Revising national disease surveillance budgets can come with unexpected challenges. One key hurdle is determining how surveillance systems can become more efficient, responsive and cost-effective through the integration of surveillance for different diseases.
A new Planning and Budgeting Tool for Vaccine-Preventable Disease Surveillance in Priority Countries for Polio Transition, and accompanying user guide, developed by WHO’s Polio Transition Programme, aims to fill the gap. Using the tool, countries can more accurately plan and budget the appropriate level of financing required to sustain and strengthen integrated disease surveillance as part of their national health system.
Claudio Politi, project lead, and Health Economist at the World Health Organization, explains, “Our project successfully builds on lessons learned from other costing tools. We set out to determine from colleagues in countries what the current issues were with costing and budgeting, and solve them through the creation of a user-friendly tool.”
The project is one of the 2020 – 21 WHO Technical Products. Carried out under the umbrella of the Universal Health Coverage (UHC) Partnership, which aims to build country capacity for health, the tool allows countries to identify the critical cost components of their surveillance systems and ensure the integration of these costs into their national budgets and strategic plans for polio transition and surveillance. The outputs resulting from the tool allow countries to advocate for the correct levels of domestic and external funding for integrated disease surveillance.
Politi explains, “Polio transition refers to sustaining and repurposing the network and infrastructure set up to eradicate polio to strengthen broader health priorities, especially essential immunization, disease detection, and emergency preparedness and response. Surveillance is a particularly important aspect of transition, as it is vital to ensure that the surveillance systems developed by the polio programme are sustained in the long-term to detect polio as well as other vaccine-preventable diseases (VPDs).”
David Sulaberidze, an expert on public health financing, who supported the development of the tool and its piloting in countries, said, “Using our tool, countries can accurately document surveillance costs across the health system, and recognize opportunities to integrate activities, for instance across diseases, in order to achieve cost efficiencies.”
“This is critically important to enable countries to effectively plan to strengthen the surveillance system in the long-term. The tool outputs also provide surveillance teams with the information they need to advocate for the timely allocation of budgets, to ensure the financial sustainability of the system.”
To ensure the tool and user guide were fit for country needs, the team undertook piloting in 2021 with surveillance experts in Sudan and Karnataka State, India. In both locations, the tool was successful in assisting budget officers to create a more accurate and comprehensive integrated surveillance budget.
Arun Kumar, National Professional Officer (Vaccine Preventable Disease Surveillance) WHO India, who participated in the piloting, explained, “Output from the tool allows for crucial comparisons of key budgetary information.”
“Using the tool, we were able to clearly see the different budgetary lines necessary for effective surveillance. This is really helpful for our future planning purposes.”
Naglaa Ahmed, WHO EMRO Polio Transition Focal Point, noted, “The methodology and tools can be widely applicable for polio transition countries, as well as countries aiming to integrate surveillance functions and move towards domestic financing. We are excited to look at the wider application of the tool in the Eastern Mediterranean Region.”
Commenting on the tool, Ebru Ekeman, WHO Policy Lead for Polio Transition explained, “This is a strong example of transition in action – providing countries with the tools needed to ensure that vital assets are sustained in the long term, and are used in the most effective way to deliver stronger health systems and protect global health security.”
“In particular, we have strived to align the tool with global and regional agendas for surveillance, such as the Investment case for vaccine-preventable diseases surveillance in the African Region 2020-2030 and the Strategy for Integrated Disease Surveillance in the Eastern Mediterranean Region, as well as the Immunization Agenda 2030. We hope that the methodology, tool and user guide will be helpful for countries as they look to recover from the pandemic and bolster their surveillance systems.”