Kathmandu, March 28:

At a time when the country is all set to implement the National Immunisation Plan (NIP) from 2008, the government’s Expanded Programme on Immunisation is likely to be badly affected by a huge resource gap caused by a rise in the cost of vaccines and lack of financial commitment from the partner international agencies.

The Financial Sustainability Plan on Immunisation has estimated a resource gap of $7 million by 2008 and $10 million by 2009. It has estimated a budgetary requirement of $18 million in 2006 for the programme to run smoothly. The costs are estimated to rise up to $28.91 million by 2008 and $35.83 million by 2014.

The financial gap will be caused by an increase in the coverage of Japanese Encephalitis vaccine from 10 per cent in 2006 to 45 per cent in 2012. The NIP also envisages the introduction pentavalent (DPT+ HBV+HiB), measles, mumps and rubella (MMR) and Japanese Enchepalitis vaccines in the routine immunisation programme from 2008, which are also expected to create a huge fund crunch for the programme.

Dr Shyam Raj Upreti, chief of the Expanded Programme on Immunisation (EPI) at the Child Health Division of the Health Ministry, told this daily that the cost of new vaccines will be very high but it is very important to introduce them in order to achieve the national goal of eliminating various diseases.

“The financial gap will increase over time especially from 2008 as the donor partners have not expressed long-term commitment to provide funds,” Dr Upreti added.

“There is a need to explore additional funding sources such as development loans from the World Bank or the Asian Development Bank and the government is studying possibilities,” he said. “Reviewing objectives and accelerating programme efficiency are a must to get the donor agencies’ commitment for financial support.”

“We have appealed to the international agencies to financially support us as immunisation is a globally interdependent programme,” said Dr Upreti.

The government spends Rs 60 million each year to buy BCG/ measles and Tetanus vaccines, while the external partner agencies have been providing vaccines worth Rs 320 million against Hepatitis B and polio every year.

The government has recently started a mop up programme for children under five in the 15 high-risk districts to check the spread of

poliovirus following its detection in several Terai districts. Though Nepal had declared eradication of polio in 2000, it was detected in 2004 in the Terai.

Similarly, the national measles campaign has just been completed and the DPT-3 coverage has been increasing by 3 per cent every year. The government has been buying various vaccines since 1998 while most of the underdeveloped countries still don’t buy any vaccine at all.

The major partners in Nepal’s immunisation programme are: the Global Alliance for Vaccines and Immunisation (GAVI), United Kingdom’s Department for International Developemnt (DFID), Japan International Cooperation Agency (JICA), Wor-ld Bank, UNICEF, the World Health Organisation (WHO) and USAID.

Even though the government on its part has been increasing the budget for the programme by 10 per cent each year, commitment from the donors for more financial support is needed to run the programme smoothly.