World Health Organization Global Immunization Newstesting to support HPV surveillance, namely...

WHO RECOMMENDATION TO TEMPORARILY SUSPEND PROCUREMENT AND USE OF ALL LOTS OF SHAN5 (DTWP-HEPATITIS B-HIB) VACCINE 31/03/2010 from Melinda Henry WHO/HQ: As of 12 March 2010 the World Health Organization (WHO) recommends to stop procurement and to suspend use in countries of all lots of the Shan5 vaccine produced by Shantha Biotechnics, India pending ongoing investigations regarding white sediment apparent on vaccine vial walls that cannot be resuspended through shaking. Countries are advised to put any remaining vaccine in quarantine until further notice. If it is confirmed that the country has received shipments of any lot of Shan5 vaccine, the vaccine should not be used, but kept under recommended storage conditions, clearly marked ‘QUARANTINED; NOT TO BE USED OR DISTRIBUTED’ until further direction is provided by WHO. WHO recommends that countries continue vaccination using pentavalent vaccine from an alternative manufacturer or an alternate DTP-containing vaccine until further notice. Countries may contact WHO and UNICEF country offices for assistance to fill shortfalls in vaccine supply as a result of the temporary suspension. For more information please see the Joint WHO-UNICEF Statement.

Technical Information

RECOMMENDATIONS ON USE OF ROTARIX VACCINE 31/03/2010 from Alison Brunier WHO/HQ: In early February, GSK Biologicals was informed by a research team based in the United States of America of their discovery of the presence of DNA fragments of a porcine circovirus (PCV1) in two batches of the GSK vaccine, Rotarix, during a study using a new technology for detecting viral genetic material. WHO, following announcements on 22 March by the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMA) regarding continued use of the vaccine, issued a statement on its web site http://www.who.int/immunization/newsroom/news_rotavirus_vaccine_use/en/index.html encouraging all countries using Rotarix to carefully consider the significant benefits of continued use in any decisions about further use. WHO indicated its concurrence with the views of the FDA and EMA that the findings do not present a threat to public health and did not recommend any change in use of the vaccine. Rotarix is prequalified by WHO, and the prequalification status remains unchanged. The Global Advisory Committee on Vaccine Safety (GACVS) considered the issue during a teleconference on 25 March. Following review of the safety data from both clinical trials and spontaneous reports, GACVS concluded - in a statement posted on its web site on 26 March - that "the benefits of vaccination far outweigh any currently known risk associated with use of Rotarix." WHO will continue to work closely with the FDA , EMA and other regulatory agencies to evaluate further information that the manufacturer has been asked to provide as a matter of urgency.

World Health Organization

31 March 2010 Global Immunization News

Global Immunization News

Inside this issue:

New publication - technical and commer-cial feasibility of stabi-lizing vaccines

2

Building Up HPV Labo-ratory Testing Capacity

2

Update to WHO posi-tion paper on cholera vaccines

3

THE SIVAC INITIATIVE 3

Meningitis Vaccine Project Meeting

4

Update from Sabin Vaccine Institute

4

Call for Nominations- WHO Immunization Practices Advisory Committee (IPAC)

5

GAVI related informa-tion

5-6

Regional Information—Africa

6-8

Regional Information—Americas

9

Regional Information— Eastern Mediterra-nean

10

Regional Information—Europe

11

Regional Information—Western Pacific

12

Regional Meetings & Key Events

13

Related Links 14

http://www.who.int/immunization_standards/vaccine_quality/shan5_suspension_12_march_10.pdf

http://www.who.int/vaccine_safety/topics/rotavirus/rotarix_statement_march_2010/en/index.html

NEW PUBLICATION HIGHLIGHTS KEY FINDINGS ON THE TECHNICAL AND COMMERCIAL FEASIBILITY OF STABILIZING VACCINES 31/03/2010 from Amy Wales, PATH: In an editorial published in the March issue of Human Vaccines, PATH reflects on nearly eight years of work to optimize the heat- and freeze-stability of seven types of vaccines with 33 collaborators. PATH also explores the key logistical, regulatory, procurement, and policy issues associated with the development and use of stabilized vaccines. See: http://bit.ly/b8ULlC

WHO PROVIDES TECHNICAL SUPPORT TO COUNTRIES IN BUILDING UP HPV LABORATORY TESTING CAPACITY TO SUPPORT HPV SURVEILLANCE 31/03/2010 from TieQun Zhou, WHO/HQ: HPV laboratory surveillance and vaccination impact monitoring is a critical element in the process of HPV vaccine introduction. WHO established the HPV LabNet to harmonize and standardize laboratory testing procedures to support consistent laboratory evaluation of regional disease burden and monitor the performance of HPV vaccines (http://www.who.int/biologicals/vaccines/hpv/en/index.html). Significant progress has been made in the area of standardization of HPV laboratory testing to promote international harmonization including development of international standards, evaluation and standardization of HPV assays, development of Quality Assurance (QA)/Quality Control (QC) scheme, capacity building and training. Requests for technical support on HPV laboratory testing have been received from countries. In response to requests, WHO/HQ organized the WHO HPV LabNet Training Workshop on HPV Genotyping and HPV Serology Laboratory Performance, at the Institute of Microbiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland on 15-18 March 2010. The main objectives of the meeting were to provide training on basic/general knowledge of HPV biology and vaccines; the concept of international standardization; theoretical knowledge and practical performance of HPV genotyping and serology assays; principles and knowledge of HPV laboratory QA/QC; andto share experience of WHO HPV LabNet. The workshop was attended by 15 participants from 12 countries. The trainees were nominated by WHO Regional Offices and from countries who are active in HPV laboratory testing to support HPV surveillance, namely Argentina, India, Iran, Italy, Morocco, Republic of Korea, Uganda. They were trained on all aspects involved in HPV laboratory testing, and on laboratory performance of proficient HPV genotyping and serology assays verified by the WHO HPV LabNet. A comprehensive HPV Laboratory Manual (to be published) and critical materials were provided to participants to take back to help them set up new assays. Participants regarded this training as very informative, helpful and in good timing when they are setting up the HPV laboratory testing capacity in the countries to support HPV epidemiological studies. Implementing good performance of HPV laboratory testing and international standardization will ensure that proficient and standardized assays are used in HPV epidemiological studies and reliable data are generated to promote international harmonization of HPV laboratory testing and comparability of data cross different laboratories. It is anticipated that participants will be able to assist the HPV LabNet Regional Reference Laboratories to provide technical support to other laboratories in the respective Region, when such need is identified.



