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Falling vaccinations rate threatens children’s lives and universal healthcare

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I in 3 under five year olds does not have access to life saving vaccines

Kenya could miss the opportunity to save billions of shillings for use in accelerating the country’s quest for Universal Health Coverage if the current trend of a declining immunisation rate is not reversed, child health data shows.

Illnesses and deaths due to vaccine-preventable diseases cost sub-Saharan Africa Sh1.3 trillion each year – resources that could be channelled towards strengthening health systems and building economies, according to WHO figures.

”Vaccine-preventable diseases contribute a large chunk of causes of illnesses and deaths, especially in children in Kenya. Since it is much cheaper to prevent a disease than to treat, prioritising immunisation in Universal Health Coverage will go a long way in achieving the objectives of UHC,” says Dr Rudi Eggers, WHO Kenya representative.

A study conducted in 94 low and middle income countries by the Johns Hopkins University School of Public Health in 2016 estimates that for every shilling invested in immunisation, a country saves an average of Sh16 in the health system, and the wider economy benefits with Sh44, by preventing death and disabilities in children and by keeping parents and families working, instead of spending time taking care of sick or disabled children.

”By vaccinating children, we are doing more than preventing diseases and saving lives. We are also ensuring that children get the education they deserve and returning valuable time to their families because they no longer need to make long hospital visits. Vaccinations also release scarce government funds,” said Dr Matshidiso Moeti, WHO regional director for Africa. In sub-Saharan Africa, nearly 31 million children below age five suffer from vaccine-preventable diseases every year. More than half a million of them die due to lack of access to the vaccines they needed.

In Kenya, according to the United Nations Children’s Fund, one in three children aged below five years are at risk of diseases which can be prevented through vaccinations.

A NationNewsplex review of the national full immunisation coverage trend shows that Kenya is one of the many African countries missing out on the huge investment opportunity.

Kenya’s vaccination coverage has been falling steadily for the last five years, according to the Kenya National Bureau of Statistics (KNBS). In 2017, the country recorded a 63 percent coverage in full immunisation of children under the age of one, a 12-year low and lower than Africa’s average of 72 percent, which has stagnated for five years. Full immunisation is defined as a child having received a BCG vaccination against tuberculosis; three doses of DPT vaccine to prevent diphtheria, pertusis, and tetanus (DPT); at least three doses of polio vaccine; and one dose of measles vaccine.


Over half a million children missed vaccination in 2017, indicates data from the Ministry of Health. Mandera County had the lowest coverage (25 percent), followed by West Pokot (40 percent) and Trans Nzoia (44 percent).

According to the ministry, one in every five children is not fully vaccinated by their first birthday with vaccine formulations provided against 10 childhood diseases.

Even though the very low coverage was largely occasioned by the five-month nurses’ strike, the country’s vaccination rate had been declining since 2012, when it stood at 83 percent after rising from 30 percent in 2000.

Kenya’s immunisation programme is jointly funded by the government and the Global Alliance for Vaccines and Immunisation (Gavi), which disbursed a total of Sh47.9 billion from 2000 to 2018 in vaccine and non-vaccine support. Gavi data indicates that Kenya has been shouldering between 10 percent and 25 percent of its the vaccines budget every year.

However, this collaboration has been shaky for the last five years, the same period vaccination coverage recorded a steady decline.

Gavi requires the costs of its supported vaccine be shared between the government and the alliance, in a co-financing arrangement. In the first stage countries pay a fraction of the costs of the vaccine introduced by Gavi support (Sh20 per dose).
In 2014 Kenya ascended to a lower-middle income country status, which, according to the Gavi arrangement, translates into preparation for a gradual reduction of funding.

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The co-funding rules stipulate that contribution by a government receiving Gavi funding increases by 15 percent per year in the preparatory transition stage (phase 2).

Kenya entered the preparatory transition stage in 2017 and will proceed to the accelerated transition phase in 2022. It is projected that the country will have to raise more than Sh5 billion for child immunisation annually by 2026 when the co-funding deal with have wound up, an amount that will certainly rise over the subsequent years in consistence with population growth.

