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Newsletter Date

SUSTAINABLE IMMUNIZATION FINANCING

Summary Digest Volume 4, Issue 4 | December 2012

In this issue:

Joint GAVI/SIF

Mission to Vietnam

Mongolia Advocay

Plan Rolls Out

Mali: MoH and

National Assembly

Draft Immunization

Legislation

Liberia Progressing

6 Countries Take

Part in a Workshop

on Legislative and

Financial Strategies

for Immunization

Uganda Private

Member’s Bill on

Immunization

Leads to Regional

Action

SIF Team takes

part in 5th GAVI

Partner’s Forum

SIF Peer

Exchangers Share

their Experiences at

WHO ARIC

Experts Trade

Thoughts on

Immunization

Financing in

Cambodia

Progress Towards

Country Ownership

SIF Immunization

Champion

SIF Sabin News

Highlights

On October 29 – November 2, 2012, a joint GAVI/

Sabin mission visited Vietnam. Representing GAVI

were Santiago Cornejo (GAVI Senior Specialist

Immunization Financing) and Raj Kumar (GAVI Senior

Program Manager). Representing Sabin were Mike

McQuestion, SIF Program Director, and Khongorzul

Dari, Senior Program Officer (Mongolia). The visit

served two purposes: To assess national prospects for

new and underutilized vaccine financing and, with

support from GAVI, to invite Vietnam to become the newest SIF country. Meetings were held with senior

officials of the Ministry of Health, Ministry of Finance

and the National Assembly.

With its robust economy, Vietnam continues to

increase its annual health investments. Its high-

performing EPI program has virtually eliminated

vaccine-preventable diseases. The country

manufactures and exports a range of traditional

vaccines. Recent economic shocks led to cuts in other

sectors but the health sector was spared. By law, the

Government cannot decrease the annual EPI budget

relative to previous years. An analysis of the budget

showed the government fully financed routine

immunization and the program ran at nearly 100

percent absorptive capacity in 2011.

One area of concern is financial reporting from the

country’s 63 provinces, some of which raise and spend

their own revenues on immunization. These provinces

fear their matching budgets will be cut if they report

their expenditures to federal level, government

counterparts theorized. The government’s total

routine immunization investment, which stood at

US$7 per infant in 2011 according to the WHO/

UNICEF Joint Reporting Form Indicator 6730, is

therefore underreported. To address this problem,

the SIF Program will co-sponsor a briefing with

provincial officials and immunization managers.

Financing and budgeting will be discussed along with

programmatic performance. “We want to make the

provinces active stakeholders in the program. They

are also investing. The local officials should be credited

for this and for doing such a good job getting their

own kids immunized. When they see this logic the

financial reporting will improve”, predicted SPO Dari,

who faces similar problems in her native Mongolia and

will manage SIF activities in Vietnam. The briefing is

slated for February 2013.

Now in French!

Maintenant en

français!

www.sabin.org/fr

Visit us online!

www.sabin.org/sif

Joint GAVI/SIF Mission to Viet-

nam On October 22 – 26, 2012, SIF Program Director Mike

McQuestion and Senior Program Officer Khongorzul Dari

met with government, parliamentary, and external

immunization partner agency counterparts in Ulaan Baatar,

Mongolia. The topic of interest was national immunization

financing in this soon to be GAVI-graduating country. The

visit followed a joint WHO-GAVI-Sabin mission last April in

which national counterparts agreed to join the SIF Program

[see related story, Summary Digest 4(3)]. Mongolians

directly elect a president and parliament; parliament then

elects the government. Elections took place in June 2012. In

a meeting at the State Great Khural (parliament),

McQuestion and Dari shared ideas with the Chief Advisor to

the Speaker of the House, Mr. Durzee Odkhuu. The

discussion focused on advocacy for sustainable immunization

financing and how parliaments in other SIF countries are

helping to achieve it. With the newly seated government and

parliament, this a good time to entertain such initiatives,

commented Mr. Odkhuu.

Mongolia has a strong EPI program with a long track record of successfully controlling vaccine-preventable diseases.

Immunization financing ( is a concern because GAVI support

for pentavalent vaccine will soon end and the government

will need to purchase all of its vaccines. The country’s

Immunization Fund is poised to handle this.

