Many low and middle-income countries are undergoing a transition from external sources of financing (e.g. organizations such as GPEI, Gavi and GFTAM) to domestic sources of financing for their health system. In many countries, GPEI has been the main funding source for disease surveillance, and countries transitioning out of GPEI support have developed national polio transition plans to prepare for the reduction of external financing, while sustaining critical functions like vaccine-preventable disease (VPD) surveillance. To implement these plans, countries must quantify the domestic resources required to sustain the scale and the quality of VPD surveillance.
Responding to requests from countries, WHO has developed a Planning and Budgeting Tool for VPD Surveillance in Priority Countries for Polio Transition https://www.who.int/teams/polio-transition-programme/tools-and-guidance to provide technical guidance to health authorities to plan and implement this transition smoothly, underpinned by a feasible operational and financial plan.
The methodology is based on analysis of current diversified surveillance systems, building on lessons learned from other budgeting tools. It is suitable for use by national staff and comprises a user-friendly Excel tool accompanied by a user guide and online tutorials. The methodology is flexible and can be custom tailored to countries aiming to integrate surveillance functions and move towards domestic financing. The methodology facilitates the process of planning and budgeting the activities to strengthen the surveillance function.
The methodology has been piloted in Bangladesh and Karnataka State of India to test whether it can be used with ease by national staff; and to identify constraints, gaps or required improvements to the tool and methods.
Representatives of the Ministries of Health, immunization programme managers and surveillance officers participated in the piloting. They identified the various inputs required for each activity of each disease under surveillance and provided the unit costs. The use of the tool was judged by the representatives to be extremely user-friendly and intuitive.
The outcome of the piloting includes the calculation of the total resource requirements for the implementation of VPD surveillance activities, the expected share of domestic and external funding in the total budget for VPD surveillance, as well as per capita indicators. The budget figures are presented with breakdown by disease under surveillance, by function and by main input required.
The results of the piloting in the two countries will be compared to highlight similarities and differences, by focusing on the organization of the surveillance systems and the degree of dependency on external funding.
The use of the methodology for scenario building and facilitating the process of planning and developing a national VPD surveillance budget funded by domestic resources will be discussed in the light of the implementation of polio transition plans and national immunization strategies.