The information contained in this Newsletter depends upon your contributions

Please send inputs for inclusion to:

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“Introducing new vaccines and technologies”

“Immunizing in the context of global independence”

http://bit.ly/b8ULlC

http://www.who.int/biologicals/vaccines/hpv/en/index.html




mailto:[email protected]

UPDATE TO WHO POSITION PAPER ON CHOLERA VACCINES 31/03/2010 from Alison Brunier, WHO/HQ: An update to the WHO position paper on cholera vaccines (first published in 2001) was published in the WHO Weekly Epidemiological Record on 26 March 2010. Given the availability of two oral cholera vaccines and data on their efficacy, field-effectiveness and feasibility, these vaccines should be used, in conjunction with other prevention and control strategies, in areas where the disease is endemic. Use of the vaccines should also be considered in areas at risk for outbreaks. Both vaccines have been shown to provide protection of > 50% lasting for two years in endemic situations. One, Dukoral, has been shown to provide high short-term protection in all age groups at 4-6 months following vaccination, and also provides short-term protection against Enterotoxigenic Escherichia coli. The other, licensed as mORCVAX in Viet Nam and as Shanchol in India, has shown longer-term protection in children under five-years, does not require water for administration, requires less storage space and is less expensive to produce. Cholera is a disease of poverty, and is closely linked to poor sanitation and lack of clean drinking water. In the majority of cases, it is characterized by acute, profuse watery diarrhoea of one or a few days’ duration. In its extreme form, it is one of the most rapidly fatal infectious diseases known. The global disease burden is estimated to be 3–5 million cases and 100 000–130 000 deaths per year, with the disease affecting both children and adults. During the last years, protracted outbreaks have occurred in Angola, Ethiopia, Somalia, Sudan and northern Viet Nam. An epidemic in Zimbabwe lasted nearly a year and spread throughout the country (with over 98 000 cases including over 4 000 deaths as at end July 2009) and to neighbouring Zambia and South Africa. Vaccination should be implemented as part of a comprehensive programme to prevent and control cholera. The programme should also include appropriate treatment for people with cholera (primarily prompt rehydration), and water quality and sanitation improvements. The revised position paper in English and French, together with background material, can be downloaded here. Arabic, Chinese, Russian and Spanish translations will be available at the same link in due course.





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“Integrating Immunization, other linked health interventions and surveillance in the health systems context”

THE SIVAC INITIATIVE 31/03/2010 from Kamel Senouci, AMP / SIVAC Initiative: A significant milestone was achieved in December 2009 when Côte d’Ivoire’s Ministry of Health created the “Comité National d’Experts Indépendants pour la Vaccination et les Vaccins de la Côte d’Ivoire” (CNEIV-CI). The CNEIV-CI is the first National Immunization Technical Advisory Group (NITAG) in a GAVI-eligible African country (read the press release). The committee will play an important role in providing recommendations for shaping immunization policies and strategies in Côte d’Ivoire. Above all, it will serve as a model for other states committed to developing sustainable and effective NITAGs. The CNEIV-CI’s first technical meeting, held on 12 March 2010, served to establish the agenda for 2010. A representative from the WHO country office provided the WHO perspective as a liaison member. Another recent highlight was a SIVAC workshop, held in Paris from 21-22 January 2010. The event brought together 35 representatives from existing NITAGs, countries seeking to establish NITAGs, WHO headquarters and regional offices, the US Centers for Disease Control and Prevention (CDC), the London School of Hygiene & Tropical Medicine (LSHTM), the Kenya Medical Research Institute (KEMRI), PATH, and the West African Health Organization (WAHO). During the workshop, participants identified the needs of the NITAG scientific and technical secretariat as well as those of committee members. They also determined the specifications of the future NITAG Resource Center—a collaborative online tool that will provide relevant information, tools, and resources to members of NITAGs and the global immunization community. The goal of the resource center is to enhance the use of evidence-based decision making for immunization and vaccines. For more information, please visit the SIVAC website

Credit: WHO/C.-L. Chaignat

http://www.who.int/immunization/documents/positionpapers/en/index.html


http://www.prnewswire.com/news-releases/amp-supports-the-creation-of-a-national-immunization-technical-advisory-group-in-cote-divoire-82589672.html

http://www.sivacinitiative.org/

UPDATE FROM SABIN VACCINE INSTITUTE 31/03/2010 from Sandra Keller, Sabin Vaccine Institute: As of March 2010, the Sabin Vaccine Institute’s Sustainable Immunization Financing Programme is active in all of its 15 pilot countries. Eleven countries have participated in SVI-sponsored parliamentary briefings; four have hosted two or more briefings. These events have opened new dialogues among governments, parliaments and external partners about long-term immunization financing. Acting as a facilitator, the SIF Programme frames immunization financing as a capacity-building exercise. EPI managers have responded by reporting budget and finance indicators, along with technical performance indicators, to make investment cases for their programmes. In the briefings, the managers present their cases to members of parliament who sit on budget and health committees and to ministry of finance counterparts. The aim is to induce the three national institutions to act together in new ways to increase immunization budgets based on demonstrated performance. A second aim is to increase popular participation in immunization by attracting new stakeholders, particularly from the domestic private sector, and educating the public about the programs.