The more difficult question is how operational costs are

being financed at subnational levels. Federal transfers cover

an estimated 92 percent of routine immunization operational

costs. (cont on p.2)

GAVI and SIF team on the joint mission to Vietnam, left to right:

Raj Kumar (GAVI), Santiago Cornejo (GAVI), Mike McQuestion

(Sabin SIF); Trung Dao (staff National Assembly of Vietnam),

Khongorzul Dari (Sabin SIF).

Mongolia Advocacy Plan Rolls Out

2

The new Budget Law mandates the creation of Local Development Funds,

which are controlled by local governments. Each of the country’s 21 aimags

(districts) and soums (municipalities) creates and administers its own

immunization budget from these funds. Aimags and central health institutions

report their expenditures twice yearly to the Ministry of Finance and

Economics while the Ministry of Health reports its expenditures each quarter.

Like many countries, Mongolia underreports its immunization investments

because subnational operational costs are not properly captured and reported.

In meetings with Ministry of Health and Ministry of Finance and Economics

counterparts, the team learned that both ministries would like to improve immunization expenditure reporting, especially at the aimag and soum levels.

Engaging newly elected officials in the process could help bring about needed

improvements. Dari and her counterparts are planning a series of SIF-

supported briefings in which immunization budgeting and financial reporting

practices will be discussed at both national and subnational levels. The briefings

will involve parliamentarians, local elected officials and health officers and

federal counterparts. The first, a national parliamentarian briefing, is scheduled

for 24 January 2013.

The National Directorate of Health of Mali organized a five-day workshop on sustainable immunization financing with the support of the

Sabin SIF program. The workshop took place in the National Park in Bamako on 5-9 November 2012. Attending were over fifty government

officials, parliamentarians and partner representatives. Representing WHO/Mali was Dr. Baba Tounkara. Dr. Etienne Dembélé represented

UNICEF/Mali. Facilitating from Sabin were Jonas Mbwangue, Senior Program Officer responsible for Senegal, Mali and Cameroon, and

Washington, DC-based Program Officer Mariya Savchuk.

This was the fourth Sabin-supported briefing since 2009. Mali has made remarkable progress in immunization financing, beginning with the

inclusion of a budget line for the "purchase of medicines and vaccines" in the annual Finance Bill. This line, introduced in 1994 through the

Vaccine Independence Initiative, has allowed Mali to pay for all routine vaccines for almost 20 years. More recently, Mali has introduced new,

more expensive vaccines to the routine EPI Program. In view of rising vaccine costs, coupled with a growing population, national authorities

are searching for new sources of sustainable immunization financing and this was the main theme of the workshop. The Malian Minister of Health, Mountaga Boré, and Hon. Kalifa Doumbia, Member of the Health Committee of the National Assembly,

opened the workshop. The program began with an overview of the Decade of Vaccines, the Global Vaccine Action and the African Region’s

own Regional Strategic Plan for Immunization. Participants then analyzed immunization-related legislation from other SIF pilot countries and

went on to develop their own draft legislation. In doing so, participants considered strategies to mobilize the needed resources from both

public revenues and from the domestic private sector.

This workshop generated the following recommendations:

Revise and update Law n° 98-036 of 20 July 1998 “Regulating the fight against epidemics and compulsory vaccinations against certain

diseases”, to incorporate provisions drafted by the workshop participants

Organize follow-on workshops on communication and research in the field of immunization

Create a National Immunization Fund

Create a commission for following up on the recommendations of this workshop.

In 2011, Mali spent US$7.9m on routine immunization, marking a 30% increase over the 2010 figure ($6.1m).

Mali: Ministry of Health and National Assembly Advance Draft Legislation for Immu-

nization Financing

Mongolia Advocacy Plan Rolls Out (con’t)

Great Khural (Parliament), Ulan Baatar, Mongolia.

Participants of the legislative and financial strategy workshop

in Bamako, Mali, 5-9 November 2012.

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Ugandan Ministry of Health Hosts Second Forum on Sustainable Immunization

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Midyear elections led to many turnovers in Liberia’s Con-

gress. To reestablish ties, SIF Senior Program Officer Clif-

ford Kamara, conducted a mission to Monrovia on 12-16

November, 2012. There Kamara met with the co-

Chairman of the House Standing Committee on Health

and Social Welfare, Honorable Chea Johnson, and Repre-

sentative Honorable William Dakel. They discussed plans

for the upcoming Sabin-sponsored legislative briefing of

Representatives and Senators. As a Sabin peer exchanger,

Representative Dakel attended a similar immunization

legislation meeting in Kampala, Uganda this past June.

