) and IPV ( 2015 ).