Bosnia and Herzegovina, like other developing countries, has a problem with the procurement of vaccines for immunization of the population against the COVID-19 virus. The high degree of decentralization of the state, a large number of levels of government, and a cumbersome administrative apparatus, lack of accountability of the government, non-functioning of the global COVAX system, are just some of the problems hindering the national immunization program in BiH. One of the key shortcomings is the lack of a state-level ministry of health, which would have a dedicated budget in such crisis situations, and coordination and monitoring of the fight against the COVID-19 pandemic.

While some countries of the Western Balkans, more specifically the Republic of Serbia, in their vaccination program have the priority of solidarity with other countries in the region, where citizens of BiH and the region can register and be immunized free of charge, other countries, specifically BiH, are unable to offer an adequate set of measures and mechanisms for collective immunization of the population.

We asked the citizens of BiH on the platform www.mojauprava.ba within the WeBER 2.0 project – Western Balkan Civil Society Empowerment for a Reformed Public Administration – how worried they are because immunization has not yet begun – vaccination of the population at COVID-19 in BiH. 474 BiH citizens participated in our survey, and 87.55% of respondents expressed concern, while 4.85% of the respondents were neutral. A total of 7.6% of respondents did not express concern about the fact that immunization of the population with COVID-19 in BiH has not started.

What when immunization starts? Where is the public administration in all this?

A number of vaccines arrived in BiH last week via the COVAX global system, and collective and mass immunization of the population will begin. Bosnia and Herzegovina does not have a national immunization program for its citizens in accordance with modern policies and strategies that are primarily a reflection of the recommendations of the World Health Organization. Due to the high decentralization of the state, programs are adopted at lower levels of government. Currently, the Agency for Medicines, which participates in safety and in the procedures of regulation and approval of vaccines, has competencies in the entire immunization protocol of BiH, and there is a high degree of transparency.

The recommendations of the World Health Organization are that states should have strong mechanisms that enable informed decision-making on immunization priorities and the introduction of new program strategies and technologies.

At the moment, we do not have uniform protocols in BiH, nor a transparent way of informing citizens about the ways of immunization of the population in BiH. The state has not provided at any level a campaign to inform citizens about the vaccines that have arrived, side effects, vaccination plan and methods, priority groups, etc., all with the aim that as many citizens as possible participate in collective immunization. Ad hoc strategies are adopted at lower levels, for example at the level of the entities of the Federation of BiH, in one cantonal unit we have modern electronic forms, while in another citizens have to express their desire for vaccination again at the counter.

In order to respect the principles of transparency of open public administration and modern digitalized e-government, it is necessary for the BiH authorities to do the following:

• Adopt uniform mechanisms that will be harmonized at the entire level of the state, with the participation of all levels of government. These mechanisms will ensure a unique set of measures for monitoring collective immunization in order to report as openly as possible to the domestic and international public. We currently have a large number of citizens who were vaccinated in the neighbouring Republic of Serbia, and we also have a large number of citizens who were vaccinated in the BiH entity of Republika Srpska, as well as individual cases of health workers out of 5,000 vaccines donated by the Republic of Serbia. All of these data do not exist in a single global immunization monitoring system.
• The great distrust of citizens in the institutions of BiH is present in all surveys in BiH, and this is one of the indicators that the public administration must take into account. It is necessary to do a single campaign at all levels of government in order to inform the citizens and restore trust in government. This mistrust is especially caused by this case because the vaccines were not procured on time, and collective immunization has been promised since December last year. In order to make public administration more transparent, this should be one of its priorities. Also, in the world, including BiH, there is an infodemia, and a high degree of distrust in the safety of vaccines is to be expected, and for this reason the campaign is very much needed to raise awareness of the importance of collective immunization.
• A unique e-government register is needed, which will enable transparency in vaccination, simplicity and protection of citizens from the possible spread of the corona virus by going to the counter. The quality and availability of these services are key factor in the fight against the COVID-19 pandemic. However, the results of our research conducted last year as part of the WeBER 2.0 project, showed that the pandemic did not affect the fact that citizens in BiH and in our region are more likely to start using e-services.

4th April 2021.

Blog post by Mahir Sijamija, Project and Communications Officer at Foreign Policy Initiative (FPI BH)