MENINGITIS VACCINE PROJECT MEETING: VACCINE DEVELOPMENT FROM BENCH TO LICENSURE TOWARDS LARGE SCALE INTRODUCTION OF A MENINGOCOCCAL A CONJUGATE VACCINE FOR THE AFRICAN MENINGITIS BELT 31/03/2010 from Marie-Pierre Preziosi, WHO/HQ: A meeting was convened in Pune, India on 10-12 February 2010 by the Meningitis Vaccine Project, a partnership between WHO and PATH, and its associates in the development of an affordable meningococcal A conjugate vaccine for the African meningitis belt. The Conference, hosted by Serum Institute of India Ltd, was organized by Fondation Mérieux, PATH and WHO, and was also supported by the Research Council of Norway and the United States Agency for International Development. The workshop was attended by over a hundred scientists, public health officials and experts from Africa, India, North America and Europe and provided a unique forum for all MVP partners to review salient experiences and results, to share knowledge and expertise and to identify strengths and lessons learned that could benefit similar projects, while enhancing capacities in a dynamic group of African and Indian investigators. The workshop was launched with a tribute to Dr Charles Mérieux by his son Dr Alain Merieux that highlighted Charles Merieux’s extraordinary contributions in the development and widespread use of meningococcal vaccines in the 1970s to control large epidemics in Latin America. Professor Francis Nkrumah’s keynote address summarized the scope of and the importance of epidemic meningococcal meningitis in Africa. Subsequent presentations and discussions reviewed the entire development of a new Group A meningococcal conjugate vaccine from the conjugation technology, pharmaceutical development and production scale up, through the clinical development and closed with discussions of proposed vaccine introduction strategies, including the linked meningococcal carriage studies in the African belt. The meeting report will be published in the coming months. More information on the meeting; More information on the Meningitis Vaccine Project and the African Meningococcal Carriage Consortium.

Participants at the Meningitis Vaccine Project Meeting 10-12 February 2010



[email protected]

“Protecting more people in a changing world”

http://www.who.int/vaccine_research/%20and%20http:/www.fondation-merieux.org/

http://www.meningvax.org/

http://www.menafricar.org/


CALL FOR NOMINATIONS- WHO IMMUNIZATION PRACTICES ADVISORY COMMITTEE (IPAC) 31/03/2010 from Simona Zipursky, PATH and Rudi Eggers, WHO/HQ: The Immunization Practices Advisory Committee (IPAC), established in 2010 by WHO, will support and advise the Director of Immunization, Vaccines and Biologicals (IVB), with the review and/or formulation of immunization practices, operational standards, tools and technologies to strengthen and improve the delivery of immunization programmes at the country level in order to realize the Global Immunization Vision and Strategies (GIVS) goals. IPAC members will be selected following a broad and public call for nominations, which will open at the end of March 2010. To be considered as an IPAC member, individuals must be recognized experts in the field of immunization. Candidates for membership can be either nominated or self-apply. The membership of IPAC seeks to reflect a representation of the following: 1. Areas of expertise: programme management, logistics and vaccine management, information

systems, programme strategic design, monitoring and evaluation, systems strengthening. 2. Professional affiliation: academics, medical professionals, governmental or non governmental

organizations, public health specialists, clinical practitioners. 3. Geographic representation and gender balance: all efforts will be made to ensure equitable

geographic and gender balance. Please note the Call for Nominations will be released shortly, no later than the end of March, 2010. More information





[email protected]


GAVI related Information

GAVI ALLIANCE HIGH-LEVEL MEETING ON FINANCING COUNTRY DEMAND, 25-26 MARCH 2010, THE HAGUE, NETHERLANDS 31/03/2010 from Arian Leroy, GAVI: At an unprecedented High-level Meeting on Financing Country Demand in The Hague, GAVI’s partners, donors and some potential donors, noted the need for US$ 2.6 billion on top of current and expected donor commitments, in order to achieve GAVI’s goals by 2015. GAVI challenged donors to make a strong impact on Millennium Development Goal 4 to reduce child mortality by investing in immunization in the world’s poorest countries. While current levels of funding will allow the Alliance to sustain commitments of the Board, a further US$ 2.6 billion over six years will be required to allow the introduction of pneumococcal and rotavirus vaccines, the complete roll out of pentavalent vaccine and the advancement of new vaccines: HPV, Japanese Encephalitis, Epidemic meningitis, rubella and typhoid. With full funding, GAVI can save the lives of 4.2 million children in developing countries, preventing deaths from diseases such as hepatitis B, diphtheria, tetanus, whooping cough and Haemophilus influenzae type b, but mainly from pneumococcal disease and rotavirus diarrhoea which are among the biggest child killers of children in developing countries. The meeting took place back to back with the First Meeting of the Third Voluntary Replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria. On this occasion, the GAVI Alliance and the Global Fund held a joint session on Health System Strengthening and Aid Effectiveness. Papers produced for the GAVI Alliance High-Level Meeting on Financing Country Demand, include: Investing in immunization through the GAVI Alliance: the evidence base Financing Country Demand for accelerated access to new and underused vaccines 2010-2015 These publications and additional information about the event on can be found here.

http://www.who.int/entity/immunization_delivery/systems_policy/ipac/en/


http://www.gavialliance.org/media_centre/press_releases/2010_03_22_the_hague_media_advisory.php




[email protected]


GAVI related Information

Next GAVI Review Dates: Information on 2010 GAVI submission and review dates to be confirmed.

