Sustainable Immunization Financing in Asia Pacific: Philippines Country Brief

Key messages

Overview

• The Philippines has experienced high rates of economic growth by regional standards (5% annually), allowing for strong government investment in social programs.
• Economic growth is accompanied by a demographic transition characterized by an aging population and a rising burden of NCDs, both of which carry significant implications for population health needs.
• The Philippines includes more vaccines in its NIP than any of its neighbors, but is struggling with sustainable planning and declining low coverage rates.

Immunization Financing

• The budget for health flows into the immunization program through three channels. The DoH is responsible for procurement of vaccines for the NIP, and finances campaigns, updates the cold chain, and trains health workers as needed. Local government units cover all operational expenses for local facilities to deliver immunization services.
• The national immunization schedule is variable as some vaccines have been removed due to poor coverage performance.

Key Findings

• The limited engagement from PhilHealth, the national health insurance mechanism, in immunization presents opportunities to increase their role. The benefits package includes only immunizations associated with birth, although in practice this is complex and confusing to providers. PhilHealth’s large presence in the healthcare sector could potentially be leveraged for gain in immunization financing.
• High levels of decentralization have led to communication and collaboration issues between the two levels of government, benefitting the coverage issues the country is currently experiencing.
• The Philippines has successfully diversified the domestic revenue supporting the immunization program. In 2015, the NIP was allocated PhP 3.34 billion, of which 42% was funded from the sin tax incremental revenue for health. The sin tax has been instrumental in supporting the health and immunization budgets, allowing for multiple adoptions of new and underutilized vaccines into the immunization package.
• A tax on sugar-sweetened beverages with earmarked revenues for health is a new and emerging opportunity. Specific advocacy efforts to dictate which health issues the funds will support will be required to increase funding for new vaccines or activities to improve delivery performance.
• The Philippines does not currently have a NITAG to make recommendations for the immunization program, or a formal HTA body to produce the evidence to support recommendations. The development of either would have great benefits for evidence-based decision making in the program.