Capitol Hill — Lofa County District #2 Representative Julie Fartoma Wiah has formally called for the establishment of a Legislative Caucus on Immunization and Primary Health Care (PHC) to help protect Liberia's public health achievements and address worsening funding gaps threatening the country's fragile health system.
In a communication addressed to the House of Representatives through Speaker Richard N. Koon, Rep. Wiah warned that Liberia's continued dependence on donor support for immunization and PHC is unsustainable--particularly as external funding sources begin to dwindle.
"Honorable Speaker, immunization and PHC remain among the most cost-effective public health interventions, saving lives and preventing disease," she said. "In Liberia, routine immunization has significantly reduced child mortality and strengthened health outcomes. However, persistent funding shortfalls and limited domestic financing are putting these gains at risk."
Her communication was read during the 18th day sitting of the second quarter of the 55th Legislature's second session.
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Rep. Wiah's proposal seeks to establish a legislative caucus that would enhance parliamentary engagement on health issues, promote budgetary accountability, and support the passage of policies to ensure long-term, sustainable financing for health services--including the creation of a National Immunization Trust Fund.
She noted that Liberia's health system has endured repeated shocks in recent years, including the 2014-2016 Ebola outbreak and the COVID-19 pandemic. The recent resurgence of monkeypox (Mpox), she added, further highlights the urgent need for a resilient and well-funded public health infrastructure.
Rep. Wiah cited alarming figures in her communication. Of the US$79.36 million appropriated for PHC over five years, only 35.5% was disbursed. In 2024, disbursement dropped further to just 19.6%. PHC currently accounts for less than 10% of national health spending--far below the World Health Organization's recommended 40%.
She also highlighted a significant shortfall in immunization funding. Between 2020 and 2024, Gavi, the Vaccine Alliance, contributed US$13.36 million to Liberia's immunization program, while the government provided only US$2.33 million--covering just 15% of the cost, below Gavi's 20% co-financing requirement. Even more concerning, she noted, domestic disbursements outside of the Gavi framework totaled just US$1.12 million, or 42% of the amount allocated.
With World Bank support for traditional vaccines expected to end in 2026, Rep. Wiah warned that the government must begin preparing to assume full financial responsibility or risk reversing critical public health progress.
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"These gaps are more than financial--they are systemic," she stressed. "Underinvestment weakens service delivery, reduces immunization coverage, raises household health costs, and exacerbates regional disparities. Most importantly, it endangers Liberia's preparedness for emerging health threats like Mpox and undermines our transition to self-reliant health financing."
In her proposed caucus, Rep. Wiah outlined several key objectives, including advocating for increased and sustained national budget allocations for immunization and PHC; encouraging the use of earmarked revenues--such as health levies or taxes--to support essential services; promoting accountability and transparency through legislative oversight and supporting the passage of a dedicated bill on immunization and PHC.
She submitted a draft concept note and charter outlining the caucus's mission and structure and, speaking with legislative reporters afterward, appealed for her colleagues' support.
"A Legislative Immunization Caucus will not only demonstrate our political will but also institutionalize the mechanisms needed to safeguard Liberia's immunization achievements and prepare for future health challenges," she said.