There he observed the work of the Ugandan Parliamen-

tary Forum on Immunization (see related story this issue).

Hon. Dakel is now taking steps to establish a Parliamen-

tary Immunization Forum in Liberia. “This was one of the

“best practices” Honorable Dakel observed in Uganda”,

said Kamara. “He wants to create a core group, a critical

mass, of Liberian MPs who will advocate in unison for

immunization issues and financing in the parliament.”

Kamara also met Senator Frederick Doe Cherue of River Gee County, a member of the Senate committee on Judi-

ciary, Claims, Petitions, and Human Rights. Senator

Cherue will assist with the review of existing health legis-

lation, as well as the procedures and regulations. The

House and Senate will need to act in unison to achieve the

country’s sustainable immunization financing goal.

Kamara also participated in an EPI Technical Coordinating

Committee meeting, which was chaired by the Assistant

Minister of Health for Preventive Services/ Deputy CMO

Hon. Nyenswah, EPI Manager Mary Momolu and other

members of the EPI team. Partner agency counterparts in

attendance included WHO’s Dr. Sei Parwon, Dr. Wam-

bai, and Roland Tuopileyi, UNICEF’s Health Program Offi-

cer Chantal Umugoni, EPI Officer Cefannie Kanneh-

Kesselly, and EPI Regional Logistician Terry Hart. Topics

discussed included the recently concluded polio campaigns

(NIDS) in October and the pending round in November

2012; urban immunization strategy; update on routine

immunization; and update on EPI Surveillance, as well as

other EPI Program issues. These included the need to

intensify supervision and support to the counties if immu-

nization coverage is to be increased. The numerous chal-

lenges include difficulties with access because of poor

roads. The meeting concluded with a firm resolution to

articulate actionable recommendations to ensure the iden-

tified weaknesses and deficiencies are appropriately taken

care of in a timely manner.

Liberia Progressing

Participants of the legislative workshop in Kinshasa, DRC, 14-16 November 2012.

ministries of finance and parliaments in six SIF francophone African coun-

tries: Cameroon, Democratic Republic of Congo, Madagascar, Mali, Re-

public of Congo and Senegal. Representing the SIF Program were Senior

Program Officers Helene Mambu-Ma-Disu and Jonas Mbwangue and

Washington, DC-based Program Officer Mariya Savchuk. Representing

SIF partner agencies were Drs. Chouaïbou NCHARRE and Yolande

MASEMBE (WHO/Kinshasa) and Dr. BA ABDERRAHMANE (UNICEF/

Kinshasa).

The aim of the workshop was to peer review the draft laws under con-

struction in the six countries and to share strategies for strengthening

routine immunization programs through legislation. Describing the proc-

ess, facilitator Mariya Savchuk listed the various provisions in the draft

laws, which address such themes as state financing mechanisms, financial

reporting and obliging the public to have their children immunized.

“There was a lot of energy”, added Savchuk. “Delegates analyzed and

commented on these texts in depth, giving their inputs, suggestions for

improvements and clarifications both on the presentation and the con-

tent.”

The countries face common constraints. On the program side, manage-

ment and surveillance systems are relatively weak. The public is largely unaware and uneducated about immunization. Governments do not al-

ways disburse budgeted funds in a timely manner and the programs de-

pend heavily on outside funding. On the legislative side, surveillance and

financial data are not readily shared between governments and parlia-

ments, making it hard for MPs to follow and defend the programs. MPs

lack a factual basis for evaluating budget requests. Governments and

parliaments lack the institutional resources needed to craft legislation

together. Once the bills pass, new mechanisms, such as regional parlia-

mentary oversight, may be needed to ensure the immunization legislation

is truly implemented in each country.

Delegates from each country received specific recommendations on their

draft laws from their peers. They will examine them and integrate those

that will add value to their drafts and that will be feasible, given their

political and legislative systems.

