News Release

From Health Affairs: Insufficient funding for vaccinations in low- and middle-income countries

Peer-Reviewed Publication

Health Affairs

Vaccines are an indispensable tool for reducing and even eradicating many infectious diseases. Ideally, countries are encouraged to take full ownership of their vaccination programs. However, some low- and middle-income countries rely on outside support for both the vaccines and their delivery, often from bilateral and multilateral organizations, such as Gavi, the Vaccine Alliance. To better understand whether the immunization programs in these countries are adequately funded, Salin Sriudomporn of Johns Hopkins University and coauthors estimated immunization program costs, financing, and funding gaps for sixteen vaccines among ninety-four low- and middle-income countries from 2011 to 2030, using data obtained from both private and government sources. They found a total funding gap of $38.4 billion for the entire period, with the cost of immunization delivery being the main driver (86 percent) of this gap. Funding support for these countries from Gavi and development assistance for health are projected to decline during the next few years. The authors conclude that to bridge the vaccine funding gap and move toward sustainability, both a national-level scale-up as well as resource mobilization are essential for improving the efficiency of each country’s immunization program. They also recommend that future research integrate the impact of COVID-19 on both the cost and financing of routing immunization, as well as on new vaccine introduction and coverage rates, along with the impact of economies of scale and program integration on the delivery cost per dose.


Health Affairs is the leading peer-reviewed journal at the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online. Late-breaking content is also found through, Health Affairs Today, and Health Affairs Sunday Update.

Health Affairs podcasts go beyond the journal’s pages to bring you insightful discussions on the latest news and research affecting health policy. On our flagship podcast, A Health Podyssey, Editor-In-Chief Alan Weil interviews the leading researchers and influencers shaping the field’s big ideas. Join Health Affairs editors on Health Affairs This Week as they discuss the week’s most pressing health policy news. All in 15 minutes or less.

Project HOPE is a global health and humanitarian relief organization that places power in the hands of local health care workers to save lives across the globe. Project HOPE has published Health Affairs since 1981.

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