When a country enters accelerated transition (phase 3), the government’s share of vaccine costs increases from the level it had reached during the preparatory transition stage to 100 percent of the cost over a period of five years.

If the country does not move in to fill the financial gap left behind in the transition stage and thereafter, many more children will be left vulnerable to vaccine-preventable diseases.

Recently, there was distress in some counties following reported incidents of vaccine shortages. Among the vaccines said to be in short supply was BCG, which protects newborns from different forms of TB, including TB meningitis, which is common in infants.

However, the Ministry of Health clarified that there was an adequate supply of all vaccines in the country and attributed the few cases of shortages to distribution failures in individual counties.


Health experts attending the biannual Regional Immunization Technical Advisory Group meeting in Brazzaville, Congo, last month urged African countries to strengthen their routine immunisation, emphasising the need for greater government ownership of disease surveillance programmes to ensure that the progress made in curbing vaccine-preventable diseases is not reversed.

”The fact that most sub-Saharan African countries continue to rely on external funding for immunisation financing is a strong indicator of the work that remains to be done,” said Dr Richard Mihigo, programme manager for immunisation and vaccine development at the WHO Regional Office for Africa. ”Governments have a central role to play to fill upcoming funding gaps and ensure immunisation programmes remain strong and vigilant.”

There has been a feeling in certain quarters that Kenya is not financially ready for a transition into self-funding, despite having leapt into a middle-income country status. Médecins Sans Frontières (MSF) has appealed to Gavi not to phase out funding for 20 countries, including Kenya, whose capacity to self-finance is in doubt, considering the prevailing low immunisation coverage levels in those countries. ”Gavi needs to improve its funding model and urgently address the structural gaps in the routine immunisation systems of countries transitioning out from support. Why should countries lose Gavi’s full support when their children still need it?” read a statement by MSF in 2017.

Universal Health Coverage

Kenya’s grim statistics and funding jitters come at a time the country plans to roll out an ambitious Universal Health Coverage programme in the country in 2022. Piloting of the package is underway in four counties: Kisumu, Isiolo, Nyeri and Machakos.
Even as the government and proponents of the programme forge ahead, there have been numerous discussions around the modalities for its financing and financial sustainability. Health experts believe that curbing vaccine-preventable diseases could be one sure way of cutting down the cost of managing a health system.

”Vaccine-preventable diseases contribute a large chunk of causes of illnesses and deaths, especially in children in Kenya. Since it is much cheaper to prevent a disease than to treat, prioritising immunisation in Universal Health Coverage will go a long way in achieving the objectives of UHC,” says Dr Rudi Eggers, WHO Kenya representative.

The importance of surveillance and prevention played out last year when a polio virus was detected in sewage, leading to several polio campaigns in selected counties to boost children’s immunity.



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Sordid tale of the bank ‘that would bribe God’

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Bank of Credit and Commerce International. August 1991. [File, Standard]

