Liberia has long relied on support for traditional vaccines through global financing mechanisms, often involving partners such as the World Bank and Gavi, the Vaccine Alliance.
However, the World Bank has notified the Government of Liberia of its intention to end financing for traditional vaccines beginning in 2026, raising concerns among health advocates about the country's readiness to assume full financial responsibility without reversing critical public health gains.
Amid these concerns, the Public Health Initiative Liberia (PHIL), in collaboration with the Global Health Advocacy Incubator (GHAI), recently launched a Budget Gap Analysis Report on Primary Health Care and Immunization in Liberia (2020-2024).
The report assesses Liberia's co-financing performance under Gavi, identifies gaps in vaccine budget execution, and highlights growing risks to the national immunization program as donor support declines.
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Concerns about Liberia's readiness to assume full financial responsibility in the absence of support from the World Bank are not new.
In July 2025, Julie Fartoma Wiah, Representative of Lofa County District #2, called for the establishment of a Legislative Caucus on Immunization and Primary Health Care (PHC) to help safeguard Liberia's public health gains and address widening funding gaps threatening the country's fragile health system.
In a formal communication 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 decline.
Key Findings from the Report
According to the report; between 2020 and 2024, Gavi contributed US$13.36 million to Liberia's immunization program. The Government of Liberia contributed US$2.33 million, representing about 15% of total costs, below the 20% co-financing requirement.
The report reveals that a significant portion of Liberia's contribution was financed through World Bank loans, rather than sustained domestic funding. Health advocates warn that if this trend continues, Liberia could face vaccine stock-outs, rising arrears, and disruptions to immunization services as World Bank support is phased out.
Importantly, the report further projects that beginning in 2026, Liberia will need to absorb an additional estimated US$1.06 million annually to cover vaccines previously financed by external partners.
Risks if Funding Gaps Persist
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Experts caution that irregular budget disbursements and heavy reliance on donor funding have already contributed to vaccine supply interruptions, weak operational capacity, reduced outreach services, particularly in remote communities.
Without timely and sustained domestic investment, the findings revealed that these challenges could undermine routine immunization coverage and reverse hard-won public health progress.
Key Recommendations from the Study
As part of their advocacy efforts, the Public Health Initiative Liberia (PHIL) and the Global Health Advocacy Incubator (GHAI) have outlined six urgent priority actions for the Government of Liberia, Gavi, and other development partners to help sustain immunization services in the country.
The institutions are calling on the Government of Liberia to:
- Institutionalize Gavi co-financing within the national budget to ensure predictable and sustainable funding
- Develop a clear fiscal transition plan in preparation for the World Bank's exit from vaccine financing
- Improve vaccine budget execution, noting that the current 42% execution rate is inadequate
- Reduce reliance on World Bank loans for co-financing and prioritize genuine domestic resource mobilization
- Establish a robust immunization financing accountability mechanism to track commitments and spending
- Engage donors through a structured, time-bound transition plan to ensure a smooth shift from external to domestic funding
These recommendations, according to PHIL and GHAI, aim to strengthen Liberia's financial readiness and safeguard the long-term sustainability of its immunization program.
