Economic burden of sustainable EPI : implications for donor policy

But can developing countries bear the economic burden of sustaining these programs? This study projects the ability of 50 sample countries to support EPI in the year 2000 and considers the implications of these projections for donor strategies. The analysis focuses on four basic questions: What will the EPI target rate of 80% coverage cost? What will the countries be able to afford? At what cost to the countries would the EPI targets be affordable? Will economic growth make the targets affordable? The study found that, while increases in economic growth and reductions in the cost of immunization and in the size of the target population would improve economic capacity to support EPI, many countries (particularly African) will remain incapable of achieving coverage targets within the foreseeable future. In fact, many countries would be hard pressed even to allocate the amounts of resources required to maintain existing coverage levels without external resources. Consequently, donors should not make EPI sustainability (i.e., independence from donor funding) a precondition for support, but should help countries move towards sustainability. This can be done through: (1) general initiatives to lessen the economic burden of EPI (by expanding the country"s resource base and by reducing the costs); and (2) country-specific partnerships that are based on shared goals and commitments and realistic assumptions.