Network for Education and Support in Immunisation Report NESI 2014.pdfThe Network for Education and...

Network for Education and Support in Immunisation

Saving lives through immunisation

ANNUAL REPORT 2014

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4 List of abbreviations 7 Foreword 8 Highlight 2014 11 About NESI 15 Chapter 1: Education and Training 15 1.1. In-service training 23 1.2. Pre-service training 25 1.3. Development of training materials27 Chapter 2: Technical support: Institutional strengthening 31 Chapter 3: Networking and advocacy 31 3.1. Symposia 33 3.2. Meetings 39 NESI Oversight Committee Meeting 42 Colofon

ADVAC Advanced Course of Vaccinology

AMP Agence de Médicine Préventive

BMGF Bill and Melinda Gates Foundation

CDC Centers for Disease Control and Prevention

CHAI Clinton Health Access Initiative

CIDRZ Centre for Infectious Disease Research in Zambia

cVDPV circulating Vaccine Derived Polioviruses

DNA Deoxyribonucleic acid

DoV Decade of Vaccines

DTP Diphtheria-Tetanus-Pertussis

ECTS European Credit and Transfer Accumulation System

EPI Expanded Programme on Immunization

ECDC European Centre for Disease Prevention and Control

EU European Union

GCC Gulf Cooperation Council

GIVS Global Immunisation Vision and Strategy

GVAP Global Vaccine Action Plan

HepB Hepatitis B

Hib Haemophilusinfluenzaetypeb

HIV HumanImmunodeficiencyVirus

HPV Human Papillomavirus

ICRH International Centre for Reproductive Health

IPROVE Innovation Partnership for a Roadmap on Vaccines in Europe

IPV Inactivated Polio Vaccine

ITMIH Institute of Tropical Medicine and International Health

KMTC Kenya Medical Training College

KPA Kenya Paediatric Association

LSHTM London School of Hygiene and Tropical Medicine

MCHIP Maternal and Child Health Integrated Program

MDG Millennium Development Goal

MLM Mid-Level Management

MNT Maternal and Neonatal Tetanus

List of abbreviations

MoH Ministry of Health

MoU Memorandum of Understanding

MPH Master of Public Health

MSc Master of Science

NESI Network for Education and Support in Immunisation

NGO Non-Governmental Organisation

NITAG National Immunisation Technical Advisory Group

OPV Oral Polio Vaccine

PCV Pneumococcal Conjugate Vaccine

PhD Doctor of Philosophy

RTAG Regional Technical Advisory Group

SAGE Strategic Advisory Group of Experts

SAVIC South African Vaccination and Immunisation Centre

SEA South-East Asia

SMU Sefako Makgatho University

SOMIPEV Société Marocaine d’Infectiologie Pédiatrique et de Vaccinologie

SRHR Sexual and Reproductive Health and Rights

UAntwerp University of Antwerp

UAE United Arab Emirates

UK United Kingdom

UNICEF United Nations Children’s Fund

UNPAD University of Padjadjaran

USAID United States Agency for International Development

VAPP Vaccine Associated Paralytic Polio

VLIR-UOS Flemish Inter-University Council

WHO World Health Organization

WHO/AFRO WHORegionalOfficeforAfrica

WHO/EMRO WHORegionalOfficefortheEasternMediterranean

WHO/HQ WHO Headquarters

WHO/IVB WHO Department on Immunisation, Vaccines and Biologicals

Annual report 2014

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Dear colleagues,

We are pleased to present the annual report of the Network for Education and Support in Immunisation (NESI) summarising the achievements of 2014.

Human resources are essential to deliver quality immunisation services to the public. Healthcare workers play a central role in maintaining public trust in vaccination through direct communication with the vaccinated person or the caregiver. Well-educated medical andnursingstaffwillreceivetheconfidenceofthepublic,andthereforecontributetohighimmunisation rates. These issues, among others, were elaborated on during the Symposium “Publicconfidenceinvaccines:buildingtrust,managingrisk”,organisedincollaborationwiththe London School of Hygiene and Tropical Medicine.

It was also a year of proposal writing and pursuing additional resources. During 2014, we have succeeded to obtaining additional funding for the Network. This new funding gaveus theopportunity toextendouractivities to theSouth-EastAsianRegion.OurfirstSymposium“BuildingVaccinologyExpertiseinSouth-EastAsia”wasorganisedinIndonesia,in collaboration with the University of Padjadjaran and the Indonesian Paediatric Society. Funding was also received for a two-year project on “Strengthening country adolescent immunisation programmes and health systems in the African Region using HPV vaccine asacasestudy”.TheprojectwasjointlydevelopedwiththeSouthAfricanVaccinationandImmunisation Centre (SAVIC), based at Sefako Makgatho University in South Africa.

Some changes occurred to the NESI Oversight Committee. Professor Paul-Henri Lambert, who has guided us since the launch of NESI at the end of 2002, has resigned from his position as chair. We would like to sincerely thank Prof. Lambert for his leadership and dedication through all those years. His vision and experience greatly contributed to the quality and credibility of NESI.

The Annual Report 2014 summarises the highlights of NESI’s activities during the year 2014 in capacity building in immunisation. We would like to thank all our partners for their continued support to NESI, contributing to the achievements of the Network. We are looking forward to continue this fruitful collaboration, and to maintain and increase the momentum of proposal writing keeping our commitment of contributing to reducing morbidity and mortality due to vaccine-preventable diseases.

Sincerely,

Dr Carine Dochez

Programme Director

Foreword

Annual report 2014

Highlight 2014

Symposium “Building Vaccinology Expertise in South-East Asia”, Bandung, Indonesia, 29-30 November 2014.

Annual report 2014

Sandis Sveicers / Shutterstock.com

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The Network for Education and Support in Immunisation (NESI) was established in 2002. NESI was built on the experience of the “International Network for Eastern and Southern Africa on HepatitisBVaccination”,whichwasestablishedin1999byfiveuniversitiesinEasternandSouthern Africa (Kenya, Tanzania, Zambia, Zimbabwe and South Africa), Ministries of Health in Africa and the University of Antwerp. The purpose of this network was to translate research on hepatitis B through capacity building and advocacy into universal access to hepatitis B vaccination in the partner countries.

With the development of new vaccines and increased commitment by development partners and private sector initiatives to strengthen vaccine supply and immunisation services, there are more opportunities to prevent more diseases in more children. This led to the establishment of NESI, which is a collaborative network of capacity building for the strengthening of existing immunisation programmes and introduction of new vaccines, with a broad technical scope and wide geographical focus.

NESI closely coordinates its activities with the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), Gavi, Non-Governmental Organisations (NGOs), the private sector, and other immunisation stakeholders.

Due to its links with universities and other health professional training institutions, which are vitaltoachievingsustainablecapacityandcompetencebuildinginthefieldofvaccinology,NESI is unique in its attention on pre-service training, particularly on the development of curricula and training for nurses, medical doctors, pharmacists, public health specialists and other related health professionals.

AMemorandumofUnderstandingbetweenNESIand theWHORegionalOffice forAfrica(WHO/AFRO)clearlydefines theoverallgoalsandactionsofNESI in theareaofcapacitybuilding. With the Eastern Mediterranean Region of WHO (WHO/EMRO), NESI works on the basis of an annual joint plan of action for key areas of capacity building. This validates the position of NESI as an integral partner in capacity building within the WHO African and Eastern Mediterranean Regions. Collaboration with the South-East Asian Region has been initiated during 2014.

