Zimbabwe
Zambia
Yemen
Viet Nam
Uzbekistan
Ukraine
Uganda
Turkmenistan
Sudan
Sri Lanka
Somalia
Sierra Leone
Rwanda
Pakistan
Nigeria
Niger
Nepal
Myanmar
Mozambique
Mali
Malawi
Madagascar
Liberia
Lesotho
Kyrgyzstan
Kenya
Indonesia
India
Haiti
Guyana
Guinea
Ghana
Ethiopia
Djibouti
China
Chad
Central African Republic
Cameroon
Cambodia
Burkina Faso
Bhutan
Bangladesh
Azerbaijan
Armenia
Albania
Afghanistan
Yellow fever
Tetanus
Rotavirus
Rabies
Polio
Measles
Influenza
HIB
Hepatitis B
Post00278 GAVI GUIDELINES FORMS + VAX INTRO + UPDATES 20 September 2000
CONTENTS
1. REVISED GAVI APPLICATION FILES AVAILABLE FOR DOWNLOAD
2. WHO & ACCELERATED VACCINE INTRODUCTION
3. DOWNLOAD GUIDELINES AND FORMS: ASSESSMENT OF IMMUNIZATION SERVICES
4. GAVI & GFCV INFORMATION UPDATE 8 SEPTEMBER 2000
Moderators Note: Welcome to all subscribers!
The moderator is back from the field and beginning to catch up. This post
should have gone out a few weeks ago but field activities took priority.
Apologies!
* In the field I've seen the all too usual mix of unsafe injection
practices and frozen DPT vaccine. GAVI partners and grant applicants should
take note of the risks of not fully addressing these critical aspects of
immunization
systems.
Please send your contributions to: [[email protected]][email protected][/email]
The moderator will be on line for a long time now, and will deal with
subscriber email with the usual online promptness!
regards and best wishes,
allan
____________________________________*______________________________________
1. REVISED GAVI APPLICATION FILES AVAILABLE FOR DOWNLOAD
Go to the website
ftp://ftp.acithn.uq.edu.au/Technet/1-ClickHereForTECHNETfiles/GAVI/
GAVI-CVF-GuidelinesDirectivesAugust2kFRENCH.doc 462kb
GAVI-CVF-ProposalFormAugust2kFRENCH.doc 219kb
GAVI-Form Rev1august15.doc 195kb
GAVI-Form Rev1august15.doc.doc 195kb
GAVI-FormsRev1august15English.PDF 165kb
GAVI-GuidelineAugust2000-French.zip 165kb
GAVI-GuidelinesAugust2000English.zip 96kb
GAVI-GuidelinesRev1august15.doc 113kb
GAVI-GuidelinesRev1august15English.PDF 84kb
or send an email to: [[email protected]][email protected][/email] with the message:
get technet GAVI-GuidelineAugust2000-French.zip
get technet GAVI-GuidelinesAugust2000English.zip
Rev 1. 15 August 2000
Global Alliance for Vaccines and Immunization (GAVI )
and the
Global Fund for Children's Vaccines (The Fund)
Guidelines on Country Proposals for
Support to Immunization Services and New and Under-used Vaccines
1. Executive summary
* The Global Alliance for Vaccines and Immunization (GAVI) is hereby
inviting proposals from countries for support from the Global Fund for
Children's Vaccines (the Fund).
* National governments of countries with GNP/capita equal to or below
US$1,000 are eligible for support from the Fund, according to the non-
competitive terms outlined in this document.
* Current Fund resources have been budgeted to reach the objective of
providing all eligible countries with five years of funding support from
the start of funding of the country proposal. The Partners of the Alliance
recognise the need for sustained support and will work with countries to
find additional resources to improve immunization services that contribute
to better overall health systems. In addition, GAVI Partners are taking
steps to extend the Fund beyond five years to enable new vaccines that are
currently under development, to be introduced.
* GAVI will invite country proposals for support from the Fund in
successive rounds for the next two years. Closing dates for country
proposals for the next rounds will be 15 October 2000, 15 January 2001 and
1 April 2001. Further rounds will follow.
* The three basic conditions for support are: a functioning Inter-
agency Co-ordination Committee (ICC) or equivalent collaboration mechanism;
an assessment of immunization services during the three last years; and a
multi-year plan for immunization. Efforts to improve the safety of
immunization and to plan for sustainable financing of immunization also
need to be documented. It is anticipated that the role of national ICCs
will grow to provide support to governments in their immunization planning
and monitoring efforts.
