One of the critical questions in immunization financing is how much is being spent. Even though significant progress has been made in the accessibility and coverage of vaccination globally, challenges remain. Lack of coordination, conflicting priorities, and inadequate public financial management systems can undermine the impact of investments and benefits of immunization. Roughly 20 million children do not receive routine immunization services, and approximately 1.5 million children die each year because they are not vaccinated.
This brief explores immunization spending, drawing on budget data from BOOST. The mere existence of line items for immunization, which can increase visibility throughout the budget process, is often considered essential for ensuring sustainability. Thus, this study is intended to find related line items in 22 BOOST budget databases (2009-2017) to look at the “budget credibility” of those items – that is, the extent to which these specific line items have been executed as planned, or as initially approved by the legislature.
The study discovers that with the amounts varying greatly by country, a total of roughly $2.6 billion was approved through the budget items covered over the assessed period. However, in several of the countries, alarmingly low execution rates or large underspending are found. This finding is especially troubling given that among the 22 countries, 20 have reported at least one case of vaccine “scarcity” – i.e., shortage – over the assessed period, and 12 still have relatively low coverage (below the global average) for DTP3, the third dose of combined diphtheria-tetanus-pertussis vaccine.
Any organization or individual working in the field of immunization economics can submit findings, opportunities, calls to action, or other relevant work below to be shared with our community.