Focalofficesatpartneruniversities/organisationsinthedifferentWHORegionsplayakeyrolein implementing the activities of the Network.

About NESI

Annual report 2014

MissionThe mission of NESI is to improve the quality and sustainability of immunisation programmes and services in low- and middle-income countries through capacity building, education and training, institutional strengthening and building international networks. NESI aims to build thecapacityofMinistryofHealthmanagersandstaffworkingintheExpandedProgrammeon Immunization (EPI) in their respective countries, as well as to improve pre-service and post-graduate training at the different faculties of health training institutions involved inimmunisation, which include medicine, nursing, pharmacy, and public health.

StrategiesTo accomplish its mission, NESI engages in a number of activities, which are grouped into three main areas: education and training, technical support, and networking and advocacy. NESIoffersthefollowingineacharea:

1. Education and training

• Organises training events in collaboration with other organisations;

• Monitors and evaluates currently implemented education and training programmes;

• Validates the content of educational and training materials;

• Develops up-to-date, high-quality training materials for different audiences involved inimmunisation programmes; and

• Provides support to universities to improve the curriculum of health professionals involved in immunisation and advises on regular refresher courses in collaboration with Ministries of Health (MoH).

2. Technical support

• Performs training needs assessments in collaboration with academic and other partners;

• Assists countries in developing comprehensive training plans as part of their Multi-Year Plans;

• Providessupporttocountrystafftoimplementtrainingactivities;and

• Supports institutional strengthening to improve national and regional capacity to deliver education and training.

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3. Networking and advocacy

• Facilitates a forum to discuss and coordinate actions related to education, training, and support for immunisation programmes in low- and middle-income countries;

• Maintains a network of specialists drawn from international organisations, universities in both industrialised and developing countries, national immunisation programmes, NGOs, industry, and other relevant stakeholders, to deliver high-quality training in all aspects of immunisationandatdifferentstagesofimplementationofimmunisationprogrammes;

• Collaborates with local, regional, and global training initiatives to advocate for better education and training; and

• Offersawebsitethathousestrainingmaterialsandlinkstootherrelevantsites.

StructureNESI is a partnership between the University of Antwerp and the public and private sector. An Executive Secretariat coordinates and implements activities for the Network. The Executive Secretariat is based at the Department of Epidemiology and Social Medicine, University of Antwerp, Belgium.

The Executive Secretariat reports to the Oversight Committee, which advises on strategy and budget allocation, and reviews outcomes. The Oversight Committee is composed of representatives from this partnership, representatives of partner universities and international health organisations and alliances, and international vaccinology experts.

NESIhasfulloperationalandscientificindependence.

FundingNESI is supported by public and private funds. NESI receives an educational grant from GlaxoSmithKline; funds from the University of Antwerp which also provides infrastructure, ICT, administrative and legal support; funds from the Flemish Inter-University Council (VLIR-UOS); and funds from the Flemish Government.

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Education and Training 15

CHAPTER 1 Education and training

Human resources are key to providing good quality healthcare services to the population. A national immunisation programme relies on the support of well-trained medical and nursing staff,sothatallchildrenwillbenefitofreceivingtherightvaccineattherighttimeintherightway. Therefore, training of health personnel must be relevant to national needs. Education and training must be coordinated and integrated with the developing health system as it moves towards meeting the objectives of health for all in the 21st century included in the Millennium Development Goals (MDGs), in the Global Immunisation Vision and Strategy (GIVS) adopted by the 58th World Health Assembly in 2005, and in the Global Vaccine Action Plan (GVAP) outlined in the Decade of Vaccines (DoV) adopted at the 65th World Health Assembly in 2012.

Attention needs to be given to both in-service and pre-service education and training. National immunisation programme reviews and training needs assessments indicate that serious bottlenecks exist between in-service and pre-service training: e.g. EPI content is not outlined in the pre-service curricula or is incomplete or outdated; health training institutions often lack demonstration equipment, as well as current EPI reference materials; time allocation for EPI theory is not always sufficient; some lecturers lack knowledgeoncurrentEPI theory andpractice.

Providing healthcare workers and academics with up-to-date information on vaccines and immunisation, is key to building the technical and managerial capacity and skills of current and future healthcare workers to deliver quality immunisation services to the public.

1.1. In-service training To be effective, a national immunisation programme relies on the support ofwell-informedmedical, nursing and support staff. To provide immunisation services of good qualityit is essential to have aworkforce that is sufficient in numbers,well-educatedand trained,adequately deployed and motivated. Evaluation of Mid-Level Management (MLM) courses has clearly shown that the performance of healthcare workers improves after in-service training.

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1.1.1. Vaccinology coursesIn-service vaccinology courses are key to build national vaccinology expertise by strengthening the capacity of academics in vaccinology (involved in teaching/research related to infectious diseases, mother and child health care, vaccines and immunisation) and to guide policy makers and programme managers to make evidence-based decisions on: (1) immunisation policies and strategies; (2) introduction of new vaccines and technologies; (3) sustaining and strengthening routine immunisation; (4) adjustments of existing immunisation programmes (e.g. adolescent vaccination); (5) adjustments to vaccination schedules; (6) conducting phase 1 to phase 3 clinical trials, and post-marketing surveillance (phase 4 studies).

The target audience of vaccinology courses include:

The vaccinology courses are developed around 9themes:(1)Thescientificbasisofvaccinology;(2) Vaccine development and evaluation; (3) Prequalification, registration, production andcontrol; (4) Routine EPI vaccines and optimising the impact of immunisation; (5) New vaccines; (6) Future vaccines; (7) Vaccine safety and cost-effectiveness; (8) Programmatic issues fornew vaccine introduction; and (9) Training and research.

Lecturers in the vaccinology courses are leading international vaccinology experts from universities, WHO, UNICEF, Gavi, Ministry of Health and industry.

1.1.1.1. “TropEd” Advanced vaccinology course, Berlin, Germany, January 2014

The TropEd Advanced Vaccinology Course was organised by the Institute of Tropical Medicine and International Health (ITMIH), Berlin, and NESI/UAntwerp, from 6 to 17 January 2014 in Berlin, Germany. The course is an accredited module (3.5 ECTS credit points) of the TropEd

Teachers at health training institutions from the different faculties involved in immunisation: medicine, nursing, public health and pharmacy

Members of the National Immunisation Technical Advisory Groups (NITAG)

EPI managers

MoH support staff

Staff of multilateral (WHO, UNICEF) and bilateral organisations, and of NGOs

MSc/MPH students

The general objective of the vaccinology course is ‘’to master the basic principles and specifici-ties of a vaccine, how it is deve-loped, produced and utilised, including its use within the EPI programme’’.


Masters Programme in International Health. TropEd is a network of institutions for higher education in International Health, including European and non-European institutions. It was thefirsttimethatthecoursewasorganisedovertwoweeks,followingfacultyandstudentrecommendations from previous courses. The accreditation for the two-weeks course was obtained in October 2013 and is valid until October 2018.

Thirteen students from both industrialised and developing countries attended the course.

Lecturers came from the Universities of Cape Town and Limpopo (South Africa), Gavi (Switzerland), Ministry of Health of Ghana, Robert Koch Institute (Germany), Institute of Tropical Medicine and International Health (Germany), Freie Universität Berlin (Germany), London School of Hygiene and Tropical Medicine (UK), WHO/HQ (Switzerland), GlaxoSmithKline (Belgium and Germany) and NESI/UAntwerp (Belgium).

Teaching methods included seminar-style and interactive lectures, exercises and group work on specific target diseases. A visit was brought to the Robert Koch Institute overseeingGermany’s vaccination programme.

