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IMMUNIZATION ADVOCACY INITIATIVE PROJECT

TECHNICAL MEETING WITH KEY IMMUNIZATION ACTORS AND PARTNERS.

(PARTNERS DIALOGUE ON IMMUNIZATION FINANCING)

SEPTEMBER, 2020

INTRODUCTION

The Dialogue started with a prayer which was followed by an introduction of the chairperson done by Ms. Gladys a member of the consortium from HFFG. The Chairperson who was in the person of Dr Ebenezer Appiah Denkyirah, the former Director General for the Ghana Health Service and now the Governing Council Chair for GCNH gladly accepted to chair the occasion. He gave a brief background on Vaccines and Immunization, its origin, where Ghana is with immunization and where we are getting to, why immunization is important and hence the reason to make immunization financing a priority. He stated Ghana being of age and therefore the exit of most partners and that is the more reason to stand on our feet in order to prevent the resurfacing of all the childhood preventable diseases.

Mr Bright Ammisah Nyarko, the Vice Chair for GCNH came up next to state the purpose of the gathering, he started his speech by acknowledging all persons at the event which included the chairman of the occasion , the representatives from academia, DPs, the traditional leaders, representatives from Ministry of Health and Ghana Health Service, National Health Insurance among others.  He stated the Immunization Advocacy Initiative being a consortium project implemented by three organisations namely GCNH, SEND Ghana and HFFG seeks to advocate for an increase in immunization financing, which was because the cost of immunization in Ghana is largely paid by Gavi and by 2027, Gavi would be exiting the country. It is therefore crucial for the government of Ghana to prepare to fully fund. He stated the purpose therefore of the meeting was to initiate the development of an Immunization Financing Plan for Ghana. The outcome of the Technical meeting and a working session he said would help put together a draft immunization plan which would later be adopted and finalized by the Ministry of Health as an Immunization Financing Policy document for Ghana, he stated some challenges some transitioned countries are facing which included;

  • Insufficient Institutional Capacity
  • Lack of clear strategies for reaching under immunized children
  • Lack of Financial Sustainability Plans

In response to this, there is a need to adopt an approach to address not only Financial Sustainability but also programmatic weakness and the need to introduce new vaccines. Finally he said “our plans aims to mitigate any remaining risk to a successful transition by providing technical assistance in key areas such as supply chain, leadership, management and coordination, data and demand generation.”

The next statement was from given by Dr. Yaw Opoku Boateng a director from the NHIA. In his statement he made mention of how NHIA serves to guarantee that all persons resident in Ghana have access to adequate basic Primary Health Care, equitable distribution of health care and products and financial risk protection for the poor and vulnerable. He identified children as one they key vulnerable population for which premium exemptions have been established since the inception of the NHIA. He went on to speak of the 10% of the annual budget support given to MoH as part of their responsibility. This amount he said “further augments the national budget for implementation of healthcare policies including the procurement of vaccines and funding of other logistics of the immunization process.” In his final words he stated the authority understands the gravity of effects on Gavi’s possible exit in 2027 and applauds this move to Dialogue on a funding plan for immunization in the country.

From the Developing Partners (DPs), Dr. Felix Osei Sarpong a representative from UNICEF gave a statement saying vaccines don’t just save lives but also have a huge role to play on economic stability;  economic impact on families, communities and country as a whole. He therefore thinks there is a need to explore innovative financing approach and thus supports the act towards a domestic immunization financing.

To bring all representatives present up to speed on IAI, there was a presentation from the IAI consortium giving an overview of the IAI and this was done by Madam Harriet Nuamah Agyemang from SEND Ghana. She mentioned the project is a 3years project and the consortium is 2 years into implementation with support from African Population and Health Research Centre. With Ghana’s commitment to immunization and the vision to attain the universal health coverage there is the need for CSOs to track and help government to achieve this. Therefore the reason for the initiative is to advocate for increased domestic financing for immunization in Ghana with its outcome being:

  • Sustain increment of GOG allocation to immunization year on year
  • Ensure the full allocation to immunization is disbursed and spent

This is being done by using evidence as a key step towards advocacy. She went on and listed all the activities done by the consortium and activities yet to be done. She concluded by expressing her gratitude to all present and hoped for a progressive meeting.

Also from the consortium, we had Dr, Gabriel Bernaaku the Chairman from GCNH join in via Zoom to give his contribution to the meeting. After a brief insight on immunization and acknowledgement of those present, he concluded by stating that there is a need for government to look around the areas of public-private partnership and natural resources with regards to immunization.

Dr Kwame Amponsah-Achiano, the Expanded Programme on Immunization (EPI) manager gave his presentation next on the update of EPI. He gave a brief history and update on the launching of EPI in the 1978 till date. With the EPI contributing to the poverty reduction strategy, and reducing the magnitude of Vaccine Preventable Diseases through immunization; a component of primary Health Care, he stated the following as their objectives:

  • Accelerate Reduction of Vaccine Preventable Diseases
  • Data Quality
  • Cold Chain

          He stated elimination of neo-natal tetanus, no measles, pneumonia, diarrhoea, and meningitis related deaths some achievements of the EPI. Amidst various challenges, he conclude by mentioning financing as the major challenge to immunization. “With Gavi transitioning, we know we are at a cross roads and therefore this advocacy forum is highly welcome” he stated.

A presentation on immunization financing structure was given next by Mr Kwakye Kontor, the Head of Budget PPMED-MoH. He stated that immunization does not only bring health but also eases economic burden. Mentioning the comprehensive year plan cost structure for the next four (4) years, he said a requirement of 514million dollars would be needed to sustain achievements Ghana has made so far with regards to immunization. Breaking down to how much each sector needs he stated the following:

  • Vaccine Supply and Logistics – 177million USD
  • Service Delivery – 48million USD
  • Advocacy and Communication – 28million USD
  • Monitory and Surveillance – 120million USD
  • Programme – 55million USD
  • Supplementary Immunization Activity (SIA) – 50million USD
  • Shared System Cost EPI – 67million USD

He went on to say that NHIA gave 73million and therefore there is the need to act quickly to bring all partners on board, he also said out of the 514 million dollars, 267 million dollars is secured leaving a gap of 247 million dollars for the next for years. He went on to give the allocated budgets from 2020 to the year 2024.

He mentioned the challenges being the funding gap both from the government and also from the transiting donors.  For his recommendations, he thinks continuous negotiations should be made for GoG budget increase through advocacy.

Dr Ben Bempah the Deputy Director PPMED – Ghana Health Service facilitated the working session towards the development of Ghana’s Domestic Plan. From his speech he mentioned adequate financing being crucial for securing immunization intervention and funding challenges if not addressed would cause vaccine challenges, cold chain equipment and also other service delivery inputs. He advised that care needs to be taken not only with vaccines but all system inputs that goes with it. He designed a template which paid attention to core mandate issues and challenges and also key strategic interventions for consideration in the development of the Domestic Immunization Financing Plan (DIFP). The session was a very interactive one with all participants making inputs and contributions into the DIFP.

To conclude, the Chairperson for the meeting Dr Ebenezer Appiah Denkyirah gave his final remarks summarizing all that had been said and applauded the GCNH for the organization of such an important meeting.

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