Abstract:
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.
摘要:
COVID-19大流行导致儿童疫苗接种覆盖率大幅下降,因此,零剂量儿童数量大幅增加。为了有效应对这些下降,有必要为恢复提供资源。我们为零剂量儿童最多的20个国家的免疫接种和初级医疗保健规划了积极的外部融资,以促进透明度和捐助者协调。我们发现,各国获得外部融资的渠道各不相同,两个中上收入国家(巴西和墨西哥)只能从国际复兴开发银行获得贷款。国内资源调动是,因此,这两个国家的关键,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)没有来自Gavi的拨款,加强卫生系统疫苗联盟,或股权加速器资金,但有资格在Gavi的中等收入国家方法下获得支持。我们的方法,专注于当前的捐助者融资,是新颖的,揭示了在获得外部融资以支持高负担国家免疫接种的巨大差异。不同融资机制的现有数据差异很大,这使得很难综合不同资金来源的结果。