Each delegation presented the next steps to be taken to advance their

legislative project. The first step in most of the countries will be to pre-

sent the workshop report to the Minister of health. The second step will

be to convene a committee of experts and partners to further analyze

the draft legislation and consider the suggestions made by the peers at

the workshop. The third step is either to submit the draft law to the

Ministry of Health, which will then submit it to the Council of Ministers,

or submit it to a parliamentarian/parliamentary committee so that it can

be brought to the attention of the National Assembly as a whole.

The participants vowed that, in 10 years’ time, their countries would

have efficient, properly financed immunization programs. For more on

this SIF legislative workshop, click here.

Six Countries Take Part in a

Workshop on Legislative and

Financial Strategies for

Immunization

On 14-16 November 2012, a SIF-sponsored workshop on

legislative and financial strategies for immunization was held

in Kinshasa, Democratic Republic of Congo. The workshop

brought together 33 delegates from ministries of health,

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Ugandan Ministry of Health Hosts Second Forum on Sustainable Immunization

Page 4

Ugandan leaders in both government and parliament con-

tinue their efforts to strengthen the country’s immunization

program. On 22 November 2012, Honorable James Kye-

walabye Kabajo introduced new immunization legislation in

the Parliament. The bill was seconded by Honorable Dr

Mathias Twa-Twa and Honorable Mutwalante Jeremiah

Kasamba. The House granted leave for the Immunization

Bill 2012, to be drafted (which will include stakeholder

involvement), gazetted and brought for first reading.

Such private member’s bills are unusual in most parlia-

ments. Because the Immunization Bill carries financial impli-

cations, it is now up to the government to analyze its costs

and to return the bill to parliament with its certification to

proceed.

The following week, three Members of the Ugandan Parlia-

ment, representing the Uganda Parliamentary Forum on

Immunization (see related story in Summary Digest 4(3)),

visited the East African Legislative Assembly (EALA) in

Arusha, Tanzania. Accompanying them were Ugandan EALA

MP Hon. Mike Sebalu, Sabin Senior Program Officer Diana Kizza Mugenzi and SIF Program Officer Mariya Savchuk.

The five EALA Member Countries are Burundi, Kenya,

Rwanda, Tanzania and Uganda. The interparliamentary body

encourages MPs from its Member Countries to bring issues

to the regional level. The EALA MPs warmly welcomed

their counterparts from Uganda. The Ugandan MPs were

received by EALA Speaker Hon. Dr. Margaret Nantongo

Zziwa and met with the members of the General Purpose

Committee, which handles health affairs. The Ugandan MPs

presented the recently introduced Immunization Bill and

advocated for the passing of a similar regional bill on immu-

nization.

The Ugandan delegation stressed the key provisions of

their immunization bill:

Clear, comprehensive, up-to-date technical immu-

nization norms

Clear definition of immunization financing sources

Penalties for failing to immunize children

Clear definitions of the roles of the different insti-

tutional players

In addition to the Ugandan bill, the legislators discussed

related themes, including possible pooled vaccine procure-

ment arrangements, the need for parliaments to monitor

vaccine coverage levels and other steps to attain the goal

of country ownership.

There are several rationales for interparliamentary legisla-

tive action for immunization. Vaccine-preventable diseases

easily travel across borders. The East African Community

aspires to closer economic integration and freedom of

movement for services and people. As these goals are real-

ized, the risk of disease transmission increases. More to the

point, each Member Country must automatically take up

any bill passed by EALA.

Convincing the health savvy members of the General Pur-

pose Committee to take action for immunization is just the

first step; convincing the Member Countries to act will be

Ugandan Private Member’s Bill on

Immunization Leads to Regional

Action

Meeting with the Speaker of EALA, 25 November 2012. From left to right:

Mariya Savchuk (SIF Program Officer, DC), Hon Mathias Kasamba (MP Uganda),

Hon Anne Auru (MP Uganda), Margaret Nantongo Zziwa (MP EALA), Hon

James Kyewalabye Kabajo (MP Uganda), Diana Kizza-Mugenzi (SIF SPO, Uganda).

more difficult. The countries differ significantly, not only in geographic

and socioeconomic terms, but also in their health policies, immunization

activities and results. Some of the EALA members, like Rwanda, have

maintained high vaccine coverage for the past three decades and consis-

tently show resulting health impacts. Others, like Uganda, were early

achievers and once enjoyed high coverage, however, for various rea-

sons their coverage levels have fallen in recent years.

