Ensure sufficient local resources and budget for vaccination activities in the area.

Concerning the state budget arrangement to purchase vaccines for the Expanded Immunization Program before 2023, the Ministry of Finance (MoF) stated that in the period 2016-2020, the Prime Minister issued Decision No. 1125/QD-TTg dated July 31, 2017, approving the Target Program on Health - Population in the period 2016-2020.

Accordingly, the central budget allocates funds for the MoH to ensure vaccines meet the need for expanded immunization VND 363.26 billion, of which the cost of buying vaccines is about VND 233.47 billion.

For 2021 and 2022, Clause 1, Article 3 of National Assembly Resolution No. 129/2020/QH14 on the allocation of the central budget in 2021 to the Government states: "Allowing the allocation of the central budget in 2021 to implement unfinished regimes, policies, tasks, and investment projects under national target programs; the target program for the 2016-2020 period should continue to be implemented in 2021 until the national target programs for the 2021-2025 period are decided by the National Assembly to come into effect;…”.

Clause 2 of Article 3 of Prime Minister's Decision No. 1950/QD-TTg dated November 28, 2020, on the assignment of the 2021 state budget estimate states: "Ministries and central agencies assigned to manage the national target program and the target program for the period 2016-2020 review and develop a 2021 budget allocation plan for policies, regimes, and recurrent expenditure tasks that must continue to implement, send it to the MoF to summarize and submit it to the Prime Minister for consideration and decision on additional cost estimates for implementation.”

Based on a National Assembly resolution, the Prime Minister has incorporated the Health-Population Target Program into the expenditure of the National Target Program and the regular activities of ministries, central agencies, and localities.

In 2021-2022, the MoH proposed allocating funds from the central budget to implement the Health-Population Target Program's expenditures from 2016 to 2020 into the task of recurrent expenditures, including the purchase of vaccines for the Expanded Immunization Program, with a budget of VND134 billion in 2021 and VND 178 billion in 2022.

No regulation on the state budget to ensure the funding for purchasing vaccines for expanded immunization

By the end of 2021, the regulations on the arrangement of the state budget to deploy the purchase of vaccines under the old national target program did not continuously come into force.

However, due to the national target programs promulgated in October 2021, the guiding circulars were issued in May 2022 while the 2022 estimate for the MoH to implement the Expanded Immunization Program was developed in September 2021, so at the time of making the estimate, the MoF must apply the expanded vaccination budget allocation as in 2021 (the transition period has not been guided).

After the target programs and guiding circulars were issued, the MoF reviewed and complied with the provisions of the State Budget Law on management decentralization. As a result, there is no state budget regulation to ensure funding for the purchase of expanded immunization vaccines.

Clause 2, Article 21 of Decree No. 104/2016/ND-CP specifies the Provincial People's Committee's responsibilities as "ensuring local resources and budget for immunization activities in the area."

Clause 3, Article 23 of Decree No. 104/2016/ND-CP states that the MoF is responsible for "ensuring the funding for Expanded Immunization Program and vaccination against the pandemic under the State Budget Law."

Clause 2 of Article 2 of the Government's Resolution No. 104/NQ-CP dated August 15, 2022, on the scheme to increase the number of vaccines in the Expanded Immunization Program for the period 2021-2030 states: "The state budget ensures the cost of purchasing vaccines following the scheme. The local budget allocates funds to organize vaccination implementation in the area."

Therefore, in 2022, the Department of Finance and Administrative Affairs (MoF) submitted to the MoF for signing to promulgate three documents requesting that the MoH develop a 2023 estimate for tasks and contents implemented by the MoH under regulations and documents guiding localities to implement from local budget sources.

If it is necessary to use the state budget to purchase various medicines, vaccines, and other items for children under the age of five (in addition to those covered by the three national target programs), the MoF shall request the MoH to submit a proposal to competent authorities for consideration and decision to lay a foundation for allocating state budget funds.

Simultaneously, the MoF issued Official Document No. 7852/BTC-HCSN dated August 8, 2022, to the People's Committees of provinces and cities directly under the Central Government, directing the implementation of several tasks under the Health-Population target program for the period 2016-2020, which became a recurrent expenditure task.

However, problems have arisen because localities are cautious about purchasing vaccines (the reason being that the Ministry of Health has not specifically instructed on purchase methods, prices, types, etc.).

To address the problems, the Government Office issued Notice No. 183/TB-VPCP on May 17, 2023, announcing the conclusion of Deputy Prime Minister Tran Hong Ha at a meeting on drug bidding at the MoH and localities, in which it assigned:

"As an aid recipient, the MoH coordinates the supply of vaccines and vitamin A…In the future, the MoH will continue to organize national centralized bidding and order numerous popular drugs in large quantities, vaccines used in the Expanded Immunization Program to reduce prices and ensure supply for localities... It is essential to develop sample contracts and guide localities in working with contractors to supply drugs and vaccines after successful centralized bidding. The MoH must bear the responsibility towards the Government and the Prime Minister if there is a shortage of these medications or vaccines.

Additionally, the MoH shall take the initiative and actively coordinate with the MoF to urgently address price issues, as well as simultaneously implement solutions to promptly purchase and supply vaccines used in the Expanded Immunization Program, and report to the Prime Minister before May 25, 2023.”

On May 24, 2023, the Government Office issued an official document requesting a consultation with the Ministries of Justice, Finance, and Planning and Investment regarding the MoH’s report to implement the program./.