NESI staff gave lectures on the following topics: HPV vaccines; Adolescent vaccination;Immunisation training and education; and Cold Chain. NESI also facilitated the group work on HPV vaccines.

Student evaluation was based on presentation of the group work, a written exam and a written essay on a topic of choice relevant to vaccines and immunisation. The essays were evaluated by the course directors from ITMIH and NESI.

In addition to the Advanced Vaccinology Course, NESI is also involved in lecturing during the Core Course in Berlin, Germany, which runs from September till December each year. NESI is invitedtolectureon“BasicVaccinology”,whichisaone-daysessionduringtheCoreCourse.

1.1.1.2. Advanced course of vaccinology, Veyrier-du-Lac, France, May 2014

The 15th Advanced Course of Vaccinology (ADVAC) was organised by Fondation Mérieux and the University of Geneva, at Veyrier-du-Lac, France, from 12 to 23 May 2014.

The ADVAC course is a two-week training programme for decision-makers, academia, industry,governmentalandnon-governmentalagencies,inallfieldsrelatedtovaccinesandimmunisation. The course aims to facilitate decision-making in vaccinology by providing participants with a comprehensive overview, from immunology to vaccine development and clinical trials and the social, economic, political and ethical issues of vaccination. The 15th ADVAC course was attended by 68 participants from 35 countries, from both developing and industrialised countries.

Annual report 2014

Over 60 international lecturers and working group supervisors, all experts in vaccinology, facilitated in the course. NESI was invited to co-facilitate the working group on “National decisionmakingforimmunisationprogrammes”.

1.1.2. Mid-level management coursesMid-Level Management (MLM) courses aim to contribute to the reduction of morbidity and mortality due to vaccine-preventable diseases, through the improvement of management of immunisationprogrammes.Specifically,MLMcoursesaimtoupdateparticipantsoncurrentglobal and regional immunisation policies and strategies within the context of health system strengthening; and to update and strengthen their managerial knowledge and skills related to problem solving, decisionmaking and leadership, effective communication, strategicor operational planning, immunisation programme costing, budgeting and resource mobilisation, cold chain and vaccine management, immunisation safety management, human and financial resources management, new vaccine introduction management,conducting quality supplementary immunisation activities, integrated disease surveillance and response management, EPI monitoring and data management, supervision, EPI coverage survey and evaluation.

The target audience of MLM courses include:(1)EPImanagers;(2)MoHsupportstaff;(3)staffofmultilateral (WHO,UNICEF)andbilateralorganisations,andofNGOs;and (4)teachersathealthtraininginstitutionsfromthedifferentfacultiesinvolvedinimmunisation:medicine, nursing, public health and pharmacy.

MLM courses can be organised as regional/inter-country courses or as national courses. MLMcoursesorganisedatthecountrylevelarekeytobuildingnationalcapacityinefficientmanagement of immunisation programmes.

1.1.2.1. Inter-country EPI mid-level management course for lusophone countries, Maputo, Mozambique, November 2014

The inter-country Lusophone Mid-Level Management Course was held in Maputo, Republic of Mozambique, between 17 and 28 November 2014. The course was organised by WHO/AFRO, in collaboration with the Ministry of Health of Mozambique, UNICEF, Gavi and NESI. The main objective of the MLM course was to strengthen the capacity of EPI managers and to equip academics from medical and nursing schools with new updates in the immunisation field.

A total of 27 participants from the 5 Portuguese speaking countries of the WHO/AFRO Region attended the course: Angola (3); Cape Verde (5); Guinea Bissau (5); Mozambique (10) and Sao Tomé and Principe (4). The majority of participants were from the EPI programme; while 3 academics attended the course.

The revised MLM modules, which have also been translated in Portuguese, were used during the course. The course was facilitated by 9 facilitators: WHO (3), UNICEF (3), consultants (2) and NESI (1).


As teaching methods, a variety of adult learning techniques were used: lectures, role play, case studies, group work, group and plenary discussions. Reading material was distributed to all participants before the course.

NESI actively facilitated in the following modules: cold chain management, vaccines management, supervision and surveillance.

The course was highly appreciated by the participants. Recommendations were made to increase the number of participants involved in EPI teaching in medical and nursing schools. It was also requested that the Portuguese MLM modules be widely distributed.

1.1.3. Experience exchange meetings

1.1.3.1. Public confidence in vaccines: Building trust, managing risk. London, UK, April 2014

This one-day symposium, organised on 25 April 2014 in London, UK, by the London School of Hygiene and Tropical Medicine (LSHTM) and NESI/UAntwerp, brought together 122 internationalvaccinologyandriskexpertstodiscuss“Publicconfidenceinvaccines:Buildingtrust,managingrisk”.

The symposium marked the World Immunisation Week (24-30 April 2014) by bringing togetherexpertsfromaroundtheworldtodiscussvaccineconfidenceissuesinthecontextofbroader principles of risk communication and risk management. Experts in risk and decision sciences, public health, health diplomacy, vaccines and immunisation, anthropology, history, e-health, policy and communications presented and discussed new ways of engaging the publictobenefitfromtheconstantlyevolvingportfolioofvaccinechoices.

The meeting consisted of presentations followed by discussion sessions which focused around three themes: (1) A historical perspective on public trust in vaccines; (2) Vaccine confidence: a global overview; and (3)Risk anddecisionmaking in theworld today: thecontextforvaccineconfidence.

A historical perspective on public trust in vaccines

Opposition tovaccinationstartedalreadywith thefirstvaccineagainstsmallpox.Manyofthe reasons for not accepting vaccination at that time still apply today: the principles of vaccinationwerenotwellunderstood;vaccinationwasperceivedasineffectiveandnotsafe;there were religious and philosophical concerns and resistance to compulsory vaccination; whiledemandisinfluencedbytheperceivedseverityofthedisease.

The power, but at the same time the challenge of vaccines, is that vaccines not only eliminate the disease, but also the memory of the disease. It is therefore important to develop strategies thatemphasizetheoverallpublichealthbenefitsaswellasindividualprotection.

Annual report 2014

Vaccine confidence: A global overview

Peoples’ feelings and perceptions of risk vary and are important when considering vaccine hesitancy. Risk drivers vary between individuals and cultures, so it is important to understand theseinfluencesatalocallevel.Theinternethasfuelledtheabilityoflike-mindedindividualsand groups to share common sentiments, both for and against vaccines, at unprecedented speed and reach.

The published literature on strategies to address vaccine hesitancy is limited, especially from regions where the majority of the world’s children live. The causes and impact of vaccine hesitancyarecomplexandcontext-specific;thereforelocalissuesneedtobeunderstood.Public forums, balanced dialogue, and increased awareness about the process are important when discussing vaccination with stakeholders. Educational initiatives should target the healthcare workers, as well as the general public and journalists.

Risk and decision making in the world today: The context for vaccine confidence

Risk communication is challenging for a variety of reasons including: social amplification/attenuation; narrative; deliberation; optimistic bias; trust/no trust. The vaccine community needs more trusted third parties who should be nurtured through dialogue and trust building; while vaccination needs to be administered by trusted local individuals. Gatekeepers can block vaccinationandthereforeneedtobeidentifiedandincludedinthebroadercommunicationand vaccine delivery strategies.

There isaneed to focusonhow to “unscare thescared”.People fall onacontinuumofawarenessandacceptance,andthereforedifferentapproachesneedtobedevelopedfordifferentpeople.

