Nepal’s immunisation programme, which has prevented hundreds of thousands of deaths in the country, could be affected as the Global Alliance for Vaccines and Immunisation (GAVI) has signaled its intent to slash funds. The alliance has, however, promised to supply the vaccine doses.

Multiple officials the Post talked to confirmed that they have been informed informally about funding cuts by the GAVI officials, and said the formal decision may come in writing in December.

“As per the information we got informally from GAVI officials, the financial support the alliance has been providing to Nepal could be slashed in coming days,” said Dr Madan Kumar Upadhyaya, director at the Family Welfare Division under the Department of Health Services. “We have been informing alliance officials about our limitations and consequences of possible aid cuts in the immunisation programme.”

The programme is a top priority of the Nepal government. It is one of the most successful public health programmes in the country, credited with preventing hundreds of thousands of deaths—both children and adults. The success rates of the programme and vaccine acceptance are among the highest in South Asia, according to experts.

GAVI is the principal donor that not only provides vaccine doses free of cost, but also the financial support for logistics, training, cold-chain support, equipment, awareness and overall system strengthening.

“We have been told many times informally that other support except supply of vaccine doses could be slashed by up to 70 percent,” said Dr Abhiyan Gautam, chief of the Immunisation Section at the Family Welfare Division. “You may think that as the aid cuts don’t touch vaccines, it is not a serious issue. But its impact will be huge. We need millions of rupees to fill the gap if GAVI slashes its fund.”

With the United States deciding to stop financial support, the global vaccine alliance has been struggling with fund crunch. Health experts from across the globe have warned of devastating consequences for children around the globe as the US is the single largest donor to the alliance.

Health officials say Nepal’s overall health programme could be affected and the country may struggle to maintain the progress made over the years in immunisation if GAVI and agencies like it cut their funding. Altogether, the alliance’s stake in Nepal’s immunisation programmes is over 50 percent, according to officials.

Currently, the alliance provides human papillomavirus vaccine, measles rubella vaccine, inactivated polio vaccine, Japanese Encephalitis vaccine, typhoid conjugated vaccine, rota virus vaccine, pneumococcal conjugated vaccine, oral cholera vaccine, vaccines for outbreak control and also funds various campaigns.

“In informal discussion, we are assured of a smooth supply of vaccines that the alliance has been providing us,” said Dr Bhim Sapkota, chief of Health Coordination Division at the Ministry of Health and Population. “We have told them about our situation and also have requested not to cut the budget for other programmes.”

Public health experts warn that the immunisation programme, which has over the years prevented hundreds of thousands of deaths in Nepal, could be thrown into disarray if GAVI slashes its funding.

“Government officials might be downplaying the impending effects of the aid cuts but its impact will be beyond our imagination,” said Dr Shyam Raj Upreti, former director general at the Department of Health Services.

Upreti added that GAVI’s funding has helped in maintaining cold chains, system-strengthening, capacity-building and making people aware about the importance of vaccines. “These things make a big difference in vaccine efficacy, acceptance and other things,” he said.

Some officials the Post talked to said that Nepal may have to increase its share of vaccine co-financing if the alliance continues to struggle for funds.

Nepal is steadily progressing toward achieving its national and global vaccination goals, reflecting one of the strongest public health performances in the region.

Over the past decades, the country has expanded its immunisation programme to include a wide range of life-saving vaccines that have significantly reduced child mortality and prevented outbreaks of diseases.

High routine immunisation coverage, supported by strong community mobilisation and an effective cold-chain system, has kept Nepal on track to meet its targets.

This year, the country eliminated rubella as a public health problem, a year before the target.