IMFIN brief 6: Earmarking to finance immunization

What is earmarked funding? What are the pros and cons of earmarking for immunization?

Key points

• Earmarking—setting aside some or all revenue from a tax or group of taxes for a designated purpose—is a domestic financing option considered by some countries for health, particularly as they transition away from donor support.
• Some immunization advocates are attracted to earmarking as a source of guaranteed funding, but finance authorities typically oppose it because earmarking can undermine their ability to allocate the budget most effectively.
• Earmarking can safeguard particular funding streams for immunization. But this protection can be undermined by reductions in other parts of the health budget. Such offsets can jeopardize health services that are essential for vaccine delivery.
• As funding requirements for vaccines and injection supplies increase, funding sources should be structured to support, and not limit, these changing requirements.
• A more holistic approach to protecting and increasing general funding for the health sector and ensuring immunization services is likely to yield better results than advocating for earmarks.