The Symposium concluded with a plea for a consortium of researchers and implementers building a new body of evidence and approaches of trust-building to get ahead of the trend ofwaningvaccineconfidence.


1.1.3.2. Building vaccinology expertise in South-East Asia, Bandung, Indonesia, November 2014

TheSymposium“BuildingVaccinologyExpertiseinSouth-EastAsia”wasorganisedbytheUniversity of Padjadjaran (UNPAD), Indonesia, and NESI/UAntwerp, in collaboration with the Indonesian Paediatric Society, on 29 and 30 November 2014, in Bandung, Indonesia.

Vaccine-preventable diseases remain a major public health problem despite the availability ofsafeandefficaciousvaccines.Manyeffortsarebeingmadetobuildsustainablecapacityto address the challenges related to new vaccine introduction and immunisation programme strengthening. The South-East Asian (SEA) Region is the one most lagging behind in this respect, while suffering from a high disease burden. Therefore, organising a VaccinologySymposium in Indonesia, reaching out to other countries in the SEA Region, will strengthen their capacity, and contribute to the further reduction of vaccine-preventable diseases and child morbidity and mortality.

The objectives of the Symposium included:

• Update participants on the Decade of Vaccines and its related Global Vaccine Action Plan;

• Discuss recent advances in new vaccines and their use;

• Exchange lessons learned and best practices regarding new vaccines introduction among participating countries;

• Discuss cold chain and logistics for preparation of new vaccines introduction;

• Discuss integrated management of immunisation;

• Discuss training in immunisation at medical and nursing schools;

• Strengthen immunisation programmes through partnerships between various stakeholders.

ThefirstdayoftheSymposiumfocusedonnewpoliciesandissuesrelatedtonewvaccineintroduction. The Indonesian Ministry of Health shared their lessons learned and best practices regarding new vaccines introduction in the country. The rationale and current vaccination scheduleswerediscussed,aswellasspecificvaccinesincludingpneumococcal,rotavirus,HPV,influenzaanddenguevaccines.

Theseconddaywasorganised inparallelsessions,whereby thefirstsession focusedonscientificaspectsof vaccinologyand thestatusof immunisation training inhealth traininginstitutions; while session two addressed the programmatic issues of national immunisation programmes, including immunisation in a health systems context, surveillance, immunisation safety, cold chain management, and community participation and communication.

More than 200 participants from ten countries attended the Symposium: Bangladesh, Cambodia, China, India, Indonesia, Malaysia, Pakistan, Sri Lanka, Thailand and Vietnam. The

Annual report 2014

participantshaddifferentbackgrounds,including:academia,NITAGmembers,EPImanagersandotherMoHstaff,membersofPaediatric,Obstetrics/GynaecologyandCommunityHealthAssociations, and medical students.

Speakers included national and international vaccinology experts from universities, Ministries of Health, Paediatric Societies, WHO, UNICEF, International Vaccine Institute, industry, and NESI.

The Symposium was well appreciated by the participants and created lively discussions amongexpertsofthedifferentcountriespresent.Arequestwasmadetoorganiseanannualsymposium, alternating in one of the participating countries.


1.2. Pre-service training 1.2.1. EPI prototype curricula for medical and nursing/midwifery schools in the African region

Tobeeffective,anational immunisationprogrammemusthavethesupportofwell-trainedmedicalandnursingstaff.TheincorporationofEPI intoundergraduatemedicaleducation,nursing/midwifery, and other health professional training programmes is important towards improving and strengthening immunisation service delivery, logistics, surveillance, communication and management practices. Clinical and public health training that incorporatesthelearningobjectivesofEPIwillenablestudentstodevelopafirmbasisofcoreknowledge and skills.

Training needs assessments conducted in various countries during the last decade pointed out several bottlenecks in EPI training at health training institutions. To facilitate the systematic revision of EPI curricula at training institutions, two EPI prototype curricula (one for medical schools and one for nursing/midwifery schools) were developed in 2006 by WHO/AFRO, NESI/UAntwerp, UNICEF, USAID and Gavi. Both prototype curricula are available in English and French, and have been widely distributed to health training institutions within the African Region. The general objective of the prototype curricula is: “to strengthen the teaching and learning of immunisation within the existing curriculum for pre-service education programmes formedicaldoctors,nurses/midwivesandotherhealthprofessionals”.

Thefirstpartofthecurriculumdescribestheexitprofileandcorecompetenciesrequiredfora medical doctor and nurse for immunisation activities at the district level. It also includes the jobdescriptionsforcorestaffinthenationalimmunisationprogramme,includingthenationalEPImanager,diseasesurveillanceofficer/epidemiologist,coldchainofficer,logisticsofficer,communication/socialmobilisation/healthpromotionofficeranddatamanager.Thesecondpart of the curriculum describes in detail the content topics of the EPI curriculum. Each topic is divided into sub-topics, including for each the learning objectives, time required to cover the topic, type of practical exercises and how to organise them, and recommended reference materials.

In 2013, during a regional workshop in Ivory Coast, the EPI prototype curricula for medical and nursing/midwifery schools were revised and updated with new content related to the Decade of Vaccines/Global Vaccine Action Plan and current new vaccines (e.g. PCV, rotavirus,HPV,MeningococcalAvaccine)andtechnologies.During2014thefinaldraftsofthese two prototype curricula were produced, both in English and French. Final proofreading is currently taking place.

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1.2.2. Technical competencies of nurse lecturers on expanded programme on immunization in Kenya Medical Training College, Kenya

KenyaMedicalTrainingCollege(KMTC),incollaborationwithNESI/UAntwerp,initiatedafieldbased study to assess the “technical competencies of nurse lecturers on the Expanded Programme on Immunization in KenyaMedical Training College”.With its network of 31colleges across the country, KMTC is one of the leading health training institutions training up to 90% of health workforce in Kenya. This study is a follow-up of the evaluations carried out in Kenya in 2011, accessing the status of EPI training at pre-service health training institutions. In Kenya, KMTC is taking the lead in driving the EPI pre-service curriculum implementation at the nursing schools. A representative of KMTC contributed to the EPI prototype curriculum revision for the nursing/midwifery schools during the workshop in Ivory Coast in 2013.

The aim of the study was to determine the technical competences (knowledge, skills and attitudes) of nurse lecturers in EPI at KMTC. The study also aimed to determine factors that couldinfluenceEPIcompetenciesamongnurselecturersandtoproposerecommendationsto address the needs.

Ethical approval was obtained by the KMTC ethical research committee and by the National Commission of Science and Technology and Innovation. In addition, all participants signed a consent letter.

Before the start of the study, enumerators were trained on data collection and a pilot study was conducted in one of the colleges. The survey was conducted in 23 nursing colleges. Qualitative (key informant interviews, focus group discussions, checklists) and quantitative (structured questionnaires) methods were used for data collection. A total of 110 lecturers and23headsofthedifferentnursingdepartmentsparticipatedinthestudy.

Data analysis is currently being completed. Preliminary findings indicate that:

• The 23 colleges participating in the study use a standard EPI curriculum with the EPI prototype curriculum content embedded.

• All nursing students undertake an integrated EPI clinical placement; although supervision is not always adequate.

• The majority of nurse lecturers teaching EPI have not attended any EPI refresher course forthelastfiveyears.

• The majority of the colleges lack demonstration equipment.

After completion of the data analysis, feedback will be given to all the participating colleges during departmental meetings and the Academic Board meeting. The results of the study will be further disseminated through seminar presentations and publications.


