Minsk, Belarus, August Vladimer Getia

Transcription

1 Achievements of financial sustainability of the in countries that are leaving GAVI support Problems and ways of solving them Georgia s Experience Minsk, Belarus, August Vladimer Getia

2 The economic efficiency of investments in immunization Immunization is one of the most cost-effective interventions in public health and optimal use of limited public funds for public health; Immunization should be considered in the context of the global movement to ensure universal coverage of health services. Immunization should be free of charge, since even small expenditures of the population may be an obstacle in terms of its accessibility; As a result of the analysis, it was determined that for every dollar invested in immunization, the economic benefit was more than $16 US (Return On Investment From Childhood Immunization In Low- And Middle-Income Countries, Ozawa S, Clark S, Portnoy A, Grewal S, Brenzel L, Walker DG.)

3 Fundamentals of financial sustainability of national immunization programs and state responsibility Many believe that immunization is the responsibility of the state; The success of s depends on their long-term effectiveness and sustainability and therefore involves long-term investments that require stable, longterm financing; Program sustainability is the ability of the country's immunization systems and processes to achieve sustainability without or with limited need for external financial / other support; After cessation of Gavi's support, countries must ensure adequate technical, financial and institutional capacity to maintain the financial sustainability of the immunization program.

4 Area (sq.km) State language Georgian Basic Faith Orthodoxy State Arrangement System - Unitary Population of Georgia (thousand persons) Capital Tbilisi Population (thousand persons) GDP at current prices, mil. US Dollar 15164,5 GDP Per Capita at current prices, US Dollar Live births Birth rate (per 1000 persons) 15.2

5 Since 2012, 3 new vaccines have been introduced; The cold chain has been updated at central and regional level; An electronic vaccination registration system was introduced; Unplanned vaccinations of the adult population against measles are conducted, to create collective immunity; All financial commitments from GAVI are accounted for in the program budget; The program budget is increased 5 times.

6 Dynamics of the budget of the Georgia in Budjet of immunisation programm (GEL) budget for procurement of planned vaccines and injection materials (GEL)

7 Despite the delays in the supply of certain vaccines, the country has, in the last 5 years, practically not had a breakdown with the continuous supply of vaccines through an established procurement and planning system The country ensures timely delivery of the preliminary order to UNICEF, at the beginning of the budget year, the order of vaccines and payment for vaccines. Vaccines are procured at reasonable prices in the international market In raising the budget of the, special support was received from the country's parliament, which lobbied to the Ministry of Finance our increased costs Working closely with the Ministry of Finance, Health, with NITAG, with the Immunization Coordination Committee The promotion of immunization included well-known individuals, artists, athletes, etc.

8 Financing of the is based on the general tax revenue; The is allocated a separate line in the state budget of the country; The country uses the system of medium-term budgeting for 4 years, including when planning the program budget; The basis for medium-term planning is a comprehensive multi-year plan for immunization;

9 When compiling the national budget, all of its components should be considered: The cost of vaccines and supplies; Logistics costs for the delivery, storage and distribution of vaccines and supplies; Cold chain equipment and capital investment in buildings and technologies; Payment of medical services of primary sanitary-medical service; Providing an information system for the collection and processing of vaccination data; Training of doctors and nurses, supervision and monitoring, communication costs; Expenditures for the introduction of new vaccines;

10 In the decision-making process, the introduction of new vaccines should take into account the following critical aspects: The burden of the disease and its relevance to public health; Effectiveness and safety of vaccines; Requirements for supply and the possibility of introduction into practice; Cost; Economic efficiency; Cost affordability; Adequacy of vaccines and demand among the population.

11 The main obstacles to achieving financial sustainability of the program and ways to address them: Problems associated with the devaluation of the exchange rate of national currencies against the US dollar and the euro, in which vaccines and consumables are purchased: Lack of financial resources for the purchase of vaccines and supplies; Suppliers may refuse to fulfill the vaccine supply obligations taken; For insurance of risks, suppliers increase procurement prices for vaccines Ways to solve above-mentioned problems: Increase supplies, Allocation of financial resources from other financial sources introduction of pre-purchase practice;

12 The main obstacles to achieving financial sustainability of the program and ways to address them: Problems associated with the effective purchase of vaccines and supplies: Small volumes of purchases; The small number of registered vaccines in the country; Deficiency of some vaccines in the world market; (Disbalance between supply and demand of some vaccines on the world market ) Ways to solve above-mentioned problems: UNICEF Unified Procurement Mechanism; Increase in quantity through multi-year purchases; Legislation that provides opportunities to ensure transparency and free competitive environment, through the electronic system of international procurement; The use of the mechanism for the abolition of registration of those vaccines that are registered in countries with a high level of control and also prequalified by WHO;

13 The main obstacles to achieving financial sustainability of the program and ways to address them: Problems associated with the mobilization of financial resources for the : A lot of priorities with limited resources; A disapproving approach by financiers to a sharp increase in the requested financial resources; Politicians sometimes prefer to receive points for satisfying the present needs of voters; Ways to solve above-mentioned problems: Identify the decision makers and draw them to your side; Involve external experts and international organizations in the process of justifying financial needs; Summarizes the economic benefits that the budget will receive by financing immunization;

14 The end justifies the means when it comes to mobilizing financial resources for the!

15 Thank you for your attention!