The Costs of Implementing Vaccination With the RTS,S Malaria Vaccine in Five Sub-Saharan African Countries
Date
2023
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
MDM Policy & Practice
Abstract
Background. The World Health Organization has recommended pilot implementation of a candidate vaccine against
malaria (RTS,S/AS01) in selected sub-Saharan African countries. This exploratory study aimed to estimate the costs
of implementing RTS,S in Burkina Faso, Ghana, Kenya, Mozambique, and Tanzania. Methods. Key informants of
the expanded program on immunization at all levels in each country were interviewed on the resources required for
implementing RTS,S for routine vaccination. Unit prices were derived from the same sources or from international
price lists. Incremental costs in 2015 US dollars were aggregated per fully vaccinated child (FVC). It was assumed
the four vaccine doses were either all delivered at health facilities or the fourth dose was delivered in an outreach set ting. Results. The costs per FVC ranged from US$25 (Burkina Faso) to US$37 (Kenya) assuming a vaccine price of
US$5 per dose. Across countries, recurrent costs represented the largest share dominated by vaccines (including
wastage) and supply costs. Non-recurrent costs varied substantially across countries, mainly because of differences in
needs for hiring personnel, in wages, in cold-room space, and equipment. Recent vaccine introductions in the coun tries may have had an impact on resource availability for a new vaccine implementation. Delivering the fourth dose
in outreach settings raised the costs, mostly fuel, per FVC by less than US$1 regardless of the country. Conclusions.
This study provides relevant information for donors and decision makers about the cost of implementing RTS,S.
Variations within and across countries are important and the unknown future price per dose and wastage rate for
this candidate vaccine adds substantially to the uncertainty about the actual costs of implementationBackground. The World Health Organization has recommended pilot implementation of a candidate vaccine against
malaria (RTS,S/AS01) in selected sub-Saharan African countries. This exploratory study aimed to estimate the costs
of implementing RTS,S in Burkina Faso, Ghana, Kenya, Mozambique, and Tanzania. Methods. Key informants of
the expanded program on immunization at all levels in each country were interviewed on the resources required for
implementing RTS,S for routine vaccination. Unit prices were derived from the same sources or from international
price lists. Incremental costs in 2015 US dollars were aggregated per fully vaccinated child (FVC). It was assumed
the four vaccine doses were either all delivered at health facilities or the fourth dose was delivered in an outreach set ting. Results. The costs per FVC ranged from US$25 (Burkina Faso) to US$37 (Kenya) assuming a vaccine price of
US$5 per dose. Across countries, recurrent costs represented the largest share dominated by vaccines (including
wastage) and supply costs. Non-recurrent costs varied substantially across countries, mainly because of differences in
needs for hiring personnel, in wages, in cold-room space, and equipment. Recent vaccine introductions in the coun tries may have had an impact on resource availability for a new vaccine implementation. Delivering the fourth dose
in outreach settings raised the costs, mostly fuel, per FVC by less than US$1 regardless of the country. Conclusions.
This study provides relevant information for donors and decision makers about the cost of implementing RTS,S.
Variations within and across countries are important and the unknown future price per dose and wastage rate for
this candidate vaccine adds substantially to the uncertainty about the actual costs of implementation
Description
Research Article
Keywords
costs of implementing vaccination, malaria, RTS, sub-Saharan Africa