This document summarizes recent trends in government health and immunization spending based on data from the National Health Accounts and the Joint Reporting Form. It finds that general government health spending is rising with income in all countries. Government routine immunization spending is also increasing everywhere up to a GNI per capita of $50,000. Specifically, it shows that over 2011-2015, government immunization spending rose with national income in both Sabin Sustainable Immunization Financing countries and non-SIF Gavi-eligible countries. However, government immunization spending is now higher in SIF countries than in non-SIF Gavi countries.

1. Recent trends in government
health and immunization
spending
Mike McQuestion
Director Sustainable Immunization Financing
Sabin Vaccine Institute
26 July 2016

2. Presentation
•Lowess regressions are used to compare trends in
general government health spending (National
Health Accounts) and government routine
immunization spending (JRF) over time and gross
national income
•Comparisons
•GVAP countries: High and middle income vs low
and lower middle Gavi-eligible
•Gavi-eligibles: Sabin SIF vs non-SIF

3. General government health spending is rising with
income in all GVAP countries- Gavi-eligible and
higher income
0
2000400060008000
0 20000 40000 60000 80000 100000
gni per capita US$
2011 2012 2013
2014
GGHE
Fig. S2b. Govt NHA spending, non-Gavi countries
0
20406080
PercapexpendUS$
0 500 1000 1500 2000
gni per capita US$
2011 2012 2013
2014
GGHE
Fig. S2a. Govt NHA spending, Gavi-eligible countries

4. And among SIF and non-SIF Gavi-eligibles1020304050
0 500 1000 1500
gni per capita US$
2011 2012 2013
2014
GGHE
Fig. S4b. Govt NHA spending by gni
SIF countries
0
20406080
PercapexpendUS$
0 500 1000 1500
gni per capita US$
2011 2012 2013
2014
GGHE
Fig. S4a. Govt NHA spending by gni
non SIF Gavi countries

5. Government health spending is higher and
increasing faster in non-Gavi vs Gavi-eligibles
0
500
10001500
PercapexpendUS$
6 8 10 12 14
year
Gavi non-Gavi
GGHE
Fig L1. Govt NHA spending by year

6. Government routine immunization spending is
increasing everywhere up to gni per capita $50k
0
200400600800
US$/infant
0 20000 40000 60000 80000 100000
gni per capita (US$)
2012 2013 2014
JRF Indicator 6730
Fig. S5. Govt RI spending by gni

7. Over 2011-2015, government immunization
spending in both SIF and non-SIF Gavi countries
rose with national income
0
1020304050
US$/infant
0 1000 2000 3000 4000
gni
SIF Gavi non-SIF
JRF Indicator 6730
Fig. 1. Government RI spending by income (nominal US$)

8. Government immunization spending in SIF
countries is now higher than in non-SIF Gavi
countries
1214161820
US$/infant
11 12 13 14 15
year
SIF Gavi non-SIF
JRF Indicator 6730
Fig 2. Government RI spending over time

9. Caveat: Chronic JRF under-reporting
No. Proportion No. Proportion No. Proportion
2011 19 0.86 35 0.69 56 0.46
2012 12 0.55 38 0.75 48 0.40
2013 13 0.59 37 0.73 48 0.40
2014 19 0.86 39 0.76 48 0.40
2015 21 0.95 41 0.80 48 0.40
Gavi-eligible (n=73)
non-SIF (n=51)SIF (n=22)
Other GVAP (n=121)
Year
Countries reporting R.I. expenditures to WHO/UNICEF JRF

10. Comments
• Ability to pay and willingness to pay are both
increasing for general health as well as for routine
immunization
• Immunization spending is increasing except in the
richest countries
• The 2016 JRF data will show whether the crossover in
government immunization spending in SIF vs non-SIF
countries is apparent or real

11. Thank you!