Women should lead advocacy for increased immunisation funding, says Chizoba Wonodi
Dr. Chizoba Wonodi is the Country Director of John Hopkins International Vaccine Access Centre (IVAC) and the National Convener of Women Advocates for Vaccine Access (WAVA). In this interview with EMEKA ANUFORO on the sidelines of the launch of Vaccines Champions in Abuja, she spoke about dwindling donor funding for vaccine procurement and how women would lead the way in advocating for greater funding.
Why is WAVA’s work important?
It is important because vaccines save lives, save money and build nations. How do vaccines save lives? By preventing diseases from happening in the first place. Every year, more than 750,000 children die before their fifth birthday. About 30 per cent of these children die from diseases like malaria, pneumonia, diarrhoea, pertussis, meningitis, tetanus, measles – disease for which there are vaccines. We have very good examples of the positive impact of vaccines – Small pox has been eradicated, polio is nearly eradicated, measles cases and deaths have declined by 90 per cent, when the HiB vaccine was introduced in the Gambia and Kenya (as part of the pentavalent vaccine) cases virtually disappeared.
We also know that vaccines save money. It does not take a doctor or an economist to know that if you prevent a disease like pneumonia or meningitis, then it saves you the cost of treatment, the lost wages associated with – say an admission in a hospital and the lost productivity that may come with long term sequel of diseases like meningitis, which if it didn’t kill you, it will maim you.
I must admit that the government of Nigeria, through the National Primary Health Care Development Agency (NPHCDA), the Federal and State Ministries of Health are doing a good job with the vaccine program. They have introduced four new vaccines in four years and they have plans to introduce more. But we still have pressing problems to overcome. Some of these problems have been in existence since the immunization programme started some of them are looming in the horizon and warming up.
First not all kids have access to vaccines or immunisation – either because their parents cannot or don’t want to take them to be vaccinated (what we call demand-side problems) or because the immunisation services are not accessible, affordable or appropriate for them (supply side problems). As a result, only one in five children in Nigeria, receive all the full complements of vaccines. If you are an infant and your family is poor, your mother is not educated, you live in rural area or you live in the northern part of the country, you are less likely to be vaccinated. That brings up the issue of equity. Every child has a right to be protected from harm, including harm from vaccine preventable disease.
Second, the Nigeria immunisation programme is facing a funding cliff, as Gavi support declines over time. Gavi co-pays for new vaccines, by 2017, Nigeria will begin an accelerated transition from Gavi support. By 2020, we will be on our own in funding the vaccine programme.
There is an urgent need to speak out, advocate and take action, so we continue to have money to buy vaccines, and deliver vaccines to women and children in Nigeria.
We are launching the Vaccine Champions and the small grants programme. We are honoured that seven illustrious leaders in Nigeria have accepted both the honour and mandate to WAVA champion.
Who is a champion – Martin Luther King was a Champion. As vaccine advocates and champions, WAVA expects us to add our voice in advocating for increased budgetary allocation and financing for vaccines at various tiers of government to make vaccines readily available to people of all socio-economic strata. Better immunisation services will secure the health of our children, create a healthier society, and bring about increased socio-economic returns on investment for a prosperous nation.
Women Advocates for Vaccine Access (WAVA) is a coalition of 34 women-led and women-focused organisations spanning across the six geopolitical zones in Nigeria. The idea is to inspire organisations from the broad spectrum of the development space and build a critical mass of advocates to give voice to vaccine access and financing. An initiative of the International Vaccine Access Center (IVAC), WAVA was conceived in Baltimore in 2012 but was launched in Abuja in 2015 when we assembled women-focused organisations to commemorate the international women’s day and introduce the idea of WAVA. Our participants all agreed that it was worthwhile to establish such a platform.
After that, it looked like we went to sleep. But we didn’t. Behind the scenes, we began to craft and develop a strategy that could make the platform work and be sustainable. As you know, in this development advocacy world, one needs money to make things happen. If you call a meeting like this or a meeting in your office, you need people, logistics, food, sound and projection. All these cost money. We needed some take off grant.
So, I want to thank the Bill and Melinda Gates Foundation and Gavi for the grant to Johns Hopkins International Vaccine Access Center, part of which funds WAVA activities and secretariat. With that support, we have been able to bring 34 organisations from all geopolitical zones to train and inspire them to be vaccine advocates. We are not done yet. Our goal is to have WAVA members in every state of the federation – because, no child must be left behind. We also plan to have at least one Champion in every state.
Do you see the government increasing the funding for vaccine from domestic sources?
I think that is even the best thing to do because if you consider the alternative, if there is no vaccination and children get sick, it actually cost more than the diseases that will come out of not being vaccinated.
How will you appraise vaccine availability in the country?
Right now it’s really good because there has being no stock out of the routine vaccine in the last two years or so. We can say that government is doing a good job.
But why we are setting up this process is to warn that there is a funding clips coming up beginning from 2017 when the funding from GAVI will start to decline we need to have our plans in place. We need to know how we are going to replace the money that is leaving from GAVI. We need to know how we are going to fund the addition of new vaccine that is going into the programmes. That is why it is really important at this point.
Is local production of vaccines something that you think is possible?
Local vaccines production have being spoken about and is something that that the National Immunisations Financing Task Team is looking into. We are working in collaboration with the Ministry of Health, and also with Ministry of Science and Technology to develop a framework in this area.
What creative measures should be adopted to fill in the gap when donor funds dry?
Government cannot do it alone but it needs to do more. The first thing is that budget for vaccine at the federal and state levels should be increased. We have to look at the corporate organisations and at private individuals and look at how we can either raise taxes or put taxes on some of the luxury goods items that we all enjoy. A small amount of money from our recharge cards will go a long way. So we have to start sensitizing people of the need for additional funding.