Nigerians, Can We Talk Less and Save More Kids From Dying?

The death of a child brings a lot of sorrow to the family and community. This is the plight of thousands of Nigerian families every year as UNICEF 2015 report shows that up to 750,000 Nigerian children die before their 5th birthday with about 28% of these deaths caused by Vaccine Preventable Diseases. Vaccines work and save lives. A joint report of the World Health Organization, UNICEF and World Bank on the State of the World’s Vaccines and Immunization estimates that about 2.5 million lives are saved globally yearly due to immunization. Further, improved immunization program in Nigeria resulted in 2.7% annual rate of reduction in under-5 mortality rate between 1990 and 2015, interruption of wild poliovirus transmission in 2015 and delisting from polio endemic countries.

The Nigerian immunization program faces a huge risk in the coming years with a progressively widening of a fund gap for her immunization program due to increasing birth cohort, cost of new vaccines, inadequate budgetary allocation following dwindling economy (falling price of crude oil which is Nigeria’s key revenue source) and loss of donor funding following Nigeria’s transition from GAVI support. The country’s Multi-Year Plan (cMYP) for immunization states that the government of Nigeria will require 13.7 billion naira ($69 million) in 2017, 21.9 billion naira ($110 million) in 2018, 35 billion naira ($176 million) in 2019 and 40.8 billion naira ($205 million) in 2020 to co-finance procurement of vaccines and devices alone. These values in naira were derived using a $1 to 197.5 naira Central Bank of Nigeria exchange rate as at 26th January, 2015 thus the cost to Nigeria is likely to increase as the country’s currency continues to plunge against the US Dollar.

Achieving this co-financing plan appears unrealistic considering the trend of the Federal Government of Nigeria annual budgetary appropriation for vaccines and devices in the years of oil boom. Certainly, Nigeria requires innovative ideas to fill this fund gap so as not to lose the gains in her immunization program which will in turn lead to more deaths of her citizens.

The National Immunization financing task team (NIFT), mandated by the government of Nigeria to develop a sustainable vaccine financing advocacy strategy and roll out plan, recommended the following for Nigeria to meet its immunization finance needs: state governments should support the federal government in funding vaccine procurement;  local vaccine production should be prioritized and a Nigerian Immunization Trust Fund (NITF) should be established to draw support from individuals, the private and public sector for Nigerian immunization programs. To achieve this, innovative funding approaches must be evolved.

John F Kennedy ‘s popular quote from his inaugural speech as president of the United States on 20th January, 1961, “Ask not what your country can do for you, ask what you can do for your country” readily comes to mind. Is there anything we can do, as Nigerians, to support the government of Nigeria to fill this immunization fund gap? Of course there is! NIGERIANS CAN TALK LESS AND SAVE MORE KIDS FROM DYING FROM VACCINE PREVENTABLE DISEASES!!!

But how does this work?

Data from the Nigerian communication commission website shows that as of November 2015, there were 152,123,172 active mobile and fixed telephone lines in Nigeria. Also, GSMA intelligence analysis in Nigeria revealed a 2012 and 2013 average revenue per user (ARPU) by subscriber of 15 US dollars. This means that an average subscriber in Nigeria spends about 3000 naira (1 US dollars = 199 naira) every month on telephone usage which translates to about 100 naira daily. If all telephone subscribers in Nigeria decide to talk less and contribute just a percent of this amount to the proposed Immunization Trust Fund, Nigeria should be generating over 150 million naira daily which translates to over 54 billion annually. This exceeds the Government of Nigeria’s vaccine procurement co-financing for 2020. It’ll only cost each of us 1 naira a day from our daily phone call expenditure to save 210,000 lives annually!

However, for this strategy to be effectively implemented, government must first establish the Nigerian Immunization Trust Fund (NITF) in line with the task team recommendations. Furthermore, given Nigeria’s history with trust funds, a strong legislation and accountability mechanism is required to ensure that proceeds of this trust fund are not misappropriated but rather used solely for the intended purpose. Finally, only men and women of proven integrity must be appointed into the management board of this trust fund.

The good news is that with an accountable and transparent immunization trust fund, local vaccine production and other innovative financing ideas; Nigeria will have enough to fund her planned immunization programs and have some leftover funds to introduce anticipated “future vaccines” like that for malaria and HIV/AIDS – a key intervention that is needed if we must eliminate these two diseases that have remained a scourge in Nigeria.

Dr. Obinna Ebirim

Senior Program Officer (Advocacy and Technical Assistance), Direct Consulting and Logistics.

Consultant for International Vaccine Access Center (IVAC) in Nigeria.