“This bank would bribe God.” These words of a former employee of the disgraced Bank of Credit and Commerce International (BCCI) sum up one of the most rotten global financial institutions.
BCCI pitched itself as a top bank for the Third World, but its spectacular collapse would reveal a web of transnational corruption and a playground for dictators, drug lords and terrorists.
It was one of the largest banks cutting across 69 countries and its aftermath would cause despair to innocent depositors, including Kenyans.
BCCI, which had $20 billion (Sh2.1 trillion in today’s exchange rate) assets globally, was revealed to have lost more than its entire capital.
The bank was founded in 1972 by the crafty Pakistani banker Agha Hasan Abedi.
He was loved in his homeland for his charitable acts but would go on to break every rule known to God and man.
In 1991, the Bank of England (BoE) froze its assets, citing large-scale fraud running for several years. This would see the bank cease operations in multiple countries. The Luxembourg-based BCCI was 77 per cent owned by the Gulf Emirate of Abu Dhabi.  
BoE investigations had unearthed laundering of drugs money, terrorism financing and the bank boasted of having high-profile customers such as Panama’s former strongman Manual Noriega as customers.
The Standard, quoting “highly placed” sources reported that Abu Dhabi ruler Sheikh Zayed Sultan would act as guarantor to protect the savings of Kenyan depositors.
The bank had five branches countrywide and panic had gripped depositors on the state of their money.
Central Bank of Kenya (CBK) would then move to appoint a manager to oversee the operations of the BCCI operations in Kenya.
It sent statements assuring depositors that their money was safe.
The Standard reported that the Sheikh would be approaching the Kenyan and other regional subsidiaries of the bank to urge them to maintain operations and assure them of his personal support.
It was said that contact between CBK and Abu Dhabi was “likely.”
This came as the British Ambassador to the UAE Graham Burton implored the gulf state to help compensate Britons, and the Indian government also took similar steps.
The collapse of BCCI was, however, not expect to badly hit the Kenyan banking system. This was during the sleazy 1990s when Kenya’s banking system was badly tested. It was the era of high graft and “political banks,” where the institutions fraudulently lent to firms belonging or connected to politicians, who were sometimes also shareholders.
And even though the impact was expected to be minimal, it was projected that a significant number of depositors would transfer funds from Asian and Arab banks to other local institutions.
“Confidence in Arab banking has taken a serious knock,” the “highly placed” source told The Standard.
BCCI didn’t go down without a fight. It accused the British government of a conspiracy to bring down the Pakistani-run bank.  The Sheikh was said to be furious and would later engage in a protracted legal battle with the British.
“It looks to us like a Western plot to eliminate a successful Muslim-run Third World Bank. We know that it often acted unethically. But that is no excuse for putting it out of business, especially as the Sultan of Abu Dhabi had agreed to a restructuring plan,” said a spokesperson for British Asians.
A CBK statement signed by then-Deputy Governor Wanjohi Murithi said it was keenly monitoring affairs of the mother bank and would go to lengths to protect Kenyan depositors.
“In this respect, the CBK has sought and obtained the assurance of the branch’s management that the interests of depositors are not put at risk by the difficulties facing the parent company and that the bank will meet any withdrawal instructions by depositors in the normal course of business,” said Mr Murithi.
CBK added that it had maintained surveillance of the local branch and was satisfied with its solvency and liquidity.
This was meant to stop Kenyans from making panic withdrawals.
For instance, armed policemen would be deployed at the bank’s Nairobi branch on Koinange Street after the bank had announced it would shut its Kenyan operations.
In Britain, thousands of businesses owned by British Asians were on the verge of financial ruin following the closure of BCCI.
Their firms held almost half of the 120,000 bank accounts registered with BCCI in Britain. 
The African Development Bank was also not spared from this mess, with the bulk of its funds deposited and BCCI and stood to lose every coin.
Criminal culture
In Britain, local authorities from Scotland to the Channel Islands are said to have lost over £100 million (Sh15.2 billion in today’s exchange rate).
The biggest puzzle remained how BCCI was allowed by BoE and other monetary regulation authorities globally to reach such levels of fraudulence.
This was despite the bank being under tight watch owing to the conviction of some of its executives on narcotics laundering charges in the US.
Coast politician, the late Shariff Nassir, would claim that five primary schools in Mombasa lost nearly Sh1 million and appealed to then Education Minister George Saitoti to help recover the savings. Then BoE Governor Robin Leigh-Pemberton condemned it as so deeply immersed in fraud that rescue or recovery – at least in Britain – was out of the question.
“The culture of the bank is criminal,” he said. The bank was revealed to have targeted the Third World and had created several “institutional devices” to promote its operations in developing countries.
These included the Third World Foundation for Social and Economic Studies, a British-registered charity.
“It allowed it to cultivate high-level contacts among international statesmen,” reported The Observer, a British newspaper.
BCCI also arranged an annual Third World lecture and a Third World prize endowment fund of about $10 million (Sh1 billion in today’s exchange rate).
Winners of the annual prize had included Nelson Mandela (1985), sir Bob Geldof (1986) and Archbishop Desmond Tutu (1989).
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Monitor water pumps remotely via your phone

Tracking and monitoring motor vehicles is not new to Kenyans. Competition to install affordable tracking devices is fierce but essential for fleet managers who receive reports online and track vehicles from the comfort of their desk.

