Faniyan Olumide, Opara Chidiabere, Oyinade Akinyede, Botchway Pamela, Soyemi Kenneth
Department of Pediatrics, John H Stroger Hospital of Cook County, 1901 W Harrison Street, Chicago, IL 60612, United States.
Pan Afr Med J. 2017 Jun 21;27(Suppl 3):9. doi: 10.11604/pamj.supp.2017.27.3.11528. eCollection 2017.
Nigeria has an estimated population of 186 million with 23% of eligible children aged 12-23 months fully immunized. Government spending on routine immunization per surviving infant has declined since 2006 meaning the immunization budget needs to improve. By 2020, Nigeria will be ineligible for additional Global Alliance for Vaccination and Immunization (Gavi) grants and will be facing an annual vaccine bill of around US$426.3m. There are several potential revenue sources that could be utilized to fill the potential funding gap, these are however subject to timely legislation and appropriation of funds by the legislative body. Innovative funding sources that should be considered include tiered levies on tele-communications, airline, hotel, alcohol, tobacco, sugar beverage taxes, lottery sales, crowd-sourcing, optimized federal state co-financing etc. To demonstrate monthly income that will be derived from a single tax revenue source, we modelled using Monte Carlo simulation trials the Communication Service Tax that is being introduced by the National Assembly. We used number of active telephone subscribers, penetration ratio, monthly charges, and percent of immunization levy as model scenario inputs and dollars generated monthly as output. The simulation generated a modest mean (SD) monthly amount of $3,649,289.38 ($1,789,651); 88% certainty range $1,282,719.90 to $7,450,906.26. The entire range for the simulation was $528,903.26 to $7,966,287.26 with a standard error of mean of $17,896.52. Sensitivity analysis revealed that percentage of immunization levy contributed 97.9 percent of the variance in the model, number of active subscribers and charges per month contributed 1.5%, and 0.6% respectively. Our modest simulation analysis demonstrated the potential to raise revenue from one possible tax source; when combined, the revenue sources will potentially surpass Nigeria's long-term financing needs. The ROI of vaccine should supersede all other considerations and prompt urgent activities to cover the impending finance coverage gap.
尼日利亚估计有1.86亿人口，12至23个月大符合条件的儿童中，23%已完全接种疫苗。自2006年以来，政府为每名存活婴儿的常规免疫接种支出有所下降，这意味着免疫预算需要改善。到2020年，尼日利亚将无资格获得全球疫苗免疫联盟（Gavi）的额外资助，每年将面临约4.263亿美元的疫苗账单。有几个潜在的收入来源可用于填补潜在的资金缺口，但这取决于立法机构及时立法和拨款。应考虑的创新资金来源包括对电信、航空、酒店、酒精、烟草、含糖饮料征税、彩票销售、众包、优化联邦与州共同供资等。为了展示从单一税收来源每月可获得的收入，我们使用蒙特卡洛模拟试验对国民议会即将引入的通信服务税进行了建模。我们将活跃电话用户数量、普及率、月费用以及免疫征税百分比作为模型情景输入，将每月产生的美元数作为输出。模拟得出的月平均金额为3,649,289.38美元（标准差为1,789,651美元）；88%的确定性范围为1,282,719.90美元至7,450,906.26美元。模拟的整个范围为528,903.26美元至7,966,287.26美元，平均标准误差为17,896.52美元。敏感性分析显示，免疫征税百分比在模型方差中占97.9%，活跃用户数量和每月费用分别占1.5%和0.6%。我们适度的模拟分析表明了从一种可能的税收来源筹集资金的潜力；综合起来，这些收入来源可能会超过尼日利亚的长期融资需求。疫苗的投资回报率应超越所有其他考虑因素，并促使开展紧急活动以弥补即将出现的资金覆盖缺口。