GLAXOSMITHKLINE (GSK) AND PFIZER INC. COMMIT TO AMC FOR PNEUMOCOCCAL VACCINES 31/03/2010 from Arian Leroy, GAVI: On 23 March, GAVI announced that agreements have been reached with major pharmaceutical companies, GlaxoSmithKline (GSK) and Pfizer Inc., to supply life-saving vaccines for the world’s poorest countries through the Advance Market Commitment (AMC) against pneumococcal disease, one of the world’s largest killer of children under five. The supply agreements were made possible thanks to the innovative financing mechanism piloted by the GAVI Alliance. The governments of Italy, the United Kingdom, Canada, Russia, Norway and the Bill & Melinda Gates Foundation committed US$1.5 billion to launch the programme. GSK and Pfizer Inc. have committed to supply 30 million doses each for a 10 year period and at a fraction of the price currently sold in industrialised countries. These vaccines may be available as early as this year. The Pneumococcal AMC could help prevent up to 900,000 million deaths by 2015, thus significantly contributing to reaching MDG4. More information

Country Information by Region AFRICAN REGION:

EPI MANAGERS MEETING AFRO WEST 15-17 MARCH 2010 31/03/2009 from Auguste Ambendet, WHO/AFRO: The sub-regional Working Group for Africa West and Central Africa met on 18 March in Ouagadougou, Burkina Faso after the EPI managers meeting on 15-17 March 2010. On the agenda was strengthening routine EPI, sharing of successful experiences, the financing of health systems through existing funds and to review recommendations from the EPI manager's meeting. The President of the Working Group reported on main activities, including the high level advocacy mission in Guinea Bissau, which received a very favorable response. Current issues were also reviewed including immunization date quality, integrated programmes, and health systems strengthening to improve vaccination coverage. Another issue raised was the new platform for health financing which will be made available by the World Bank, GAVI and the Global Fund. The working group is an instrument in place to promote joint activities for strengthening countries to improve EPI performance in West and Central Africa.

HIB INTRODUCTION IN EAST AND SOUTHERN AFRICA, 2010 31/03/2009 from Mutale Mumba, WHO/AFRO Seychelles and Botswana, the remaining two out of eighteen countries to introduce the Hib vaccine, were supported by WHO/IST to prepare introduction plans in December 2009 and January 2010 respectively. Seychelles has set June 2010 for introduction while Botswana plans to introduce in July 2010.


http://www.gavialliance.org/media_centre/press_releases/2010_03_23_amc_commitment.php

HSS= Health Systems Strengthening; IST = Inter Country Support Team; ISS = Immunization Services Support; INS = Injection Safety Support; NVS = New Vaccine Support; DQA = Data Quality Audit; DQS = Data Quality Self Assessment; RED = Reach Every District; cMYP = Fully costed multi-year plan; NITAG = National Immunization Technical Advisory Group; NRA = National Regulatory Authority

Country Information by Region


AFRICA UNITES AGAINST POLIO 31/03/2010 from Rod Curtis, WHO/HQ: In a massive example of cross-border cooperation, more than 85 million children in 19 countries across Africa are being vaccinated with oral polio vaccine in repeated immunization campaigns to end a year-long poliovirus epidemic across west Africa. Sixteen countries took part in the first high-profile synchronized campaign from 6 March, with new standardized monitoring data showing the campaigns were of varying quality. A Short-Interval Additional Dose campaign was held from 24 March in countries where either polio transmission continues or they remain at high risk of importation: Burkina Faso, Guinea, Liberia, Mauritania, Senegal and Sierra Leone. On 24 April, 400,000 immunizers will again go door-to-door to every single dwelling across 19 countries to find children under five to immunize with two drops of oral polio vaccine in a final attempt to end this outbreak, which first spread from northern Nigeria in 2008. The first synchronized round in March witnessed strong political commitment, with four Presidents, two Prime Ministers, a First Lady, and seven Ministers launching the campaigns throughout the countries. The strong engagement of traditional and provincial leaders was also a feature of this campaign. Of particular note, UNICEF Goodwill Ambassador Mia Farrow and UNICEF WCAR Regional Director Gianfranco Rotigliano travelled to Chad for a week-long awareness campaign ahead of the immunization activity. At the official launch, the President of Chad, His Excellency Idriss Deby Itno, declared "war on polio" and called on Provincial Governors, Health Ministry Officials, traditional chiefs and the military to be vigilant and to "rise up as one person and contribute to successful vaccination". The 6 March campaign was made possible by US$ 30 million in extraordinary funding released by Rotary International, a spearheading partner in the global effort to stop polio. The Bill & Melinda Gates Foundation will be principal funder of the 24 April campaigns. At the start of 2010, seven countries in west Africa are considered to have active outbreaks of polio (i.e. cases within the last six months): Burkina Faso, Guinea, Liberia, Mali, Mauritania, Senegal and Sierra Leone. As of 23 March, only four countries in Africa have reported wild poliovirus cases: Senegal, Mauritania, Chad and Nigeria.



