Ozawa Sachiko, Grewal Simrun, Portnoy Allison, Sinha Anushua, Arilotta Richard, Stack Meghan L, Brenzel Logan
Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA.
Department of Pharmacy, University of Washington, Seattle, WA, USA.
Vaccine. 2016 Dec 7;34(50):6408-6416. doi: 10.1016/j.vaccine.2016.09.036. Epub 2016 Oct 28.
Novel vaccine development and production has given rise to a growing number of vaccines that can prevent disease and save lives. In order to realize these health benefits, it is essential to ensure adequate immunization financing to enable equitable access to vaccines for people in all communities. This analysis estimates the full immunization program costs, projected available financing, and resulting funding gap for 94 low- and middle-income countries over five years (2016-2020). Vaccine program financing by country governments, Gavi, and other development partners was forecasted for vaccine, supply chain, and service delivery, based on an analysis of comprehensive multi-year plans together with a series of scenario and sensitivity analyses. Findings indicate that delivery of full vaccination programs across 94 countries would result in a total funding gap of $7.6 billion (95% uncertainty range: $4.6-$11.8 billion) over 2016-2020, with the bulk (98%) of the resources required for routine immunization programs. More than half (65%) of the resources to meet this funding gap are required for service delivery at $5.0 billion ($2.7-$8.4 billion) with an additional $1.1 billion ($0.9-$2.7 billion) needed for vaccines and $1.5 billion ($1.1-$2.0 billion) for supply chain. When viewed as a percentage of total projected costs, the funding gap represents 66% of projected supply chain costs, 30% of service delivery costs, and 9% of vaccine costs. On average, this funding gap corresponds to 0.2% of general government expenditures and 2.3% of government health expenditures. These results suggest greater need for country and donor resource mobilization and funding allocation for immunizations. Both service delivery and supply chain are important areas for further resource mobilization. Further research on the impact of advances in service delivery technology and reductions in vaccine prices beyond this decade would be important for efficient investment decisions for immunization.
新型疫苗的研发与生产催生了越来越多能够预防疾病和挽救生命的疫苗。为了实现这些健康效益，必须确保有足够的免疫接种资金，以使所有社区的人们都能公平地获得疫苗。本分析估算了94个低收入和中等收入国家在五年（2016 - 2020年）期间的全面免疫规划成本、预计可得资金以及由此产生的资金缺口。基于对全面多年计划的分析以及一系列情景分析和敏感性分析，预测了各国政府、全球疫苗免疫联盟（Gavi）及其他发展伙伴在疫苗、供应链和服务提供方面的疫苗计划资金。研究结果表明，2016 - 2020年期间，94个国家实施全面疫苗接种计划将导致总计76亿美元的资金缺口（95%不确定性范围：46亿 - 118亿美元），其中大部分（98%）用于常规免疫计划所需资源。弥补这一资金缺口所需资源的一半以上（65%）用于服务提供，金额为50亿美元（27亿 - 84亿美元），另外疫苗需要11亿美元（9亿 - 27亿美元），供应链需要15亿美元（11亿 - 20亿美元）。从占预计总成本的百分比来看，资金缺口占预计供应链成本的66%、服务提供成本的30%以及疫苗成本的9%。平均而言，这一资金缺口相当于政府一般支出的0.2%和政府卫生支出的2.3%。这些结果表明，各国和捐助方在免疫接种资源调动和资金分配方面有更大需求。服务提供和供应链都是进一步资源调动的重要领域。对本十年之后服务提供技术进步和疫苗价格下降的影响进行进一步研究，对于免疫接种的高效投资决策至关重要。