The Committee members agreed to pursue a regional immunization

legislative project. They also called for Rwanda to share its best immuni-

zation program practices with neighboring countries and urged that

these best practices be adopted across the region. The Committee

resolved to further investigate national vaccine coverage rates and im-

munization practices and to review national legislative frameworks on

immunization. Following this comprehensive assessment, the EALA MPs

will have a clear idea of where their Member Countries stand and what

they need to do in order to ensure a healthy future of all children of the

East African Community.

The following day, the Ugandan MPs attended the official opening of the

plenary session of the 3rd meeting of the 1st session of the 3rd Assembly

of EALA, which ran from 26 November through 6 December, 2012. The inspiring and successful immunization work of the Ugandan Parlia-

ment was publicly recognized the following week at the Fifth GAVI Part-

ner’s Forum (see main article on the Forum in this issue). Representing

the Ugandan Parliamentary Forum on Immunization, Honorable Oleru

Huda accepted the GAVI Inspire Award before 650 immunization lead-

ers gathered in Dar es Salaam, Tanzania.

“This award will hopefully motivate even more MPs to join the Ugandan

Parliamentary Forum on Immunization. And I hope it encourages MPs

from other countries to pass comprehensive legislation on immuniza-

tion”, effused Senior Program Officer Diana Kizza Mugenzi.

In the coming months, Kampala-based Kizza Mugenzi will be working

with government and parliamentary counterparts as they shepherd the

Ugandan Immunization Bill to passage. For her part, Hon. Oleru Huda

plans to place the issues of vaccine affordability and accessibility on the

agenda of the 25th African-Caribbean-Pacific-European Union Interpar-

liamentary Assembly, which will take place in Brussels, Belgium on 20-

25 March 2013.

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Ugandan Ministry of Health Hosts Second Forum on Sustainable Immunization

Page 5

On 4-7 December 2012 the Sabin SIF team took part in the Fifth

GAVI Partner’s Forum on Immunization, a gala event that brought

together over 650 immunization leaders in Dar es Salaam, Tanzania.

A member of the Forum organizing committee, Sabin Executive Vice

President Ciro de Quadros presided over two sessions. The SIF team

and GAVI counterparts worked together to produce a program es-

pecially for parliamentarians. Sixteen MPs participated, representing

13 African, Asian and European countries. Nine of the MPs partici-

pated as SIF Program peer exchangers: H.E. Ouk Damry (Cambodia);

Hon. Norbert Amougou-Mezang (Cameroon); Hon. Grégoire

Lusenge Kakule (DRC); Hon. Johnson Chea (Liberia); Hon. Kalifa

Doumbia (Mali); Hon. Bayartsogt Sangajar (Mongolia); Hon. Mike

Sebalu, Hon. Huda Oleru and Hon. Sylvia Ssinabulya (Uganda).

A highlight of the Forum was a workshop where the MPs shared

their best advocacy practices and the challenges they face in pushing

for funding and strengthening immunization programs in their respec-

tive countries. In the workshop, the European MPs, whose countries

provide funding for immunization, asked for more evidence that re-

sults are being achieved using their funding. Such evidence would

make their advocacy efforts more fruitful. Parliamentarians from im-plementing countries accepted that challenge and described some of

the institutional and political problems they face as immunization

advocates.

Obtaining information on immunization performance is difficult for a

host of reasons. Ongoing decentralization creates coordination gaps

between local and national authorities. The responsibility of the

health sector to keep parliament informed is not fully defined by law

but by ad hoc policy mandates. In the SIF countries, MPs explained,

legislative and budget reform efforts are underway to remedy this

and to ensure program and financial information flows regularly from

government to parliament.

Sabin SIF Team Takes Part in the Fifth

GAVI Partner’s Forum

The root problem, implementing country MPs agreed, is in-

adequate financing. Government immunization budgets are

generally insufficient. Funds for immunization are often not

released on time, nor are approved budgets always fully dis-

bursed. The MPs are often unaware of the resulting program-

matic problems, such as faltering vaccine coverage levels and

vaccine stockouts, until there are disease outbreaks. There is

clearly a need to address structural and management issues at

the different levels of government if parliaments are to play a

more constructive role in immunization. The meeting ended

with a declaration signed by all the MPs present.