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AFRICAN REGION:

The President of Chad, His Excellency Idriss Deby Itno, immunizes a child at the launch of Chad's national polio immuniza-tion campaign, which was synchro-nized with 15 other countries across Africa from 6 March. Photo: N. Jonas/WHO Chad





RWG MEETING, WINDHOEK, NAMIBIA, 2-3 MARCH 2010 31/03/2009 from Mutale Mumba, WHO/AFRO: The Regional Working Group for East and Southern Africa held its first biannual meeting in Windhoek, Namibia, on 2-3 March 2010. This meeting was attended by WHO/IST, WHO/HQ, UNICEF ESARO, American Red Cross, JSI Kenya, Sabin Vaccine Institute, MOH/EPI Namibia, WHO Namibia, and UNICEF Namibia. The meeting was graced by the UNICEF and WHO Representatives in Namibia. The Working Group reviewed EPI performance during 2009, discussed GAVI related issues and recent developments, provided updates on cold chain issues at global level and discussed the challenges facing countries in the block, and reviewed programme planning and financing. At the end of the two-day meeting, the Working Group highlighted important issues for possible consideration by the GAVI Alliance and partners, harmonized mission plans and made key recommendations to partners and countries in the sub-region.



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AFRICAN REGION:

EPI MANAGERS’ MEETING, MAPUTO, MOZAMBIQUE, 10-12 MARCH 2010 31/03/2009 from Mutale Mumba, WHO/AFRO: The IST East & Southern Africa and UNICEF ESARO held the annual EPI Managers’ Meeting in Maputo, Mozambique. The meeting was attended by EPI Managers, WHO EPI Officers, and UNICEF EPI Officers, from countries in the sub-region. Directors of Public Health from selected countries also participated. From the WHO/IST level, representatives from Child and Adolescent Health participated in the meeting as well. A number of partners were also in attendance including AFRO, WHO/HQ, PATH, GAVI Alliance Secretariat, CDC, USAID/MCHIP, USAID/JSI and NESI Belgium while the Task Force on Immunization in Africa was represented at the meeting for the first time. The main objective of the meeting was to provide a forum for technical orientation and exchange of experiences between countries in the East and Southern African sub-region and partners. The meeting was officially opened by Dr. Paulo Ivo Garrido, the Honourable Minister of Health in Mozambique. This annual forum took stock of performance of countries in 2009, provided key programme updates, and agreed on programme priorities for 2010 and made key recommendations to strengthen national immunization programmes.

SURVAC MEETING, YAOUNDÉ, CAMEROUN 9-12 MARCH 2010 31/03/2009 from Carsten Mantel, WHO/HQ: The SURVAC (Central African Surveillance Project) Project Management Team (PMT) met in Yaoundé, Cameroun from 9 to12 March to finalize the 2010 surveillance action plans for the three participating countries Cameroun, the Central African Republic(CAR) and the Democratic Republic of Congo (DRC). Assisted by PMT members, country participants worked for two days on the consolidation of the national project plans of action, the identification of additional priority activities, the revision of budgets in view of available funding and the country coordinating and monitoring mechanisms. Agreement on these plans was obtained from high-level MoH representatives of the three countries and the SURVAC project implementation phase was officially launched during a ceremony attended by the Minister of Health and the Minister of Family and Women's Affairs of Cameroun as well as the MOH Multisectoral Counsellor of DRC and the MOH Cabinet Director of CAR on 10 March. The PMT met thereafter for another two days to revise the overall project plan in view of the country plans of action, to fine tune timelines in view of project milestones and to discuss overall project management issues.


AMERICAS: 31/03/2010 from Beatrice Carpano and Carolina Danovaro, WHO PAHO:




SYSTEMATIC DOCUMENTATION OF THE PROCESS AND COST OF THE NEW VACCINE INTRODUCTION IN THE REGION OF THE AMERICAS: ROTAVIRUS AND PNEUMOCOCCUS The introduction of the rotavirus and pneumococcus vaccines in the Region of the Americas has resulted in considerable accumulated knowledge regarding processes and cost of vaccine implementation. In November 2009, with the goal of sharing learned lessons with decision-makers and health professionals in other countries and regions of the world, PAHO planned a systematic documentation of the process and the cost of rotavirus and pneumococcus vaccine introduction in the following five countries: Bolivia, Brazil, Mexico, Nicaragua, and Peru. The documentation process will include the completion of questionnaires through interviews with key professionals from the EPI, epidemiological surveillance, communication-mobilization, and other staff from Ministries of Health. The interviews will take place in Washington, D.C., in country, or by telephone conference. PAHO is currently reviewing all materials and documents to prepare the questionnaires. The documentation process will end in November 2010 with publication in the Pan American Journal of Public Health. PROVAC WORKSHOP ON THE ESSENTIAL COMPONENTS OF A COST-EFFECTIVENESS ANALYSIS: THE CASE OF THE ROTAVIRUS VACCINE The fourth Regional ProVac meeting was convened in Managua, Nicaragua, on 2 to 3 March 2010, with 90 participants from 19 countries of the Latin America and Caribbean. ProVac’s goal is to enhance national capacity to make evidence-based decisions regarding new vaccine introduction. The main purpose of this workshop was for participants to understand the main components of a cost-effectiveness analysis and discuss possible sources of data, using rotavirus vaccine as an example. Multidisciplinary country teams were formed by the PAHO focal point, the EPI manager, a health economist, and the surveillance manager for new vaccines. Representatives from the following organizations participated in the workshop: Ministries of Health, the U.S. Center for Disease Control and Prevention, the Canadian Public Health Association, SIVAC Initiative, Harvard University, the London School of Hygiene and Tropical Medicine, and the University of Medicine and Dentistry of New Jersey. In addition, the first meeting of the ProVac Network of Centers of Excellence took place on 1 March 2010. The participating centers are the University of São Paulo, the State University of Rio de Janeiro, the University of Cartagena, the National University of Colombia, the Institute of Clinical Effectiveness and Health Policy, and the National Institute of Public Health of Mexico. The methodology used for this workshop was a combination of plenary sessions and practical exercises. Each country team was provided with a computer loaded with the model and internet to access the ProVac e-Support Center. Participants were asked to think of possible local sources of data for each component of the model. The final session focused on country experiences using the ProVac cost-effectiveness model, challenges, and lessons learned.



