Vers une grave pénurie de vaccins au Sénégal: Les blocages et les responsabilités

Le Sénégal fonctionne avec sa réserve de vaccins disponibles. Depuis 2018, l’Etat peine à débourser sa contrepartie de 20% nécessaire pour l’acquisition des vaccins destinés au Programme élargi de vaccination (PEV) et autres. Son partenaire, l’ONG GAVI finance à hauteur de 80%. Les enfants sont ainsi en sursis car le stock couvre jusqu’à la fin du trimestre 2020. Au delà de cette période, le Sénégal risque de plonger dans une pénurie qui pourrait être chèrement payée par les ayant droit notamment ses progénitures. Le ministère des Finances et du budget peine à s’expliquer clairement sur le dossier. Tandis qu’au département de la Santé, le Directeur de la prévention tente de rassurer sur le stock disponible capable de couvrir jusqu’à la fin du premier semestre. La disponibilité des ressources mais aussi le montage du dossier seraient les points de blocages.

Le Sénégal pourrait connaitre une rupture des vaccins dès mars 2020, si l’Etat du Sénégal ne libère par les fonds. En effet, le ministère des Finances et du Budget dirigé par Abdoulaye Daouda Diallo n’a toujours pas approuvé le budget pour l’achat des vaccins de routine en 2019. La somme s’élève à 3 milliards 117 millions Francs Cfa. Un montant qui ne représente que 20 % de la commande de vaccins, puisque l’Ong Gavi, partenaire de l’Etat du Sénégal finance à hauteur de 80%.   

Le code des marchés publics en son article 29, stipule que l’acte d’approbation, matérialisé par la signature de l’autorité compétente à ce titre, est la formalité administrative nécessaire pour donner effet au marché public. Dans tous les cas, les fonctions d’autorité signataire et d’autorité approbatrice ne peuvent être cumulées. Ceci dit que les marchés de l’Etat sont approuvés par le Ministre chargé des Finances lorsque le montant est égal ou supérieur à 300.000.000 FCFA. Ainsi le Ministre dépensier (celui de la Santé) n’est habilité que lorsque le montant du marché est égal ou supérieur à 100.000.000 FCFA ou n’atteint pas 300.000.000 FCFA. 

« Le ministère des Finances nous a notifié qu’il n’y a pas d’argent »
Contacté par PressAfrik, un agent du ministère des Finances soutient que l’information n’est pas crédible. «A ce que je sache, il n’y a pas de marché de vaccins rejeté par la direction centrale de marché publics (DCMP)», dément-il avant de soutenir que la DCMP chargée d’émettre des avis sur les décisions concernant l’attribution des marchés et d’accorder, à la demande des autorités contractantes, les autorisations et dérogations nécessaires lorsqu’elles sont prévues par la réglementation en vigueur, « peut leur notifier des observations et non un rejet ». Ce qui signifie qu’il y a toujours pas de financement. 

Une affirmation que notre source sanitaire qui a préféré garder l’anonymat trouve incohérente. Pour lui, «comment justifie t-il l’approvisionnement des vaccins de routine qui devait être pris en charge sur le budget de 2018 (alors qu’en ce moment Amadou Ba était aux commandes aux finances), et que jusqu’en 2020, l’Etat n’a pas encore libéré les fonds. Et pourtant, ils nous ont notifié qu’il n’y a pas d’argent. Et on veut nous faire croire à des observations et non un rejet». 

 

 

Mamadou Ndiaye, Directeur de la Prévention

Mamadou Ndiaye, Directeur de la Prévention
 
Le directeur de la Prévention confirme la pénurie mais rassure
Le directeur de la Prévention médicale, Mamadou Ndiaye confirme qu’on va vers une rupture des vaccins si une solution n’est pas trouvée d’ici le deuxième trimestre de l’année 2020. « Ils (ministère des Finances) nous ont signifié que c’est un problème technique à leur niveau. Toutefois, selon leurs informations, le dossier est bien avancé et que nous devons patienter », précise le directeur de la prévention. Et de poursuivre : « pour le moment, nous disposons d’un stock de vaccins. Mais si le stock de vaccins du mois de mars est mis en place, il faut impérativement que la commande encore soit soldée et qu’elle soit livrée à temps sinon nous allons vers une rupture. Au-delà du mois de mars, cela sera très difficile. Il faut que ça se règle sinon au mois de mars nous allons fonctionner avec des réserves », prévient et alerte Mamadou Ndiaye.  

Une pénurie qui va entrainer des conséquences fâcheuses consécutives à l’indisponibilité des vaccins d’où une perturbation du calendrier vaccinal. De plus, confie un acteur du secteur de la santé «la condition première pour que l’obligation vaccinale puisse être respectée, est la disponibilité des vaccins. Si ce n’est pas le cas, pas de prévention pour les nouveaux nés, ni pour les femmes enceintes, ni les futurs pèlerins de la Mecque ainsi que Rome. Pire, les nouveaux vaccins comme celui contre le cancer du col de l’utérus administré aux filles de neuf (9) ans vont connaitre une rupture aussi.  

Le Sénégal, bon élève en 2017,  pourrait se trouver dernier de la classe en 2020
Et quant au coordonnateur du Programme élargi de vaccination (PEV), Dr. Ousseynou Badiane, «il peut y avoir un retard dans la mobilisation des fonds. Parce que le ministère de la Santé donne son rapport au ministère des Finances qui à son tour approuve le financement qui, par la suite transmet les fonds à l’Unicef qui se charge de l’achat. Mais, si cela n’est pas fait dans ce premier semestre, il y a risque de pénurie», souligne-t-il aussi, précisant que pour le moment il n y a pas de rupture. 

Le financement des vaccins de routine doit être pérenne pour le maintien des résultats. En 2017, le Sénégal était  « sur la liste des pays les plus performants en Afrique, qui ont accompli le plus de progrès dans le domaine de la vaccination». Des résultats validés conjointement pour l’OMS et l’UNICEF. Mais, les «bonnes performances» du Programme élargi de vaccination (PEV), pourrait être catastrophique, si les fonds ne sont libérés d’ici mars 2020. 
 

 

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