Tougher Sarah, Mandalia Nikhil, Kou Griffiths Ulla
Independent Researcher, Winnipeg, MB R3N 1P6, Canada.
United Nations Children's Fund (UNICEF) Programme Group, New York, NY 10017, USA.
Vaccines (Basel). 2023 Jun 26;11(7):1159. doi: 10.3390/vaccines11071159.
The COVID-19 pandemic has precipitated large declines in childhood vaccination coverage and, consequently, substantial increases in the number of zero-dose children. To effectively respond to these declines, it is necessary to direct resources for recovery. We mapped active external financing for immunisation and primary healthcare in 20 countries with the highest numbers of zero-dose children to promote transparency and donor coordination. We found that countries have disparate access to external financing, with the two upper-middle-income countries (Brazil and Mexico) only having access to loans from the International Bank for Reconstruction and Development. Domestic resource mobilization is, therefore, key in these two countries, although fiscal space is likely constrained. Four additional countries (Angola, Indonesia, Philippines, and Vietnam) do not have allocations from Gavi, the Vaccine Alliance for Health Systems Strengthening, or Equity Accelerator Funding, but are eligible for support under Gavi's Middle-Income Countries Approach. Our methods, which focus on current donor financing, are novel and reveal substantial variations in access to external financing to support immunisation in high-burden countries. The available data differ considerably across financing mechanisms, making it difficult to synthesise the results across funding sources.
新冠疫情导致儿童疫苗接种覆盖率大幅下降，因此零剂次儿童数量大幅增加。为有效应对这些下降情况，有必要将资源用于恢复工作。我们绘制了零剂次儿童数量最多的20个国家的免疫和初级卫生保健外部资金流向图，以提高透明度并促进捐助方协调。我们发现，各国获得外部资金的机会各不相同，两个上中等收入国家（巴西和墨西哥）只能获得国际复兴开发银行的贷款。因此，在这两个国家，国内资源调动至关重要，尽管财政空间可能受到限制。另外四个国家（安哥拉、印度尼西亚、菲律宾和越南）没有获得疫苗免疫全球联盟（Gavi）用于加强卫生系统的拨款或公平加速基金，但有资格根据Gavi的中等收入国家方案获得支持。我们关注当前捐助资金的方法具有创新性，揭示了高负担国家在获得外部资金以支持免疫方面存在的巨大差异。不同融资机制的现有数据差异很大，难以综合不同资金来源的结果。
