Immunisation: FG, Bill Gates Foundation Sign $75m Financing Agreement

By Ndubuisi Francis in Abuja

The federal government on Tuesday gave further impetus to childhood immunisation with the signing of a $75 million financing agreement between it and the Bill & Melinda Gates Foundation.

The agreement will ensure that increased government funding for routine immunisation further strengthens primary healthcare for Nigeria’s poorest.

At the signing ceremony in Abuja, the federal government was represented by the Minister of Budget and National Planning, Senator Udoma Udo Udoma, and his Finance counterpart, Mrs. Zainab Ahmed, as well as the Minister of Health, Prof. Isaac Adewole.

The innovative financing agreement with the Bill & Melinda Gates Foundation is aimed at strengthening both routine immunisation (RI) and broader primary healthcare (PHC) services.

Under the agreement, Nigeria will receive incentive financing of up to $75 million over five years from the Gates Foundation as the government meets existing commitments to increase domestic funding of its RI programme.

The incentive financing will be directly invested in Nigeria’s Basic Healthcare Provision Fund (BHCPF) and used in strengthening RI financing and other PHC services for the poorest.

Coming at a time when the nation’s revenue generation is constrained, the deal will direct new funds to Nigeria’s broader health sector even as more domestic resources are dedicated to critical childhood vaccines specifically creating a win-win opportunity for essential PHC services to grow in tandem.

According to the Minister of Budget and National Planning, Udoma Udo Udoma, “Childhood immunisation is one of the most effective and cost-effective health interventions, and I can think of few better long-term investments in Nigeria’s human capital and future prosperity.”

In April 2018, the federal government, through the National Primary Healthcare Development Agency, finalised its Nigeria Strategy for Immunisation and PHC System Strengthening, 2018-2028 (NSIPSS), which outlined plans to spend $1.95 billion on immunisation services over 10 years via the national budget and some World Bank loan financing.

In June, Gavi, the Vaccine Alliance, said it was committed to supporting the NSIPSS with extended donor financing as domestic resources scale up.

During this extended transition window, international donors via Gavi will provide Nigeria with US$1 billion, on top of the US$1.95 billion domestic commitment.

Together, these funds will cover procurement of vaccines — the lion’s share of the costs — as well as operational costs for routine and supplementary immunisation activities, and PHC system support.

However, even with the additional Gavi support and loan options, the NSIPSS financing strategy requires significant annual increases in funding for vaccines until the government assumes full responsibility after 2028.

While the federal government planning accounts for this, the incentive financing with the Gates Foundation will help reduce the pressure this creates on the overall health budget by providing new grant financing for PHC each year as domestic vaccine financing commitments are met.

The Minister of Finance Ahmed said: “There’s no question that immunisation is an all-around ‘best buy’ for Nigeria, and extremely high value-for-money, but we still have limited resources.

“This innovative financing will allow us to limit trade-offs in the health sector by ensuring that every additional naira released for vaccines unlocks additional resources for broader PHC improvements.”

The BHCPF implementation, which formally rolled out on January 8, 2019, finances critical PHC interventions for children, women and families with a focus on rural and underserved areas, and by providing direct funding to facilities for operational expenses.

By channelling incentive financing through the BHCPF, the federal government and the Gates Foundation will ensure that those resources, like RI commitments, directly benefit Nigerians most in need.

Under the agreement, the Gates Foundation will provide up to US$15 million per annum for five years to the Federal Government of Nigeria for financing PHC.

Payments will be made based on the conditions that the federal government is budgeting for RI programmes per the NSIPSS financing plan, that a sustainable balance of direct budget contributions and loans are being directed to RI, and that budgeted funds are released as required by the immunisation programme.