Steve Finch, Vientiane, Laos
June 23, 2014
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Vientiane, Laos has one of the highest economic growth rates in the region in recent years – about eight percent — but it also has a budget shortfall. That means many state workers including doctors and nurses also haven’t been paid in months.
Amid the ongoing fiscal crisis, aid workers were concerned the government wouldn’t meet a sharply rising financial commitment to fund patchy, but improving immunization coverage. In the absence of a local commitment, there was concern international donors would cry foul, potentially threatening the country’s vaccination program.
Then on May 12, UNICEF reported that Laos had deposited the requisite $530 000, confirming the landlocked Southeast Asian state’s small commitment to the program, which totaled US$7.9 million in 2014. The government’s commitment has placated foreign donors, guaranteeing coverage for the majority of the country’s nearly seven million people.
“In light of the fiscal situation, it is encouraging that the government of Laos is continuing to commit its financial resources to high impact and life-saving interventions for children, such as immunization,” said Julia Rees, acting head of UNICEF’s Laos office, the procurer of vaccines for the country.
In at least one province, local authorities had already asked an international health nongovernmental organization to help fund immunization efforts.
Dr. Soulivanh Pholsena, director of foreign relations at the Laos Ministry of Health, did not respond to questions on the country’s vaccination program.
Laos aims to graduate from least developed country status by 2020 — the first country in the world to state such an ambition — which will mean lowering donor funding. To that aim, the government has been asked to contribute sharply rising annual payments towards routine vaccines. It started funding them in 2012 with a payment of just $22 400.
“Over time, countries take on an increasing share of vaccine costs so that — when the time is right — they are ready to assume the full costs of financing their vaccine programs,” said Rob Kelly, a spokesman of GAVI Alliance, which has disbursed US$19.3 million since 2000 as one of the biggest funders of immunization in Laos.
Although a new real-time, digital vaccine supply system that tracks cold storage and delivery to patients was introduced this year and major progress has been made recently, many people in remote areas still do not receive routine vaccinations.
Laos has increased coverage for measles from just 40% of the population in 2007 to 82% last year, according to the national statistics bureau. But in four provinces, still less than a quarter of babies at the critical age of 12 to 23 months are immunized against the disease.
While the mortality rate for under-fives has reduced much faster than expected, studies by the University of Washington this month did not include Laos on a list of countries expected to achieve the UN Millennium Development Goal for reducing child mortality.
Viorica Berdaga, head of health and nutrition at UNICEF Laos, said there was still every chance of reducing under-five deaths by two-thirds to meet MDG4 in time for next year.
“To maintain this pace the government of Laos should continue to increase its resources for the delivery of child survival interventions to those who are hardest to reach,” she said.