Parliamentary hearings on the cost of inaction on immunization

Ladies and gentlemen, thank you for the session today. 

Some policy decisions do not produce immediate visible results, yet their consequences are inevitable over time. Vaccination is one of them. Not because it is complex, but because its effects accumulate quietly until they translate into costs that can no longer be avoided. 

To better understand what is at stake, UNICEF has worked with partners to quantify not only the health impact of declining vaccination coverage, but also its economic consequences in four countries in our region, including Moldova. The objective was straightforward: to move beyond general arguments and provide decision-makers with concrete, Moldova-specific evidence on what non-vaccination actually costs - both for the health system and for the economy as a whole. 

And these are the findings that will serve as the basis for today’s discussion. For the period 2025–2035, more than 9,300 cases of illness are projected - measles, pertussis, pneumonia, and meningitis - in the absence of optimal vaccination coverage. Managing these cases alone will require the health system to absorb direct costs of approximately USD 2.1 million. 

This is the visible part.

But it is not the full burden. 

The total estimated economic impact of non-vaccination reaches approximately USD 33.1 million for a single cohort of children. The burden of more than USD 30 million is carried by families, by the economy, and by the country’s future. 

It is reflected in lost working days, in children who miss school, in reduced productivity, and, in some cases, in lives lost too early. 

These costs do not appear in a single budget line, yet they define, in very real terms, the economic capacity of a country. 

There is also another dimension that fundamentally changes the picture.

When vaccination coverage declines, risk does not increase gradually - it increases exponentially. An outbreak is not just a cluster of cases. It triggers emergency response, resource reallocation, and disruption of routine services. Estimates show that managing a single measles outbreak can exceed USD 4 million. 

Four million - for a crisis that could have been prevented. 

This leads to a more fundamental question. 

After all, budgets are not only financial instruments. They are, in essence, statements of priority - promises about what we choose to build. 

Every dollar spent managing an outbreak is a dollar that is not invested in schools, kindergartens, hospitals, social services, or local development. It is a dollar redirected from the future into the past - from building to repairing. Non-vaccination creates this shift. It forces the state to spend reactively, under pressure, and often inefficiently. 

Non-vaccination is not a neutral decision. It is a recurring fiscal liability, absorbed by the state either directly through avoidable healthcare costs or indirectly through reduced economic output. 

Vaccination, by contrast, is one of the few investments that simultaneously reduces public expenditure and strengthens economic performance. 

The return on investment in achieving 95% coverage is estimated at approximately 11:1. In other words, every dollar invested in vaccination generates more than ten dollars in economic benefits and avoided costs. A 1000% return on investment! 

Few public policies can make that claim. 

Ladies and gentlemen,

The choice is not simply between vaccination and non-vaccination. 

It is between two very different ways of spending public money: 

• one where resources are used to build, invest, and expand opportunity;
• and one where resources are repeatedly diverted to manage avoidable crises.

A country’s wealth is always limited. The question is how deliberately it is used. 

Vaccination is not only about protecting children from disease. It is about protecting the ability of a country to invest in its future—rather than paying, repeatedly, for what could have been prevented. 

The question is whether we choose to invest wisely - preventing these costs - or whether we absorb them later, when they are higher, more urgent, and far more difficult to manage. 

Vaccination is not only a public health intervention. It is a matter of fiscal responsibility. It is a choice about how we protect not only the health of children, but also the economic stability of the Republic of Moldova. 

Thank you.