1.3. Development of training materials Providing healthcare workers and academics with up-to-date training materials on vaccines and immunisation is one of the key activities of NESI. Training materials are being developed for different levels of the immunisation programme, capturing the needs of all staff. Thetraining materials should be easily accessible and available for the intended user. As the immunisation programme is characterised by rapid progression, regular revision of training materials will be necessary.

1.3.1. Audio-visual materialsTraining methods are evolving over the years and the classical classroom training could be complemented by the use of audio-visual training materials or interactive resources, which can be made available on a CD-ROM or USB. They do not necessarily require an internet connection, as compared to e-learning; and therefore might be more convenient to use in resource-poor settings. Audio-visual training materials and interactive resources can be used during face-to-face training to demonstrate certain techniques or procedures, but can also be used as a self-learning tool. It has the advantage that the information given is consistent minimising the risk of messages being diluted, any section can be repeated at any time and procedures are easier to understand when they are demonstrated. Questions and answers after each section reinforce the learning and test the users’ knowledge. The videos provide real-life examples of healthcare workers at work and put procedures into context.

1.3.1.1. Development of script for the introduction of IPV into national immunisation programmes

Polio is a highly infectious disease caused by a virus which invades the nervous system and can cause permanent paralysis. There are three types of polioviruses: poliovirus type 1, 2 and 3. Poliovirus type 1 is the only wild poliovirus in circulation today. Currently, three countries (Afghanistan, Pakistan and Nigeria) are still endemic for transmission of wild poliovirus type 1; while seven countries have re-established transmission.

Two polio vaccines are available: the oral polio vaccine (OPV) and the inactivated polio vaccine (IPV). In very rare cases, OPV can lead to Vaccine Associated Paralytic Polio (VAPP) and outbreaks of circulating Vaccine Derived Polioviruses (cVDPV); the majority related to type 2 component of tOPV (containing poliovirus type 1, 2 and 3).

In 2012, the World Health Assembly declared poliovirus eradication to be a Global Public Health Emergency. To achieve a world free of polio, the use of OPV must ultimately be stopped worldwide, starting with the removal of type 2 OPV. Countries still using only OPV in their national immunisation programme should introduce at least one dose of IPV by the end

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of 2015. A switch from tOPV to bOPV (containing poliovirus type 1 and 3) is foreseen in April 2016. Withdrawal of all OPV is foreseen in 2018-2019.

The main reasons for the introduction of IPV include: to protect the majority of the population against type 2 polio, after the withdrawal of type 2 OPV; to mitigate the risk of type 2 reintroduction; and to boost immunity to types 1 and 3.

In order to assist the respective national EPI programmes with the introduction of one dose of IPV (which should be given at 14 weeks at the same time as the third dose of OPV and pentavalent (DTP-Hib-HepB) vaccine), NESI was requested by WHO to write a script for the development of a training DVD. This DVD can be used in addition to other WHO training materials to train all the healthcare workers delivering the vaccine. The script is developed in eight sections:

• Polio disease and introduction to the polio endgame

• IPV presentation, attributes and storage requirements

• IPV eligibility

• IPV administration

• Recording and monitoring the uptake of IPV

• IPV Adverse Events Following Immunisation monitoring

• Communication with caregivers

• Safety and acceptability of multiple injections

Afterfinalisingthescript,itwillbewidelydistributedtoallWHORegionsandcountries,whocan then use it to develop their training DVD. If required, NESI can provide assistance with filmingandeditingofthetrainingDVD.

Technical support 27

To ensure the sustainability of the Network’s activities and to increase its reach and impact, focalofficesarebeingestablishedinthedifferentWHORegions.Institutionalstrengtheningwill allow to share efforts in strengthening immunisation programmes through capacitybuilding, education and training.

Focaloffices,establishedatpartneruniversities/organisations,andNESIshallcollaborateinthe following areas:

• Conduct training needs assessment at pre- and in-service training institutions;

• In-service training: development of training materials and organisation/facilitation of vaccinology courses/workshops;

• Pre-service training: evaluate the curriculum in medical and nursing schools and assist the schools with updating their curriculum;

• Advocate for good interaction between the immunisation programme and academic institutions;

• Joint proposal writing;

• Exchange of students;

• Joint publications.

Focalofficeshavetheopportunitytoapplyfortheirownfunding,inadditiontothesupportprovided by NESI. A representative of each focal office participates in the annual NESIOversight Committee Meeting as a core member.

CHAPTER 2 Technical support: Institutional strenghtening

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2.1. South African Vaccination and Immunisation Centre The South African Vaccination and Immunisation Centre (SAVIC), hosted at Sefako Makgatho University(SMU),SouthAfrica,functionsasfocalofficesinceJanuary2012.

SAVIC and NESI share a common goal of improving the quality and sustainability of immunisation programmes, through education and training; and have a long working relationship spanning over more than 12 years. SAVIC was established at the Medical University of Southern Africa in 2003, now called Sefako Makgatho University. It isanetworkofpartnersinthefieldofvaccinationandimmunisation.SAVIC is a Public Priva te Academic alliance between the South African Department of Health, Vaccine Industry, Academic institutions and other stakeholders. SAVIC activities are undertaken in close collaboration with the South African National Department of Health, NESI/UAntwerp, WHO and other partners. The strategic operational areas of SAVIC include Education and Training, Operational Research and Technical Support and Advocacy.

Joint proposal writing

During 2014, SAVIC and NESI have successfully written a joint proposal “Improving skills and institutional capacity to strengthen country adolescent immunisation programmes and health systems in the African Region”.TheproposalreceivedfundingfromtheFlemishGovernment for two years and will run up to May 2016. The project aims to strengthen country adolescent immunisation programmes and health systems in the African Region using HPV vaccine as a case study.

Joint activities

Among the many activities conducted by SAVIC in 2014, joint SAVIC-NESI activities included:

• Participation in the TropEd Advanced Vaccinology Course in Berlin, Germany, from 6-17 January 2014. SAVIC facilitated the group work on rotavirus vaccines and gave lectures on: Immunising the immuno-compromised; Rotavirus vaccines; HIV vaccines (see section 1.1.1.1.).

• ParticipationintheSymposium“Publicconfidenceinvaccines:buildingtrust,managingrisk”inLondon,UK,on25April2014(seesection1.1.3.1.).

• Participation in and development of joint SAVIC-NESI presentation for the Eighth African Rotavirus Symposium in Livingstone, Zambia, from 12-13 June 2014, on “Capacity buildingactivitiesinsupportofnewvaccineintroduction”(seesection3.1.1.).

• A planning workshop between SAVIC and NESI was organised in Pretoria, South Africa, from 21-23 August 2014, to develop the roadmap of the HPV project. During this visit, NESI was also invited to give a guest lecture on HPV vaccines at the Department of Virology.

Technical support 29

2.2. Société Marocaine d’Infectiologie Pédiatrique et de VaccinologieSOMIPEV (Société Marocaine d’Infectiologie Pédiatrique et de Vaccinologie), is a non-profit association of paediatricschaired by Prof Mohammed Bouskraoui, head of the Paediatric Department at Centre Hospitalier Universitaire Mohammed VI, Marrakech, Morocco. This association congregates all Moroccanexpertiseinthefieldofpaediatricinfectiousdiseasesand vaccinology. The objectives of SOMIPEV are: to improve and share knowledge of paediatric infectious diseases and vaccinology; to strengthen health education for the prevention

of infectious diseases in Morocco; to strengthen education and training in medicine, nursing, public health and pharmacy; to create an international scientific platform in this field; totranslate research into better prevention of paediatric infectious diseases in Morocco; and to guide and assess the impact of national vaccination strategies of the Ministry of Health.

