Financing the introduction of new vaccines to the national immunisation programme in China: challenges and options for action.

Ensuring adequate and sustainable financing of national immunisation programmes (NIPs) is one of the important elements to achieve the Immunisation Agenda 2030. Many middle-income countries ineligible for support from the Global Alliance for Vaccines and Immunisation have relatively slow progress in introducing new critical vaccines, due largely to financial constraints. China has not introduced any vaccines into the NIP since 2008. Its funding for the NIP, relying solely on the government budget, has been decreasing as the number of targeted children has declined. This paper presents the current situation of NIP and identifies main challenges in vaccine introduction in China: fluctuating and insufficient financing, restrictions on using health insurance funds for immunisation, high prices for non-NIP vaccines and the complicated and non-transparent decision-making mechanism to adjust NIP. There are also opportunities for introducing vaccines, such as local pilots to provide free or subsidised new vaccines and reducing domestic vaccine prices. Feasible options to optimise NIP financing in China include increasing government funding, diversifying financing channels such as using health insurance funds, improving the vaccine procurement mechanism and optimising the new vaccine introduction decision-making process.