A child receives the polio vaccine.
For the last six weeks, Halima Parmuat, a Kenyan mother of three who lives along the Kenya-South Sudan border has been unable to get any childhood vaccine for her latest bundle of joy.
All the health facilities she has visited in Turkana County say they do not have even have polio vaccines.
Her baby is among thousands of Kenyan babies born since January around the country who may miss vaccinations due to stock outs.
And they may have to wait longer for the life-saving doses after the government refused to wire Sh1,612,291,233.72 ($ 12,485,880) owed to Gavi, the Vaccine Alliance ahead of 30th June deadline.
The Ministry of Health (MoH) in an official Facebook post on Monday this week had indicated that Cabinet Secretary Aden Duale had officially asked Gavi for a ‘new co-financing framework ’ and an extension of the deal until 2035.
However, a senior Gavi Spokesperson told Nation the health ministry is not being honest about what was agreed on and in fact the position is that Kenya plans to ‘transition out’ of the Gavi agreement by 2029 after refusing to settle her debt on time.
The co-financing is needed so Gavi can replenish the country with vaccines.
The shocking revelations comes after President Ruto’s government recently allocated Sh2.3 billion for State House repairs in the new budget.
In the last one year also, President Ruto’s advisors have grown from 7 to 17 gobbling up over Sh1.14 billion according to budgetary documents tabled in parliament.
This also comes after a spot-check by Nation in the last one week has established that at least 10 counties have in the last three months run out of BCG (Bacillus Calmette-Guérin), Polio, Hepatitis B, Tetanus-Diptheria and DTP (Diptheria, Tetanus, Pertusis), HPV vaccine, Typhoid Conjugate Vaccine (TCV), Measles Rubella (MR), Pentavalent Vaccine, Pneumococcal Vaccine (PCV), Yellow Fever and malaria vaccine which are all supplied by Gavi.
The counties affected include Marsabit and Turkana where the MR vaccine has totally run out, Garissa where polio vaccine especially around Daadab refugee camp is missing, parts of Nairobi, Mombasa, Homa Bay, Kakamega, Nyamira, Trans Nzoia, Nakuru, Murang’a and Bungoma.
“To safeguard the immunization gains made over the years, CS Duale proposed a new framework that demonstrates the government’s commitment to the health of Kenyan children and its partnership with Gavi, he recommended that Kenya be reverted to the Preparatory Financing Phase, with a gradual increase in co-financing obligations extended up to 2035—allowing the country to transition sustainably towards full financing of its public health and immunization programmes,” the Health Ministry announced in an official statement after CS Duale met with a high-level delegation from Gavi led by Country Director Mr Thabani Maphosa.
“In response, Gavi reaffirmed its support to Kenya and announced an extension of the co-financing transition period from 5 to 8 years.
The move is aimed at providing the country with more fiscal space to strengthen its health systems,” the official statement from the health ministry further noted.
However, a Gavi senior spokesperson told Nation they have not agreed to any ‘new framework’ and have not announced any extension for Kenya’s co-financing obligations until 2035 as Duale’s ministry stated.
In fact, the purpose of the visit was to know exactly when Kenya is going to pay her portion of the co-financing deal by clearing her huge debt so that Gavi can replenish the country with vaccines but their pleas seem to have fallen on deaf ears.
“The Kenya 2024-2025 co-financing amount is USD$ 12,485,880 and is due in full by 30 June 2025 to avoid vaccine stock-outs. As is the case for all Gavi-supported countries, the Government of Kenya needs to ensure that immunisation procurement for both traditional vaccines and Gavi co-financing is adequately resourced on an annual basis,” he said while reminding that the discussions Gavi recently had with health ministry officials concluded that Kenya will be ‘transitioning out’ of the deal in 2029 and not 2035.
“Kenya entered the Accelerated Transition Phase in 2022 and, based on the current trajectory, will transition out of Gavi support in 2029.
Gavi’s co-financing model supports countries like Kenya by gradually increasing their financial responsibility for immunization as their national income grows,” the senior spokesperson said.
“Co-financing encourages governments in Gavi-supported countries to invest in new vaccines, enhance country ownership of vaccine financing and helps them plan for financially sustainable immunisation programmes in preparation for the phasing out of Gavi support,” he added.
When Nation sought to know whether in Gavi’s view Kenya is ready to ‘transition out’ by 2029 with all factors considered, Gavi declined to respond.
Speaking to Nation in an interview, Dr Margaret Lubaale, Executive Director of the Health NGOs Network (HENNET) reminded that last year Kenya reported vaccine stockouts mainly because of delayed disbursement of funds from the government to pay the co-financing to GAVI to the tune of Sh1.25 billion.
“Considering the Covid-19 pandemic, the period of the deal with GAVI which was supposed to end in 2027 was extended until 2029 which means that this year, we are expected to pay Sh1.6 billion,” she explained then painted a picture on how the deal works.
“The co-financing deal works in a way that there are vaccines that the government pays for ‘alone’ while there are others in that package that are jointly paid for by the government and Gavi.
The BCG (Bacillus Calmette-Guérin),Polio(both oral and injectable),Hepatitis B which is given at birth, Tetanus-Diptheria vaccines and DTP(Diptheria,Tetanus,Pertusis) vaccines are fully paid for by government while the HPV vaccine, Typhoid Conjugate Vaccine (TCV) ,Measles Rubella(MR) vaccine, Pentavalent Vaccine, Pneumococcal Vaccine (PCV),Yellow Fever vaccine and malaria vaccine are paid for by both GAVI and the government Lubaale noted then pointed out that the Rotavirus vaccine is fully paid for by GAVI, ”she said while highlighting that the time to act is now, so that by June we can continue the seamless distribution of vaccines to counties.
“Having transitioned from a low-income to a lower-middle-income country in 2014 after its per capita GDP crossed a World Bank threshold, Kenya is expected to see GAVI withdraw by 2029, leaving the country to fully self-finance its immunization programme,” Dr Lubaale added further noting that as stakeholders, they are worried that if immunization funding is not safeguarded each year after GAVI’s exit, millions of lives will be affected.
“We need a clear a consistent payment plan for the 2024/2025 co-financing obligation. If Kenya is locked out of the procurement, yet it is not ready to self-finance, it will be catastrophic. Kenya will lose the gains made over the years. If we are going to lose children to preventable diseases like polio, it means Primary Health Care has failed, and therefore achieving Universal Health Coverage will not be realized by 2030,” she told Nation.
Kenya is also almost running out of HIV commodities such as testing kits and laboratory reagents as President Ruto’s government is yet to honour its co-financing obligations the Global Fund.
“Kenya has contributed Sh653,550 and Sh1.7 billion ($13 million) to the Global Fund to date. The country pledged Sh1.3 billion ($10 million) for the Global Fund’s Seventh Replenishment, covering 2023-2025,” Global Fund, which is committed to fight against HIV, Malaria and TB says on its official website while highlighting that they are yet to receive a wire transfer from President Ruto’s government.
When Nation reached out to CS Duale via telephone seeking to know why the country is yet to honour her co-financing obligations to both Gavi and the Global Fund and when the government going to do so, the Health CS who did not go into specifics said that Kenya will meet her commitment.
“We are focused on delivery and will meet our part of the commitment and deliver on our mandate as well,” he said.