Given the common goals of SOMIPEV and NESI/UAntwerp, a Memorandum of Understanding (MoU)hasbeensignedin2013tojoineffortssupportingthenationalimmunisationprogrammein Morocco through capacity building, education and training.

Following two successful workshops in 2013 to develop the roadmap for education and training activities at both pre- and in-service level for strengthening the national immunisation programme in Morocco, 2014 was devoted to the development of a training manual as well asascripttodevelopatrainingDVD.Themanualiscurrentlybeingprinted;whilefilmingofthe DVD will take place during 2015.

2.3. University of JordanThefirstjointprojectbetweentheUniversityofJordanandNESI/UAntwerp, is the development of an Immunisation newsletter/website.

Vaccines and immunisation are considered to be one of the most important and cost effective preventive health measures. While thenumber of vaccines used to be limited, often administered primarily during infancy or early childhood, the number of vaccines that are

routinely recommended for children has almost doubled in the past two decades and the host range has also increased to include adolescents, adults and even the elderly. This has increased both the number of vaccines administered routinely as well as including a much larger part of the population that are targeted to receive vaccines on a wide scale. In addition, many special hosts, such as the immune compromised and the chronically ill patients, such a patients with diabetes, renal failure and cardiac diseases, are candidates to receive special vaccines that help prevent diseases such as pneumonia which cause morbidity and mortality decreasingthebenefitfromtheirrelativelycostlymedicalcare.

In order to help the medical community and healthcare workers, as well as the general public to be well-informed, a newsletter will be published online to have the maximum distribution and to help upgrade the knowledge of the public about vaccines and immunisation. The issues to be discussed will be mainly directed at the EMRO Region, however it will include

Annual report 2014

news itemsaboutother regions, aswell asprovide timely informationabout thedifferentvaccines that are being introduced in the Region and other parts of the world.

Each issue of the newsletter will provide vaccines and immunisation insights from the experts and the latest news from the Region and beyond. The newsletter should act as an educational platform, highlighting the latest immunisation trends. The website supporting the newsletter will provide e.g. useful links, info-graphics and videos.

2.4. University of Padjadjaran, Bandung, IndonesiaThe University of Antwerp has a long-standing collaboration with the University of Padjadjaran (UNPAD) in Bandung, Indonesia, with activities initiated in the early 1980’s. Priority domain of collaboration between the Faculty of Medicine of UNPAD and the Department of Epidemiology and Social Medicine of the University of Antwerp was institutional strengthening and capacity building in teaching and research, formalised

through regularly updated Memoranda of Understanding. An interdepartmental Medical Research Unit was established in UNPAD which was highly active in education and training in (clinical) epidemiology and medical statistics, evidence-based medicine/clinical trials and health research development in general. Research led to numerous publications, MSc and PhD degrees. Of the two studies in neonates in South-East Asia with recombinant hepatitis B vaccine, one was implemented in Bangkok, Thailand, and the second one in Bandung, Indonesia. The Faculty of Medicine of UNPAD has grown tremendously in the last decades in research and training capacity and capability, and substantial funding was attracted from national and mainly international resources (multilaterals, major bilaterals and foundations).

Within the scope of this MoU, NESI/UAntwerp and the Department of Child Health/UNPAD, strengthened the collaboration in the area of vaccine-preventable diseases. The South-East Asian (SEA) Region is the one most lagging behind regarding new vaccine introduction and immunisation programme strengthening. This has considerable impact on child morbidity and mortality, as by far the greatest birth cohorts are in this region (India, China and Indonesia are respectively number 1, 2 and 4). Most countries in the SEA Region have not yet introduced new vaccines like rotavirus, PCV or HPV vaccines into their national immunisation programme. Therefore national immunisation programmes need to be strengthened in understanding the need and use of these new vaccines in order to further reduce the morbidity and mortality of vaccine preventable diseases.

TheSymposium “BuildingVaccinologyExpertise inSouth-EastAsia”was the first activitydeveloped within this framework (see section 1.1.3.2.). Discussions are on-going to develop a joint plan of action for 2015 and beyond.

Networking and advocacy 31

NESI works with both the public and private sector to develop and deliver high-quality training programmes. An international network is created for sharing experiences and best practices.ThroughnetworkingandadvocacyNESIaimstoalignthedifferentstakeholdersin immunisation to achieve faster and coordinated introduction of new and under-utilised vaccines.

NESI is committed to providing up-to-date information on vaccines and immunisation. The NESI website (www.nesi.be) plays an important role in the dissemination of this information. The website hosts high-quality training materials, which can be downloaded if required.

A mailing list linked to the human resources and alumni database has been established, in order to send out news updates and updated training materials.

Participating in networking meetings is an important opportunity for NESI to discuss and plan collaborative activities, to share experiences with other immunisation partners, and to receive latest updates and recommendations on vaccines and immunisation, which can immediately be incorporated in our education and training activities.

3.1. Symposia 3.1.1. 8th African Rotavirus Symposium, Livingstone, Zambia, June 2014

The 8th African Rotavirus Symposium was organised from 12 to 13 June 2014 in Livingstone, Zambia, by the African Rotavirus Network; a network of global rotavirus researchers, African Ministries of Health, WHO and other key partners and stakeholders. The Symposium was hosted by the Centre for Infectious Disease Research in Zambia (CIDRZ), in collaboration with the Ministry of Community Development, Mother and Child Health of Zambia. The theme oftheSymposiumwas“RotavirusLandscapeinAfrica–TowardsPreventionandControl”.

The Minister of Community Development, Mother and Child Health, Emerine Kabanshi, gave theofficialopeningspeech.ZambiarecentlyintroducedthreenewvaccinesintotheirNationalImmunisation Programme: pneumococcal, measles second dose, and rotavirus vaccine. The Minister announced that “necessary commitments were made to ensure that no Zambian childdiesfromvaccine-preventablediseases”.

The Symposium was attended by 133 delegates from 35 countries; including 27 African countries.Scientists,academics,governmentofficialsandrepresentativesfrompharmaceuticalcompaniesdiscussedtheachievementsandchallengesinthefieldofpreventingchildhooddiarrhoea caused by rotavirus in Africa. During this two-day Symposium, more than 35 scientificpresentationsweregiven,andmorethan70postersweredisplayedonavarietyoftopics: disease burden and rotavirus epidemiology, strain diversity and emerging surveillance results from African Countries, current and future vaccines, vaccine introduction and impact studies, and global perspectives with interest to Africa. NESI was invited to present on “Capacitybuildingactivitiesinsupportofnewvaccineintroduction.”Thispresentationwasjointly developed with SAVIC.

CHAPTER 3 Networking and advocacy

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As more and more countries are introducing the rotavirus vaccine into their respective national immunisation programme, this Symposium was an important opportunity to share experiences and lessons learned and to discuss early impact data. The Symposium also provided a platform for networking.

3.1.2. 10th International Congress on Tropical Paediatrics, Nairobi, Kenya, August 2014

The 10th International Congress on Tropical Paediatrics was hosted by the Kenya Paediatric Association (KPA) from 25 to 29 August 2014, in Nairobi, Kenya. The theme of the conference was“TropicalPaediatricsandtheMDGs:wherearewe?”.

As the deadline of the MDGs is approaching, the goal of the congress was to review progress towards the MDG4 target of reducing child mortality by two-thirds by 2015, as compared to 1990, and to stimulate member countries to take appropriate actions according to their individual country needs towards achieving this target.

