South Africa’s high-priority, under- funded Expanded Programme on Immunisation is understaffed and close to rudderless.
The top national Department of Health (NDoH) EPI managers resigned in August and December last year, taking with them large chunks of institutional memory and invaluable expertise. SA remains in the top five underperforming EPI African countries (according to World Health Organization (WHO) standards), for the third year running.
According to Johann van den Heever, the recently resigned (in December) national EPI manager, a ‘lack of leadership vision’ and a ZAR1.4 billion national budget provides exclusively for vaccine purchase, hugely under-prioritising human resources, social mobilisation and surveillance, supervision, and monitoring and evaluation.
“Only six of the original 13 national EPI posts (created in 1994) remain, all with relatively junior incumbents, making basic data quality audits and accurate evaluations for immunisation even more difficult.”
Calling into question the NDoH and WHO estimates, Van den Heever says that SA has little idea of its infant population, upon which any vaccine coverage estimate must be based. It was ‘absolutely imperative’ for any national health immunisation programme to have an electronic register of its target population (starting with infants), supported by a national EPI coverage survey to provide a performance measurement baseline.