The MP workshop was facilitated by the SIF Program team. “It

was really interesting to hear both European and implement-

ing country perspectives”, commented SIF Director Mike

McQuestion. “It feels like there is an interparliamentary

movement coming together to support global immunization.

Each country wants to be involved and to show it is doing its

part.”

Special Parliamentary Session, 5 December, 2012 (left to right, back row):

Hon Jim Dobbin, MP; Hilary Obioma Ibegbulem, HE Ouk Damry, MP; Lord

Paul Yaw Boateng,; Hon Dr Augustin Sawoure Dougrou, MP; Hon Kalifa

Doumbia, MP; Hon Gregoire Lusenge Kakule, MP; Hon Brig Gen Dr B

Chituwo, MP; Hon Johnson Chea, MP; Hon Bayartsogt Sangajav, MP; (left to

right, front row): Senator Dr Ifeanyi Arthur Okowa; Hon Eleni Theocharous,

MEP; Hon Sylvia Ssinabulya, MP; Hon Olearu Huda, MP; Hon Elisabeth

Bjornsdotter Rahm, MP; Hon Mike Sebalu, MP; Hon Norbert Amougou-

Mezang, MP.

Special Session on “Political Will for Health and Immunization”, Hon

Mike Sebalu describes the process of regional collaboration at the

EALA level, to the audience and fellow panelists, Lord Paul Yaw

Boateng and Dr Ciro de Quadros (Sabin).

SIF Peer Exchangers Share Their

Experiences at the WHO African

Regional Immunization Conference

Some SIF team members stayed on in Dar es Salaam to at-

tend the WHO African Regional Immunization Conference,

from 10 to 13 December, 2012. On the second day of the

conference, countries were given the opportunity to present

their work on immunization financing. Among the presenters

were two Sabin SIF peer exchangers. Honorable James Kye-

walabye Kabajo presented the Ugandan parliamentary ex-

perience (see related story this issue), where the govern-

ment’s proposed 2013 health budget was increased as a

direct result of parliamentary pressure. Sierra Leonean EPI

Manager, Dr Thomas Samba, presented a tool he and his

colleagues developed to help track subnational immunization

expenditures. This was the fourth consecutive ARIC in

which the SIF Program team has participated.

6

Page 6

Experts Trade Thoughts on Immunization Financing in Phnom Penh, Cambodia

The Cambodian Ministry of Economy and Finance was the setting for wide ranging discussions between peers from Nepal and Cambo-

dia about immunization financing. The occasion was a Sabin-sponsored peer exchange which took place in Phnom Penh on 10-12 Octo-

ber. The theme was developing institutional innovations for sustainable immunization financing.

Speaking for the host institution, His Excellency Ratanak Hav, Deputy Director of the Budget Department, outlined the Cambodian

budget cycle and explained to the visitors how allocations for health and other sectors depend on a medium term expenditure frame-

work. Immunization is well financed, added Mr. Kim Phalla, Director of Economy and Finance, because it is accorded high priority in

Cambodia’s national health plans.

This could all change as newer, more expensive vaccines are adopted and external financing ceases, pointed out Mr. Lokdarshan Regmi,

Chief of Budget and Program Division in Nepal’s Ministry of Finance. In Nepal, he continued, rising immunization costs and the march

toward country ownership are motivating the development of a public-private immunization trust fund. The Cambodians found this an

intriguing idea.

As immunization budgets grow, the peers agreed, financial performance becomes more important. Nepal’s Under Secretary of the

Budget Department, Mr. Yagya Prasad_Dhungel, and his colleague Mr. T.P. Pagyani, Under Secretary of Central Budget, described their

work on a recent World Bank Public Expenditure and Financial Accountability (PEFA) evaluation, in which financial flows in Nepal’s

health sector were studied. All five experts challenged themselves to develop another innovation: Adapt the rigorous PEFA methodol-

ogy to analyze their respective national immunization programs.

Since its inception, the SIF Program objectives have been consistent: To help countries increase their immunization budgets and to pass

legislation assuring sustainable government immunization financing in perpetuity. These objectives are now incorporated into the Dec-

ade of Vaccines Global Vaccine Action Plan. Here’s a look at progress toward these objectives in the SIF pilot countries. As Figure 1

shows, mean SIF country budgets have risen from US$3.5m in 2008 to $6.1m in 2012- an increase of about 15 percent per annum.