[email protected]






THE FIRST VACCINATION WEEK IN THE EASTERN MEDITERRANEAN 31/03/2010 from Nahad Sadr-Azodi, WHO/EMRO The WHO Regional Office for the Eastern Mediterranean (EMRO) is in the final stage of preparations for the first Vaccination Week initiative which will take place during the week of 24 to 30 April 2010. It will coincide with similar endeavors established in two other WHO regions Vaccination Week in the Americas and European Immunization Week. WHO/EMRO is pleased to announce that 100% of countries in the region will be participating in this initiative. The vaccination Week in the Eastern Mediterranean provides a unique opportunity to revive the Region's commitment and increase public awareness on the importance of immunization through advocacy, education and communication. A variety of activities will be carried out during the week including outreach, campaigns, workshops, training sessions, social mobilization, round tables, exhibitions and media events addressing a wide range of vaccine-related issues. The target audiences for these activities include parents, caregivers, health workers, mass media, decision-makers and stakeholders. For more information and access to the design solutions, advocacy materials, technical documents and country action plans, please visit the EMRO website.

EASTERN MEDITERRANEAN REGION:

THE EASTERN MEDITERRANEAN REGION CONDUCTED A FIELD TEST IN BAHRAIN OF THE REGIONAL GUIDELINES OF THE VALIDATION OF MEASLES ELIMINATION 31/03/2010 from Dr. Boubker Naouri, WHO/EMRO In 2008, EMRO developed guidelines for the validation of measles elimination at country level and in the region. These guidelines, still in draft form, needed to be field tested to evaluate the data collection tools that will be used to document measles elimination by 2010. The Kingdom of Bahrain was selected for this field test because data show that Bahrain is close to measles elimination in the presence of a well performing surveillance system. This field test, conducted from 13 to 19 March 2010 used in-depth reviews with EPI/Surveillance/Laboratory staff, desk reviews and field visits (Private hospitals and health centers). The finding of this field test showed that overall, Bahrain has a measles elimination program that responds well to the criteria and indicators of measles elimination. Bahrain has successfully implemented the measles elimination strategies: reaching a high measles coverage above 95% nationwide and in all health centers catchment areas, and implementing a nationwide high performing measles case-based surveillance supported by a WHO accredited National Measles Laboratory. This is the last field tested to be conducted for these guidelines. Four other tests were conducted in Jordan, Syria, Iran and Oman. These guidelines will be finalized by the end of 2010.

WHO and Bahrain Team who con-ducted the Field Test in Bahrain

http://www.emro.who.int/vpi/vwem




EUROPEAN REGION: 31/03/2010 from Liudmila Mosina, WHO/EURO:

BUILDING COUNTRIES’ CAPACITY IN MULTI-YEAR PLANNING ON IMMUNIZATION The WHO Regional Office for Europe (EURO) continues to support low and middle income countries in building capacity for immunization programme planning. WHO EURO hosts a Regional workshop on updating comprehensive multi-year plans (cMYP) on immunization from 29 to 31 March 2010 in Copenhagen, Denmark. Expected participants in the workshop included immunization programme personnel from seven countries of the Region (ARM, AZE, GEO, MDA, KGZ, TJK and UZB), as well as WHO headquarters experts and GAVI representatives. The workshop presents an opportunity to discuss and revise countries’ multi-year plans on immunization for the period 2011-2015 and provides training and technical assistance with developing the financial components of the plans. WHO EURO anticipates that participants in this workshop will improve their skills in comprehensive multi-year planning; gain a better understanding of revised GAVI policy; and exchange information and experiences in the implementation of GAVI supported programmes. EUROPEAN IMMUNIZATION WEEK 2010 The fifth European Immunization Week (EIW) will take place 24 April to 1 May 2010 and will focus on the Regional goal of eliminating measles and rubella by the end of the year. With a few weeks to go before the initiative launches, more than 40 countries have committed to participating in EIW 2010, the largest number of participants since EIW’s inception in 2005. This broad participation reflects a Region-wide commitment to increasing vaccination coverage and preventing the spread of vaccine-preventable diseases. The WHO Regional Office for Europe will officially launch EIW via video conference and webcast on the morning of Monday 26 April 2010, and EIW activities will take place across the European Region throughout this week. An exciting, new EIW online network will offer real-time updates on immunization-related activities in the participating countries and will allow EIW participants to interact and connect via the Internet. Based on the level of participation and the variety and quality of planned activities, EIW 2010 looks poised to build on and even surpass the success of the previous four European Immunization Weeks. More information about EIW 2010 is available at www.euro.who.int/eiw, including a link to the EIW online network. Please do not hesitate to get in touch with questions or issues regarding EIW 2010 by contacting [email protected].