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Agricultural Development Corporation Chief Accountant Gerald Karuga on the Spot Over Fraud –

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Gerald Karuga, the acting chief accountant at the Agricultural Development Corporation (ADC), is on the spot over fraud in land dealings.

ADC was established in 1965 through an Act of Parliament Cap 346 to facilitate the land transfer programme from European settlers to locals after Kenya gained independence.

Karuga is under fire for allegedly aiding a former powerful permanent secretary in the KANU era Benjamin Kipkulei to deprive ADC beneficiaries of their land in Naivasha.

Kahawa Tungu understands that the aggrieved parties continue to protest the injustice and are now asking the Ethics and Anti-corruption Commission (EACC) and the Directorate of Criminal Investigations (DCI) to probe Karuga.

A source who spoke to Weekly Citizen publication revealed that Managing Director Mohammed Dulle is also involved in the mess at ADC.

Read: Ministry of Agriculture Apologizes After Sending Out Tweets Portraying the President in bad light

Dulle is accused of sidelining a section of staffers in the parastatal.

The sources at ADC intimated that Karuga has been placed strategically at ADC to safeguard interests of many people who acquired the corporations’ land as “donations” from former President Daniel Arap Moi.

Despite working at ADC for many years Karuga has never been transferred, a trend that has raised eyebrows.

“Karuga has worked here for more than 30 years and unlike other senior officers in other parastatals who are transferred after promotion or moved to different ministries, for him, he has stuck here for all these years and we highly suspect that he is aiding people who were dished out with big chunks of land belonging to the corporation in different parts of the country,” said the source.

In the case of Karuga safeguarding Kipkulei’s interests, workers at the parastatals and the victims who claim to have lost their land in Naivasha revealed that during the Moi regime some senior officials used dubious means to register people as beneficiaries of land without their knowledge and later on colluded with rogue land officials at the Ministry of Lands to acquire title deeds in their names instead of those of the benefactors.

Read Also: Galana Kulalu Irrigation Scheme To Undergo Viability Test Before Being Privatised

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“We have information that Karuga has benefitted much from Kipkulei through helping him and this can be proved by the fact that since the matter of the Naivasha land began, he has been seen changing and buying high-end vehicles that many people of his rank in government can’t afford to buy or maintain,” the source added.

“He is even building a big apartment for rent in Ruiru town.”

The wealthy officer is valued at over Sh1.5 billion in prime properties and real estate.

Last month, more than 100 squatters caused scenes in Naivasha after raiding a private firm owned by Kipkulei.

The squatters, who claimed to have lived on the land for more than 40 years, were protesting take over of the land by a private developer who had allegedly bought the land from the former PS.

They pulled down a three-kilometre fence that the private developed had erected.

The squatters claimed that the former PS had not informed them that he had sold the land and that the developer was spraying harmful chemicals on the grass affecting their livestock and homes built on a section of the land.

Read Also: DP Ruto Wants NCPB And Other Agricultural Bodies Merged For Efficiency

Naivasha Deputy County Commissioner Kisilu Mutua later issued a statement warning the squatters against encroaching on Kipkuleir’s land.

“They are illegally invading private land. We shall not allow the rule of the jungle to take root,” warned Mutua.

Meanwhile, a parliamentary committee recently demanded to know identities of 10 faceless people who grabbed 30,350 acres of land belonging to the parastatal, exposing the rot at the corporation.

ADC Chairman Nick Salat, who doubles up as the KANU party Secretary-General, denied knowledge of the individuals and has asked DCI to probe the matter.

Email your news TIPS to [email protected] or WhatsApp +254708677607. You can also find us on Telegram through www.t.me/kahawatungu

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William Ruto eyes Raila Odinga Nyanza backyard

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Deputy President William Ruto will next month take his ‘hustler nation’ campaigns to his main rival, ODM leader Raila Odinga’s Nyanza backyard, in an escalation of the 2022 General Election competition.

Acrimonious fall-out

Development agenda

Won’t bear fruit

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