Though encouraging, the result is inconclusive because budget data have yet to be reported by half of the SIF countries.

Figure 2 shows the status of immunization legislation proposals in the SIF countries as of January 2012. Legislative projects are underway

in all but two countries. Nine countries have at least drafted laws. So far, one country, Uganda, has submitted its bill to parliament.

Figure 1

Progress Towards Country Ownership

7

Page 7

Figure 2

SIF Immunization Champions In this issue we would like to recognize the work done by all of the Members of Parliament that have worked closely with Sabin and

other partners, both domestic and external, to increase financing for immunization programs in their countries. In 2012, progress has

been made in 13 out of the 15 SIF pilot countries on the legislative side. MPs have been actively involved in drafting and discussing the

legislation. MPs were also active on the budget side. They scrutinized immunization budget proposals and advocated for budgetary in-

creases. They checked with government counterparts to see how much of the allocated budgets was actually disbursed. And they

checked how the disbursements were spent. Advocacy for immunization often lifted other boats. In Uganda, the MPs refused to pass

the 2013 budget until the health sector budget had been increased.

The MPs formed parliamentary networks and forums to strengthen the voice for immunization, both within National Assemblies and

among government institutions. They are forming critical masses that exert influence and ensure that immunization is financed. Some

MPs made it a point to inform their constituents about the benefits of immunization and negative consequences of not immunizing chil-dren, through the media, in personal meetings and in international venues.

Parliamentarians had much to do with the fact that governments in the SIF pilot countries increased their immunization budgets by 52

percent from 2011 to 2012.

This progress would not have been possible without the dedication and efforts of these individuals:

Cambodia: Hon. Ouk Damry (MP), Hon. Ho Naoun (MP), Hon. Mrs. Chhun Sarim (MP), H.E. Uy Visal (parliamentary staff); Camer-

oon: Hon. Norbert Amougou-Mezang (MP), Hon. Gaston Komba (MP); DRC: Hon. Gregoire Lusenge Kakule (MP), Hon. Gregoire

Kiro (MP), Hon Vicky Katumwa (former MP); Kenya: Hon. Dr. David Eseli (MP); Liberia: Hon. Johnson Chea (MP), Hon. Corpu Bar-

clay (MP), Senator Peter Coleman; Hon William Dakel (MP); Hon Edwin Power Gaye (former MP); Mali: Hon. Kalifa Doumbia (MP),

Hon. Lassana Traore (MP), Hon. Fanta Mantchini Diarra (MP), Dr Beffon Cisse (Executive Secretary,Health Committee); Madagascar:

Hon. Dr Rajoelina Aro Tafohasina (MP); Mongolia: Hon. Bayartsogt Sangajav (MP); Nepal: Hon Ms. Sandhya Devi (MP), Mr. Thakur

Prasad Baral, Secretary, Parliament; Senegal: Hon. Ndeye Fatou Diouf (MP), Hon. Alpha Balde (MP); Sierra Leone: Hon. Alimamy

Kamara (MP), Hon. Mohamed Albert Tarawallie (former MP), Hon. Bintu Myers (former MP); Sri Lanka: Hon Mr. Lalith Chandra Bud-

dhisiri Dissanayake (MP), Deputy Health Minister; Hon Dr. Ramesh Pathirana (MP), Mrs. Nandini Ranawaka, Secretary, Health Commit-

tee; Uganda: Hon. Sylvia Ssinabulya (MP), Hon. Olearu Huda (MP), Hon Mike Sebalu (MP, EALA), Hon. Mathias Kasamba (MP), Hon.

Anne Auru (MP), Hon. Margaret Nantongo Zziwa (MP, EALA), Hon. James Kyewalabye Kabajo (MP).

We salute each of you and the many other MPs who continue to advocate for sustainable immunization financing.