[email protected]

http://www.euro.who.int/eiw






SECOND MEETING ON VACCINE PREVENTABLE DISEASES (VPD) LABORATORY NETWORKS IN THE WESTERN PACIFIC REGION A meeting of regional laboratory networks for polio, measles and Japanese encephalitis (JE) was organized from 22 to 26 February 2010 to review the performance and identify challenges of polio and measles/rubella and JE network laboratories in the Region. Strengthening communications between network laboratories and EPI/surveillance programmes and overall data management emerged as two common themes across all lab networks. The key recommendations for the polio lab network included implementation of a new algorithm for polio virus isolation and use of a new real time PCR method for intratypic differentiation, vaccine-derived polioviruses (VDPV) screening to reduce the laboratory reporting time, and timely sharing of cell sensitivity testing results. Implementation of confirmatory testing mechanism, initiation of accreditation using the WHO JE lab checklist were some of recommendations made for the JE lab network. The measles lab network needs to implement recommendations for confirmatory testing, obtain more genotyping information and strengthen strain surveillance, and improve the quality assurance in commercial labs. WPRO will closely follow up with network laboratories to monitor the implementation of recommendations with 3rd VPD Labnet meeting planned in 2011.

VACCINE INDEPENDENCE INITIATIVE (VII) IN THE PACIFIC ISLAND COUNTRIES : WHO-HQ , UNICEF SD AND UNICEF RO (BANGKOK) ON A JOINT MISSION TO FIJI IN MARCH 2010. 31/03/2010 from Miloud Kaddar, WHO/HQ: With support from UNICEF Pacific Region Office and WHO South Pacific Office a team conducted an evaluation of the Vaccine Independence Initiative utilized by 13 Pacific Island Countries (PIC) . The global VII mechanism is under review by UNICEF and a decision could be made at its board meeting in August 2010 on the future continuation of this mechanism both for PIC and for the eight other countries utilizing this service. The PIC have actively utilised the VII mechanism since 1995 as a system to support pooled procurement in the sub-region; donors and stakeholders are very supportive of the mechanism. The 13 countries have clearly expressed the view that the mechanism is of significant benefit to the National EPI programmes and they strongly support its continuation. The PIC are characterised by isolated small populations with considerable delivery and logistics challenges. Additionally, neighbouring larger countries (such as New Zealand and Australia) utilise different vaccines and presentations; the countries therefore have no possibility of manufacturing vaccines, procuring from neighbours or of obtaining secure supply of vaccines at an affordable price in the open market. The chief recommendations from the mission were that the VII mechanism is functioning well for the PIC and there is considerable support for its continuance. If the VII mechanism were to globally discontinue then an alternative mechanism including a revolving fund facility, pooled forecasting, ordering and payment management would need to be put in place for these countries. Such a alternative mechanism is not immediately available to these countries. In order to maintain supply security of the EPI programmes the current system could only be phased out over a period following consultation with all participating countries and considerable capacity building activities to allow for the development of an appropriate new system. If the current PIC VII mechanism is to continue there are improvements that could be made. These will require technical support from both WHO and UNICEF, high level country commitment, capacity building within countries, increased analysis, monitoring and reporting supported by partners. A workshop involving all countries is to be planned and could be a starting point in implementing the mission recommendations.

WESTERN PACIFIC REGION 31/03/2010 from Manju Rani, WHO/WPRO:


Regional Meetings & Key Events Related to Immunization Title of Meeting Start Finish Location Region

2010 Meetings Effective Vaccine Management (EVM) Global Training Course 04-Apr 11-Apr TBC Global

Rubella Consultation 11-Apr 13-Apr Cairo, Egypt EMRO

Strategic Advisory Group of Experts (SAGE) Meeting 13-Apr 15-Apr Geneva, Switzerland Global

Regional Consultation Committee EMRO 14-Apr 15-Apr Cairo, Egypt EMRO

Measles Lab training wshop on measles/rubella detection & sequencing 19-Apr 23-Apr Tunis, Tunisia EMRO

First Annual Immunization Week in the Eastern Mediterranean Region 24-Apr 29-Apr Regional EMRO

Annual Immunization Week in the Americas 24-Apr 01-May 120 PAHO

Annual Immunization Week in Europe 24-Apr 01-May Regional EURO

Consultant Briefing on Surveillance, Monitoring & Evaluation 25-Apr 29-Apr Alexandria, Egypt EMRO

Human Papillomavirus Vaccine Advisory Committee 27-Apr 29-Apr Geneva, Switzerland Global

2010 Albert B. Sabin Gold Medal Award 27-Apr 27-Apr Washington D.C., USA Global

Immunization Financing Workshop - National Association of Mayors (Sabin) 28-Apr 30-Apr Yaoundé, Cameroon Africa

First Parliamentary Briefing on Child Health & Sustainable Immunization Financing (Sabin) 30-Apr 30-Apr Phnom Penh, Cambodia Western Pacific

Pooled Vaccine Procurement Meeting (PVP) 04-May 06-May Cairo, Egypt EMRO

3rd Meeting with International Partners on Prospects for Influenza Vaccine Technology Transfer to DCVMN 05-May 06-May Nha Trang, Vietnam Global

IVR Vaccine Advisory Committee meeting 2010 11-May 12-May Geneva, Switzerland Global

