Crisis looms as State fails to procure life-saving vaccines
A nurse prepares a shot to vaccinate a child against malaria in Gisambai, Vihiga County.
What you need to know:
- A drop in immunisation coverage, coupled with an increase of susceptible children and mothers, will likely increase the cost of healthcare due to treatment for vaccine-preventable diseases and their complications.
- This will eventually decrease the quality of life as a result of diseases and disability.
At least 1.6 million infants, a similar number of pregnant women as well as 750,000 girls under 10, may not get critical vaccines because the government missed out on a year-long supply after defaulting a Sh2 billion debt to a global supplier.
According to documents seen by the Sunday Nation, Kenya has not procured the DTP (Diphtheria, Tetanus, and Pertussis) vaccine for 10 months, with public hospitals reporting shortages.
The BCG vaccine, given at birth to prevent tuberculosis, has not been procured for eight months.
Already, TB, polio, measles, rubella, pneumococcal conjugate vaccine (PCV), rotavirus, inactivated polio vaccine (IPV), measles-rubella (MR), human papillomavirus (HPV), yellow fever vaccine and malaria vaccines are out of stock.
HPV vaccine is given to girls under 10 and who number about 750,000 every year. The remaining stock in some hospitals may not last a month.
It is recommended that a country has at least eight months’ stock of every vaccine in its supply chain. The stocks for these vaccines may be exhausted in two months.
The shortage is attributed to inadequate financing and delays and irregular release of money for vaccine procurement.
About 15,000 fewer children were vaccinated last month.
“A drop in immunisation coverage will likely result in a sustained threat of outbreaks and epidemics from vaccine-preventable diseases, putting millions of children at risk, contributing to increased infant and child mortality and a decrease in life expectancy,” says a document presented to the Ministry of Health.
A drop in immunisation coverage, coupled with an increase of susceptible children and mothers, will likely increase the cost of healthcare due to treatment for vaccine-preventable diseases and their complications.
This will eventually decrease the quality of life as a result of diseases and disability.
Measles could lead to blindness while polio leads to permanent disability and even death.
The country has witnessed measles outbreaks since last year. More than 1,052 cases have been reported in Turakana, Mombasa, Samburu, Kilifi, Garissa, Meru, Nairobi, Kwale and Wajir counties.
This year, the government reduced the budget for vaccines from Sh2.6 billion to Sh1.2 billion, leading to unpaid bills and a shortage of Gavi-supplied vaccines.
Kenya owes Unicef, which procures and supplies vaccines on behalf of the government to public hospitals, more than Sh500 million. The Ministry of Health says Gavi is owned Sh4.2 billion.
Acting Health Director-General, Patrick Amoth admits there is a shortage of vaccines.
The immunity of thousands of children could go down. With the country recording outbreaks of cholera, dysentry and other waterborne diseases, the likelihood of deaths is high.
The inability of the government to pay suppliers means Kenya may not benefit or stands to lose almost Sh6.5 billion in Gavi support, which includes funding for vaccines, immunisation and equipment.
The country has over the last 15 years introduced several vaccines – PCV, IPV, MR, HPV and yellow fever vaccine expansion – with support from Gavi.
In the co-financing model, the government pays approximately 15 per cent of the six “new vaccines and safe injection devices” requirements every year.
This is to put the country on a trajectory of self-sustainability and prepare it for the phasing out of Gavi backing.
“With this, the country should be increasing its financing gradually in line with the Gavi policy, and ultimately be self-sustainable by 2030. However, the payment is reducing. Will we be able to finance and procure vaccines?” the document asks.
Resources available
To fully wean itself from Gavi support and manage its vaccination programme, ensure uninterrupted availability of supplies and improve access to services, the country needs to ensure universal access to immunisation by 2030. However, Kenya faces an uphill battle in ensuring adequate immunisation coverage.
“Kenya needs to procure and maintain a critical stock of emergency strategic vaccines of national importance (anti-rabies, anti-snake venom, hepatitis B and typhoid),” the document to the ministry says.
“The country has sufficient resources to finance vaccines and an effective procurement and supply mechanism is in place to ensure uninterrupted availability of vaccines.
"However, more than 50 per cent cut in the budget for vaccine procurement undertaken in January 2024, and delays in the release of funds for vaccine procurement and payment of co-financing amounts due to Gavi means the country is unable to procure sufficient stocks.”
During the coronavirus pandemic from 2019 to 2022, more than 600,000 children in Kenya missed out on life-saving routine vaccines.
At least 48,000 children do not receive vaccines every year, according to the Health Ministry.
Most of these children are in poor marginalised communities, which may not have access to water and other basics.
Routine immunisation
The effects of climate change – including droughts and flooding – strikes by healthworkers and now a biting shortage of vaccines have contributed to the re-emergence of infectious diseases.
Routine immunisation is one of the most effective public health interventions for critical childhood diseases.
The programme has reduced the burden of vaccine-preventable diseases in Kenya by more than 70 per cent in the last two decades.
It entails vaccinating every child against a myriad of diseases at birth and afterwards.
This goes on until the child grows develops immunity against deadly illnesses.
“With no access to vaccines, children are vulnerable to preventable diseases. This puts their lives at risk and compromises their long-term health outcomes,” Dr Walter Otieno, a paediatrician said.
“Diseases like measles and polio, once on the verge of being eradicated, are making a comeback, threatening to undo decades of progress in public health.”
In a letter to the National Assembly Health Committee, Health NGOs Network (Hennet) raised concerns over vaccine stockout in hospitals, blaming the situation on budget cuts.
The network is made up of Amref Health Africa, Waci-Health, Access to Medicines Kenya, Stop TB Partnership Kenya, TB Champions and the Coalition for Health Research and Development and others.
“The shortage of vaccines not only poses a grave risk to public health, but also undermines the country’s efforts to achieve immunisation coverage targets and reduce the burden of vaccine-preventable diseases,” Hennet Executive Director Margaret Lubaale said.
The network urged the National Assembly step in and ensure the timely release of funds for buying vaccines.