Progress Towards Country Ownership (cont’d)

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Sustainable Immunization Financing is an initiative of the Sabin Vaccine Institute. Funded by a generous grant from the Bill and Melinda Gates Foundation

2000 Pennsylvania Avenue NW, Suite 7100

Washington, DC, USA 20006

www.sabin.org/sif — www.sabin.org/fr (en français)

sif@sabin.org

SIF Sabin News Highlights

Sustainable Immunization Financing Program Activity and Outputs This Period

Milestone/Activity (1.X.12 - 31.XII.12)

Achieved

this quarter

Cumulative (1.IX.09–

31.XII.12) Details:

Visits to field countries 14 115 Mali (3), Senegal (3), Cambodia, Republic of Congo (3), Sri Lanka, Kenya, Liberia, Vietnam

National Parliamentary briefing 5 77 DRC, Sri Lanka, Senegal (2), Mali

Sub-regional Parliamentary briefing 0 14 None reported this period

International Partners Meetings 8 65

• SIF meeting with WHO/WPRO (Manila, 11/12) • SIF meeting with WHO/SEARO (Bangkok and New Delhi11/12) • Immuniza-tion Working Group meeting for West and Central Africa (Ouagadougou, 12/12) • 5th GAVI Partner’s Meeting (Dar es Salaam, 12/12) • SVI/SIF Partner meeting (Dar es Salaam, 12/12) • African Regional Conference on Immunization (ARCI)/ African Regional Coordinating Committee meeting (ARCC) (Dar es Salaam, 12/12)

Advocacy activities inserted into cMYP 2 41 Mali, Cameroon

Peer exchanges involving SIF target countries 7 54 Peers from Nepal visited Cambodia; Peers from Cameroon, Mali, Senegal, Congo and Madagascar visited DRC; Peers from Uganda visited Tanzanian counterparts

National routine EPI budget increased 5 38 Cameroon, Mali, Liberia, DRC, Sri Lanka

Dar es Salaam Tanzania, 5-7 December, 2012. At the

Fifth GAVI Partner’s Forum, Hon. S. Bayartsogt, Deputy-

Speaker of Parliament and Hon. Udval, Minister of Health,

accepted the GAVI “Co-Financing & Sustainability Award”,

which recognized Mongolia for exceeding its co-financing

requirements for GAVI-supported vaccines and for providing

funding for non GAVI-supported vaccines in 2011.

Washington, DC 10-11 October 2012. SIF Director

Mike McQuestion participated in a Decade of Vaccines Col-

laboration resource tracking workshop addressing the

Global Vaccine Action Plan’s (GVAP) Monitoring and Evalua-

tion/Accountability Framework.

Manila, Philippines, 15-16 October 2012. SIF Director

Mike McQuestion and SPOs Devendra Gnawali and

Khongorzul Dari conferred with WHO/WPRO/EPI counter-

parts on regional advocacy strategies for sustainable immuni-

zation financing.

Kintele, Republic of Congo (Brazzaville), 30 October-

3 November 2012. Ministry of Health and Senate counter-

parts participated in a Sabin-supported immunization budget

analysis and legislative workshop.

Lima, Peru, 26-29 November 2012. Sabin Executive Vice President

Ciro de Quadros, SIF Director Mike McQuestion and Sabin colleagues

participated in the Second Sabin Vaccinology Course for Latin America.

Yaoundé, Cameroon, 28 November 2012. In presenting his 2013

economic and social program to the ordinary budget session of parliament,

Prime Minister Hon. Philemon YANG stated that immunization is a high

priority program and that he would request CFA 7,6 billion (US$15m) for

the 2013 EPI budget, nearly doubling the 2012 budget of US$8.7m.

Dar es Salaam, Tanzania, 6 December 2012. SIF team provided coun-

try by country updates for the Fourth SIF Partners Group meeting.

Bangkok, Thailand, 11-15 December 2012. SPO Devendra Gnawali

presented at the WHO/SEARO New Vaccine Introduction and Financing

meeting .

Kinshasa, DRC, 11 November 2012. SIF champion Hon. Gregoire

LUSENGE, Representative of the Mambasa Circumscription in the Orien-

tale Province and Chair of the Subcommittee on Gender, Children and

Family, National Assembly, was featured in an article in the Congo News for

his passionate call for a larger health budget during recent budget hearings

Dar es Salaam, Tanzania, 13 December 2012: The SIF African team

conferred with WHO/AFRO/IVD counterparts on regional advocacy

strategies for sustainable immunization financing.