International Technical Team to Review Country Data to Support Measles, Rubella, and CRS Elimination 23-May 24-May Brazil PAHO

International Technical Team to Review Country Data to Support Measles, Rubella, and CRS Elimination 26-May 28-May Argentina PAHO

EMRO EPI Managers Meeting & NTAG/RTAG 07-Jun 12-Jun Hamamat, Tunisia EMRO

First Meeting of the International Expert Committee to Verify Measles, Ru-bella, and CRS Elimination in the Americas 09-Jun 10-Jun Washington D.C., USA PAHO

Countdown to 2015 and Sustainable Immunization Financing (Sabin) 15-Jun 15-Jun Kathmandu, Nepal South East Asia

Global Advisory Committee on Vaccine Safety (GACVS) 16-Jun 17-Jun Geneva, Switzerland Global

Presentation of Progress Report on Rubella and CRS Elimination to Execu-tive Committee 21-Jun 25-Jun Washington D.C., USA PAHO

Global Meeting on Implementing New and Under-utilized Vaccines 23-Jun 25-Jun Montreux, Switzerland Global Immunization Practices Advisory Committee (IPAC) Meeting 29-Jun 30-Jun Geneva, Switzerland Global SEARO Regional Consultation on Immunization 19-Jul 23-Jul TBC SEARO

Global Technical Consultation on the Feasibility of Measles Eradication 28-Jul 30-Jul Washington D.C., USA PAHO

Regional Meeting on Mumps 23-Aug 27-Aug Washington D.C., USA PAHO

Global Consultation Meeting on Feasibility of measles eradication 06-Sep 09-Sep TBC Global

Global Measles/Rubella LabNet Meeting 20-Sep 23-Sep Geneva, Switzerland Global

Global Surveillance Meeting (TBC) Sep Sep Geneva, Switzerland Global

Regional workshop on Surveillance, Monitoring & Evaluation (8 Countries) 27-Sep 30-Sep Damascus, Syria EMRO

Regional Committee EMRO 03-Oct 06-Oct Cairo, Egypt EMRO

Regional Working Group meeting in East and South Africa 06-Oct 07-Oct Kigali, Rwanda AFRO QUIVER Meeting 12-Oct 14-Oct Geneva, Switzerland Global Global Alliance for Vaccine & Immunization (GAVI) / Regional Working Group (RWG) 18-Oct 20-Oct Sanaa, Yemen EMRO

New vaccines and surveillance meeting TBC TBC TBC WPRO Strategic Advisory Grop of Experts (SAGE) Meeting 09-Nov 11-Nov Geneva, Switzerland Global First Meeting of the Presidents of the National Commissions to Document and Verify Measles, Rubella, and CRS Elimination 10-Nov 11-Nov TBC PAHO

Malaria Vaccine Advisory Committee meeting 2010 22-Nov 24-Nov TBC Global

Measles, Rubella Meeting - Lab Meeting - RTAG 28-Nov 02-Dec Amman, Jordan EMRO

Global Advisory Committee on Vaccine Safety (GACVS) 08-Dec 09-Dec Geneva, Switzerland Global

Links Relevant to Immunization


Regional Websites New Vaccines in AFRO PAHO’s website for Immunization Vaccine Preventable Diseases in EURO New Vaccines in SEARO

Global Websites Department of Immunization, Vaccines & Biologicals, World Health Organization WHO New Vaccines Immunization Financing Immunization Monitoring Agence de Médecine Préventive EPIVAC GAVI Alliance Website IMMUNIZATION basics (JSI) International Vaccine Institute PATH Vaccine Resource Library Pediatric Dengue Vaccine Initiative SABIN Sustainable Immunization Financing SIVAC Program Website UNICEF Supply Division Website Hib Initiative Website Japanese Encephalitis Resources Malaria Vaccine Initiative Measles Initiative Meningitis Vaccine Project Multinational Influenza Seasonal Mortality Study (MISMS) RotaADIP RHO Cervical Cancer (HPV Vaccine) WHO/ICO Information Center on HPV and Cervical Cancer SIGN Updates Technet EPIVAC Network website

Newsletters PAHO/Comprehensive Family Immunization Program-FCH: Immunization Newsletter

Produced by WHO, in collaboration with UNICEF and the GAVI Alliance:

http://www.afro.who.int/newvaccines/

http://www.paho.org/english/ad/fch/im/Vaccines.htm

http://www.euro.who.int/vaccine

http://www.searo.who.int/en/section1226.asp

http://www.who.int/immunization/en/

http://www.who.int/nuvi

http://www.who.int/immunization_financing/en/

http://www.who.int/immunization_monitoring/en/

http://www.aamp.org

http://www.epivac.org

http://www.gavialliance.org/

http://www.immunizationbasics.jsi.com

http://www.ivi.int

http://www.path.org/vaccineresources

http://www.pdvi.org

http://www.sabin.org/sif

http://www.sivacinitiative.org/

http://www.unicef.org/supply/index_immunization.html

http://www.hibaction.org/

http://www.path.org/vaccineresources/japanese-encephalitis.php

http://www.malariavaccine.org

http://www.measlesinitiative.org/

http://www.meningvax.org/index.htm

http://origem.info/misms/index.php

http://www.rotavirusvaccine.org/

http://www.rho.org

http://www.who.int/hpvcentre/en/

http://www.who.int/injection_safety/sign/en/

http://www.technet21.org/

http://rie.epivac.org/accueil/

http://www.paho.org/english/ad/fch/im/Epi_newsletter.htm




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