# Health economics and vaccine financing in the eastern Mediterranean region: A needs assessment

## TL;DR

This study assesses the use of health economics and vaccine financing in the Eastern Mediterranean Region to improve immunization programs.

## Contribution

The paper provides a regional needs assessment highlighting gaps in health economics and vaccine financing integration in immunization programs.

## Key findings

- Only 19% of countries fully integrate health economics into immunization programs.
- High-income countries show stronger capacity in health economics compared to others.
- Most countries lack capacity in cost-effectiveness analysis and vaccine financial sustainability.

## Abstract

The World Health Organization Eastern Mediterranean Region (EMR) faces a high burden of vaccine-preventable diseases requiring efficient use of limited resources. A regional needs assessment was conducted to evaluate the current application of health economics and vaccine financing in national immunization programmes and policy formulation, identify capacity gaps, and inform tailored technical support.

A structured online survey was administered between January 28 and February 18, 2025. It targeted expended programme on immunization (EPI) managers and National Immunization Technical Advisory Group (NITAG) chairs across all 22 EMR countries. The questionnaire explored five thematic areas: current capacity in health economics and vaccine financing, training and capacity-building needs, demand for technical support, data availability and use in decision-making, and strategic planning for vaccine financing among immunization stakeholders at Ministry of Health and in NITAGs. The survey used multiple-choice, Likert-scale, and open-ended questions. Results were analyzed using descriptive statistics and disaggregated by income level.

The response rate was 73 % (16/22 countries). Only three countries (19 %) reported full integration of health economics within their immunization programmes, while 56 % (n = 9) reported minimal or no integration. Three countries had a dedicated health economics focal person for immunization. In two high-income countries immunization programmes demonstrated stronger capacity in health economics, whereas the rest of countries demonstrated low to moderate levels. Ten countries (63 %) rated their capacity in financial forecasting and planning for immunization as moderate or high, but eleven (69 %) rated their capacity in cost-effectiveness analysis and vaccine financial sustainability as low to none. Access to data varied, with 25 % of countries finding it easily accessible.

The findings highlight the need to strengthen the integration of health economics and vaccine financing into immunization programmes and policy decision-making across the EMR, irrespective of income level. Tailored capacity-building, technical support, and cross-sectoral collaboration, particularly with academia, are essential.