TheofficialopeningaddresswasdeliveredbyHerExcellencytheFirstLadyMrs.MargaretKenyatta. The congress brought together paediatricians, scientists, experts in child health, tropical medicine, medical education, and many other disciplines.

NESI was invited to give a presentation during the session on Medical Education: “The role of academicinstitutionsinstrengtheningimmunisationprogrammes”.

3.1.3. Symposium on “HPV - future challenges”, Ghent, Belgium, December 2014

On 4 and 5 December 2014, the International Centre for Reproductive Health (ICRH) celebrated its 20th anniversary with a two-day international symposium, in Ghent, Belgium. The theme of the conference was “Sexual and reproductive health and rights today and tomorrow - ICRH celebrates 20 years of SRHR research, training and advocacy” andconsisted of separate sessions on the following topics: Adolescent sexual and reproductive health and well-being; HPV, related diseases and vaccination; Female genital mutilation; Forced marriages; Maternal health, with focus on family planning and quality of maternal and new-born care; and behavioural change interventions.

NESI attended the symposiumon “HPV – future challenges” on 5December 2014. Thesymposium addressed the following topics: HPV and related diseases in developing countries; Reference framework for HPV; Impact and future perspectives of HPV vaccination. Developing countries have a high burden of HPV-related cancers. Despite the availability of prophylactic HPV vaccines, as well as HPV DNA testing as a primary screening tool, implementation of these new interventions remains a challenge, especially in resource-poor


settings. These implementation issues were addressed during the symposium.

HPV vaccination being one of the key interest areas of NESI; we benefited greatly fromparticipating in the symposium.

3.2. Meetings 3.2.1. EPI Managers meeting for Eastern and Southern African countries, Harare, Zimbabwe, 2014

The annual EPI Managers Meeting for Eastern and Southern Africa was organised by WHO/Inter-country Support Team from Eastern and Southern Africa from 10 to 14 March 2014, in Harare, Zimbabwe.

The meeting was attended by more than 150 participants, including EPI managers, academics, WHO and UNICEF EPI focal points from 20 countries from Eastern and Southern Africa, as well as members of the Task Force on Immunisation and other immunisation partners: AMP,

American Red Cross, BMGF, CHAI, CIDRZ, Gavi, MCHIP, NESI and Sabin Vaccine Institute.

The objectives of the meeting was to provide a forum for technical orientation and exchange of experiences between countries in Eastern and Southern Africa and partners; to discuss current issues and challenges related to vaccine preventable diseases and their solutions; and to update participants on the global and regional policies and guidelines with special focus on acceleration of the polio eradication initiative.

The meeting aimed to update participants on the GVAP and the Regional Strategic Plan and review progress and challenges in reaching the unreached target population with routine immunisationservicesandnewvaccines;todiscussthefinancingofvaccination;toagreeonways to ensure complete interruption of wild poliovirus type 1 transmission in the Horn of Africa countries and maintain East and Southern African countries polio free; and to review progress and challenges regarding the elimination of measles, MNT and Meningitis A epidemics, as well as the introduction of rubella vaccine and yellow fever control.

A special workshop was devoted to the Polio Eradication and Endgame Strategic Plan 2013-2018.

Attending the EPI Managers meeting was an excellent opportunity for NESI to discuss and planjointactivitieswithEPIstaffandotherimmunisationpartners.

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3.2.2. Strategic Advisory Group of Experts meeting, Geneva, Switzerland, April and October 2014

The Strategic Advisory Group of Experts (SAGE) Meetings were organised by WHO from 1 to 3 April 2014, and from 21 to 23 October 2014, in Geneva, Switzerland. SAGE advises WHO on overall global policies and strategies, ranging from vaccine research and development, to delivery of immunisation services and linking immunisation with other health interventions. SAGE usually meets twice a year and reports directly to the Director-General of WHO.

ThefirstsessionoftherespectiveSAGEmeetingscoveredthereportsfromWHO/IVBandGavi; followed by regional reports. During the SAGE meeting in October 2014, time was also dedicatedtothe“updateontheEbolaoutbreakandexperimentalEbolavaccines”.Othertopics addressed by SAGE during 2014 are summarised in the table.

SAGE is an excellent opportunity for NESI to network but also for understanding the rationale supporting WHO’s recommendations on vaccines and immunisation. These evidence-based arguments can be rapidly included in NESI’s education and training activities enriching discussions with the most recent information, especially relevant for vaccinology courses and immunisation management courses.


Topics addressed by the strategic advisory group of experts during 2014

Topics discussed at SAGE April 2014

Topics discussed at SAGE October 2014

Report from WHO/IVB Report from WHO/IVB

Report from Gavi Report from Gavi

Report from other Advisory Committees on Immunisation:· Global Advisory Committee on Vaccine Safety

Reports from other Advisory Committees on Immunisation:

· Global Advisory Committee on Vaccine Safety · Immunisation Practices Advisory Committee· Immunisation and vaccines related implementation research advisory committee· Product Development for Vaccines Advisory Committee· Expert Committee on Biological Standardisation

Immunisation supply chains: strategies for the future of in-country systems strengthening

GVAP progress report

Global polio eradication initiative Japanese Encephalitis vaccines

Varicella and herpes zoster vaccines Meningococcal A conjugate vaccine impact and routine immunisation schedule in infants and young children

Alternative vaccination schedules for HPV vaccines

Global polio eradication initiative

Pertussis vaccines Hepatitis E vaccine

Non-specific effects of vaccines on mortality in children under 5 years of age

Vaccine hesitancy

Integration of immunisation and child health services

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3.2.3. IPROVE training and communications workshop, Brussels, Belgium, October 2014

The EU funded project IPROVE (Innovation Partnership for a Roadmap on Vaccines in Europe) organised a stakeholder consultation workshop on “Training and communication on vaccines andvaccinology”on28October2014inBrussels,Belgium.ThegoaloftheIPROVEprojectis to develop a roadmap to assist with future programming and priority-setting at EU level in thevaccinefield.

The workshop discussed coordination and synergies between existing training schemes targeting both scientists and healthcare professionals, and how the gaps and needs could be addressed. Issues around knowledge and perception of vaccines and vaccination by the general public and healthcare workers in Europe were analysed and best practices put forward, in order to improve awareness and acceptance of the importance of vaccines.

During the plenary session, the scope and objectives of the IPROVE project were presented; as well as the views from the EU Commission. This was followed by two parallel sessions developed around the following themes:

• Training needs in vaccines and vaccinology: two roundtable discussions addressing “current needs and suggested action at EU level” and “moving forward – possibleimplementers”.

• Addressing communications and perception issues: addressing communications and perception issues; integrating health communication into programmes of infectious disease and control: ECDC roadmap.

The workshop was attended by 45 participants. NESI was invited by the IPROVE consortium to actively participate in this workshop given our expertise and involvement in vaccinology training, in order to provide our expert input to this consultation process. NESI participated intheparallelsessionon“Trainingneedsinvaccinesandvaccinology”andsharedwiththegroup the current vaccinology training activities of the Network.

3.2.4. 28th Inter-country meeting of national managers of the Expanded Programme on Immunisation, Amman, Jordan, November 2014

The 28th inter-country EPI Managers’ Meeting was organised by WHO/EMRO from 16 to 19 November 2014 in Amman, Jordan.

The meeting was attended by participants from the following countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, United Arab Emirates and Yemen; as well as by RTAG and NITAG members, AMP, CDC, Gavi, NESI/UAntwerp, Results for Development, UNICEF and WHO.

