Schreuder B, Arentsen H, Matosse M
EPI/MCH-DANIDA Project, Maputo, Mozambique.
Bull World Health Organ. 1997;75(4):315-21.
Vaccines constitute the single most important cost factor in the Expanded Programme on Immunization (EPI) in Mozambique and in view of future new disease-control initiatives, the proportional expenditure on vaccines will only increase. Airfreight may contribute up to at least 25% of the total cost of delivered vaccine. Air transport of vaccine provided by UNICEF was arranged by the vaccine supplier. As a result of a lack of control mechanisms, airfreight rates were unnecessarily high and showed considerable variation. By negotiating rates directly with the airlines, the EPI management team in Mozambique succeeded in reducing them from an average of about US$ 12 per kg to US$ 4 per kg, equivalent to an annual saving of US$ 100,000. Vaccine vials are typically packaged in one of the following types of boxes: small colourful boxes containing 5-10 vials or bigger more functional boxes containing 50-100 vials. The packaging of vials in smaller boxes can double airfreight costs compared with bigger boxes. The EPI management team for Mozambique recommends that UNICEF should take over from suppliers the arrangements for shipping vaccine and negotiate airfreight rates centrally; further, WHO should tighten current vaccine-packaging standards for net packaging volume per dose, so that packaging in uneconomical small boxes can be eliminated.
疫苗是莫桑比克扩大免疫规划（EPI）中最重要的单一成本因素，鉴于未来新的疾病控制举措，疫苗的支出比例只会增加。航空货运成本可能至少占所交付疫苗总成本的25%。联合国儿童基金会提供的疫苗的航空运输由疫苗供应商安排。由于缺乏控制机制，航空货运费率过高且差异很大。通过直接与航空公司谈判费率，莫桑比克的扩大免疫规划管理团队成功地将费率从平均每公斤约12美元降至4美元，相当于每年节省10万美元。疫苗瓶通常包装在以下几种类型的盒子中：装有5 - 10瓶的彩色小盒子或装有50 - 100瓶的更大且功能更强的盒子。与较大盒子相比，将疫苗瓶包装在较小盒子中会使航空货运成本增加一倍。莫桑比克的扩大免疫规划管理团队建议，联合国儿童基金会应从供应商手中接管疫苗运输安排并集中谈判航空货运费率；此外，世卫组织应收紧当前每剂净包装体积的疫苗包装标准，以便消除使用不经济的小盒子进行包装的情况。
