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 The power of immunization
 Data briefs: Progress and disparity

Poor countries pay for vaccines

Low-income countries – with GNPs per person ranging from $110 to $785 – are showing stronger commitment to the health of children, judging by the resources these governments are allocating for purchasing the necessary vaccines. Figures comparing 54 low-income countries indicate that 24 of them (see list, below) are financing 25% or more of vaccine costs. Nine of the 24 pay 100% of the vaccine costs.


Investing in health
Low-income countries financing 25% or more of routine EPI vaccines*
 % financed   % financed   % financed   % financed

Burkina Faso** 100 Nigeria 100 Togo 80 Gambia 30
Chad** 100 Pakistan 100 Viet Nam 73 Moldova, Rep. 29
Ghana 100 Senegal** 100 Nepal 53 Cameroon 27
Honduras 100 India   98 Uganda 50 Guinea 25
Mali** 100 Côte d’Ivoire**   95 Mongolia 40 Haiti 25
Nicaragua 100 Niger**   80 Turkmenistan 36 Lesotho 25


Bottom of the ladder
Low-income countries financing less than 25% of routine EPI vaccines*
  % financed   % financed   % financed   % financed

Benin 15 Kenya 3 Bosnia/Herzegovina


Mozambique 0
Ethiopia 15 Sierra Leone 3 Cambodia


Myanmar 0
Madagascar 10 Burundi 2 Congo


Rwanda 0
Sudan 10 Malawi 2 Eritrea


Somalia 0
Tanzania 10 Afghanistan 0 Guinea-Bissau


Tajikistan 0
Zambia 10 Angola 0 Lao PDR


Armenia   7 Azerbaijan 0 Liberia


C. African Rep.   4 Bhutan 0 Mauritania


* The routine vaccines of the expanded programme of immunization (EPI) are diphtheria, measles, pertussis, polio, tuberculosis and tetanus. Yellow fever is part of EPI coverage in countries at risk in Africa and South America. Low-income country in this list represents GNP per capita of $785 or less.

** These countries have benefited from grants from the European Union.

Sources for both lists: Vaccine finance: UNICEF; income levels: World Bank.

Some of these countries have benefited from the Vaccine Independence Initiative (VII) promoted and supported by UNICEF. The Initiative requires participating governments to plan and budget for vaccines. It then helps the countries procure vaccines at the best possible cost, accepts their currency for vaccine payment and offers flexible financial terms to support the process.

Even countries with very low GNP per capita are encouraged to meet between 10% and 25% of their vaccine costs. Twenty-nine low-income countries (see list) finance less than 25% of their vaccine costs. Six of these – Benin, Ethiopia, Madagascar, Sudan, Tanzania and Zambia – finance between 10% and 15%.

It is encouraging that although the majority of poor countries are struggling under heavy debt burdens and may be torn by conflicts and civil strife, many have shown such positive commitment to improving the health of their children.

The vaccines to protect a child against diphtheria, measles, pertussis, polio, tuberculosis and tetanus cost $1 in most developing countries when purchased through advantageous procurement systems such as UNICEF’s. Other costs – including health workers’ training and salaries, cold chain equipment and syringes and needles – bring the total to about $17.

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