The objectives of the meeting included:

• Review national and regional progress in EPI: achievements, constraints and way forward in view of the GVAP;


• Discuss recent advances in new vaccines and technologies: progress and the challenges facing their use;

• Update RTAG members on progress and constraints facing EPI and get RTAG input for supporting EPI.

The meeting was developed around the following sessions: (1) Global and regional briefings; (2) Strengthening routineimmunisation in countries of the Eastern Mediterranean Region, with a special focus on Syria and surrounding countries; (3) Poliomyelitis Eradication Initiative; (4) Hepatitis B control target; (5) Strengthening immunisation system to meet the EPI targets, including improving monitoring and evaluation of EPI, improving vaccinemanagement and logistics, planning and financing forimmunisation.

3.2.5. Meeting of chairpersons on the National Immunisation Technical Advisory Group and EPI Managers in countries of the Eastern Mediterranean Region, Amman, Jordan, November 2014

The Meeting of the NITAG chairpersons and EPI managers in countries of the Eastern Mediterranean Region was organised by WHO/EMRO on 20 November 2014 in Amman, Jordan.

The meeting was attended by participants from the following countries: Afghanistan, Bahrain, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, United Arab Emirates, Yemen; as well as by RTAG members, AMP, CDC, Health Council of the Netherlands, NESI/UAntwerp, Robert Koch Institute, UNICEF and WHO.

ThefirstpartofthemeetingaddressedspecificissuesrelatedtotheNITAGs:

• Role, scope and functions of NITAGs

• Monitoring establishment and progress of NITAGs in the Region

• Process to develop evidence-based recommendations on immunisation policy

• Methods to assess quality of evidence

• WHO collaborating center on evidence-informed immunisation decision-making: lessons learned, tools, guidelines and resources for NITAGs

During the second part of the meeting an update of the SAGE working group on Vaccine Hesitancy was given. The meeting concluded with a brainstorming session on the 2015 World Immunisation Week in the EMRO Region.

Annual report 2014

NESIwas invited to participate in thismeeting and briefed the audience on the differenttrainingcoursesandworkshopsthatcanbeofferedtostrengthentheknowledgeandskillsof NITAG members.

3.2.6. 4th annual GCC States meeting on vaccine and immunisation, Dubai, UAE, December 2014

The 4th Annual GCC states meeting on vaccine and immunisation was organised by the Executive Board of the Health Minister’s Council for Cooperation Council States, from 9 to 11 December 2014 in Dubai, UAE. The theme of the meeting was: “Towards achieving the elimination of measles and rubella and ensuring high immunisation coverage among the GCC memberstates”.

The objectives of the meeting included:

• Toreviewthepresentstatusofmeaslesandrubellainthedifferentmemberstates;

• To review the current progress towards hepatitis B elimination among the member states and advocate a way forward and propose sub-regional goals and targets;

• To expedite the future directions on adult vaccination;

• To review the current EPI schedule.

Participants attending the meeting came from 6 member states of the GCC: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and UAE, as well as from WHO/EMRO and NESI/UAntwerp.

NESI was invited to attend the meeting and give a presentation on its capacity building activities. The presentation was well received and the importance of training and education at both the pre- and in-service level was stressed and a recommendation will be made. Potential ways for collaboration will be discussed during 2015.

NESI Oversight Committee Meeting 39

NESI is a partnership between the University of Antwerp and the public and private sector. An Executive Secretariat coordinates and implements activities for the Network. The Executive Secretariat reports to the Oversight Committee, which advises on strategy and budget allocation, and reviews outcomes. The Oversight Committee is composed of representatives from this partnership, representatives from partner universities and international health organisations and alliances, and international vaccinology experts.

Specifically,thecommittee:

• shapes a strategic vision and direction for NESI;

• advisesonthestrategytofollowanddefinespriorities;

• stimulates/fosters participation of Gavi partners and others in the implementation of NESI activities;

• reviews the plans, evaluates the postulated goals and endorses the work plan and the related budget allocation;

• facilitates networking and collaboration with other bilateral and multilateral stakeholders engaged in the area of capacity building for immunisation programmes;

• ensures the academic freedom of NESI in planning and implementing its activities;

• verifiestheindependencyoftheactivitiesorganisedbyNESIinrelationtoitssponsors.

The 10th NESI Oversight Committee Meeting was organised in London, UK, on 24 April 2014.

The Executive Secretariat reported to the Oversight Committee on the implementation of the PlanofActionandthefinancialreportfortheyear2013.Afterthediscussionofthereports,the secretariat presented the work plan for 2014. A special session was devoted to the future of NESI and possible funding opportunities.

Based on the discussions of the report for the year 2013 and the work plan for the year 2014, the members of the committee formulated recommendations and approved the NESI work plan and the related budget allocation for the year 2014.

Tenth NESI Oversight Committee Meeting, London, UK, April 2014

Annual report 2014

Members of the NESI Oversight Committee 2014

Core Members Affiliation

Prof Paul-Henri Lambert, Chairman Professor, CMU Centre of Vaccinology, University of Geneva, Switzerland

Prof Mohammed Bouskraoui Professor and Head Paediatrics, CHU Mohammed VI, Morocco

Prof Tandakha Dieye Head Immunology Unit, Le Dantec University Teaching Hospital, University Cheikh Anta Diop, Senegal

Dr Carine Dochez Programme Director, Department of Epidemiology and Social Medicine, University of Antwerp, Belgium

Prof Anwar Hoosen Head of Department of Medical Microbiology and Virology, University of the Free State, South Africa

Prof Cissy Kartasasmita Professor, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Indonesia

Prof Najwa Khuri-Bulos Professor and Chairman Paediatrics Depart-ment, Jordan University Hospital, Jordan

Dr Heidi Larson Senior Lecturer, London School of Hygiene and Tropical Medicine, UK

Prof André Meheus Senior advisor NESI, Department of Epidemiology and Social Medicine, University of Antwerp, Belgium

Prof Jeffrey Mphahlele Vice President of Research: South African Medical Research Council, Head of SAVIC; Professor and Co-Director: SA MRC/Diar-rhoeal Pathogens Research Unit, Sefako Makgatho University, South Africa

Prof Fred Were Dean and Professor of Paediatrics, Department of Paediatrics and Child Health, University of Nairobi, Kenya

Prof Joost Weyler Professor and Head of Department of Epidemiology and Social Medicine, University of Antwerp, Belgium

NESI Oversight Committee Meeting 41

Non-Core Members Affiliation

Dr Karin Hardt Director, Worldwide Vaccinology, Vaccine Education and Medical Training, GlaxoSmithKline, Belgium

Dr Raj Kumar Senior Programme Officer, Gavi, Switzerland

Dr François Meurice Ambassador Vaccines, Scientific Affairs, Public Health & Medical Education, Global Medical Affairs, GlaxoSmithKline, Belgium

Dr Afisah Zakariah Director, Policy, Planning, Monitoring and Evaluation Directorate, Ministry of Health, Ghana

Secretariat Affiliation

Mrs Katrin Verboven Administrative and Finance Project Coordinator NESI, Department of Epidemiology and Social Medicine, University of Antwerp, Belgium

Network for Education and Support in Immunisation Department of Epidemiology and Social Medicine

University of AntwerpCampus Drie EikenBuilding R, 2nd FloorUniversiteitsplein 1BE-2610 AntwerpBelgium

Telephone +32 (0)3 265 25 15 Telephone +32 (0)3 265 28 91Facsimile +32 (0)3 265 28 75E-mail [email protected] Website www.nesi.be

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