* Currently the Fund provides support from two sub-accounts: for
immunization services and for new and under-used vaccines.
* Countries with DTP3 coverage below 80% will be considered for
funding from the sub-account for immunization services. A strict and
transparent system of performance monitoring with output indicators at
district level will be applied.
* Countries with DTP3 coverage above 50% will be considered for
support from the sub-account for new and under-used vaccines. In this
initial phase, vaccines for hepatitis B (hepB), Haemophilus influenzae type
b (Hib), and yellow fever will be available from the Fund, together with
related safe injection equipment.
* Countries with current DTP3 coverage below 50% that wish to
introduce the new vaccines are encouraged to initially focus on improving
their systems for delivering vaccines by seeking support from their country
Partners, and from the sub-account for immunization services.
* Country proposals should be developed in close consultation with
technical and financial Partners committed to health and immunization
programs, following the guidelines in this document and be forwarded to the
GAVI Secretariat on the enclosed form, with selected documentation
attached.
____________________________________*______________________________________
2. WHO & ACCELERATED VACCINE INTRODUCTION
From:
http://www.who.int/vaccines/aboutus/newweb/accelerated_vaccine_introduction.htm
Contributions, comments and additions please: [[email protected]][email protected][/email]
or use your reply button
___________________________________________________________________________
ACCELERATED VACCINE INTRODUCTION
Important vaccines, which could prevent millions of deaths a year, are not
being used in the developing world. In this project, the WHO Department
of Vaccines and Biologicals (V&B) will pursue a series of critical
activities to accelerate the introduction of specific vaccines, thereby
developing the infrastructure, capacity and collaborations necessary to
make new vaccine introduction an integral part of global immunization
practice. The ultimate goal is the timely introduction of vaccines of
public health importance into the developing world.
CHALLENGES
The biotechnology revolution is providing us with a number of new vaccines
to prevent infectious diseases. However, while these vaccines are being
rapidly adopted in the developed world, they are only slowly being
introduced into developing countries. The gap in protection provided by
vaccines between developed, and developing countries is widening. Several
major obstacles currently impede the rapid introduction of import vaccines
in developing countries.
2.1. Efficacy data on several new vaccines exists for developed, but not
for the developing world.
2.2. The burden of disease caused by certain infections is unknown in much
of the non-industrialized world.
2.3. The cost effectiveness of many vaccines is unclear for many regions
and countries
2.4. The demand for new vaccines, especially in the developing world, is
not well quantified, and thus supply may lag.
2.5. Recommendations for production and control of new vaccines are not
available.
2.6. Funding sources and funding mechanisms for additions to national
immunization programs are not available or have not been identified.
2.7. Plans to prioritize new vaccine introduction have not been developed
for several regions and most countries.
2.8. Technical assistance and guidelines for new vaccine introduction is
limited.
Failure to address these issues effectively will lead to further delays in
introduction of a series of vaccines. Four vaccines which either are
already available (hepatitis B and Haemophilus influenza type b) or will
soon be available (pneumococcal and rotavirus vaccines) can prevent between
three and four million deaths a year worldwide if used widely. Most of
these deaths occur in the developing world. Every year lost in
introduction directly leads to a staggering number of deaths.
STRATEGY
WHO's unique position enables it to influence new vaccine introduction at
several critical points. The goal of the project is to develop the
infrastructure necessary to facilitate introduction of new vaccines for
important public health problems into the developing world, thereby making
the process of introduction a routine part of immunization systems. An
effective infrastructure will be built to address critical problems along
the continuum of vaccine development and introduction. These include
activities in the following areas:
3.1. Coordinating vaccine development and implementation for developing
countries.
3.2. Establishing efficacy of new vaccines in developing country settings.
3.3. Clarifying disease burden and vaccine cost-effectiveness
3.4. Developing recommendations for the production and control of new
vaccines
3.5. Identifying and promoting new mechanisms and sources of financing.
3.6. Providing technical expertise to support regional and country planning
and introduction.
OBJECTIVES
The specific objectives of the project can be categorized within the
following strategic areas:
Coordination of vaccine development and implementation
Vaccine introduction requires the involvement of a wide range of partners,
including industry, international organizations, national immunization
personnel, and others. Global coordination of immunization efforts for
specific diseases will be effected in a collaborative process with
partners. For major new vaccines explicit agendas for action will be
developed.
4.2. Vaccine efficacy
Efficacy of pneumococcal conjugate vaccines for pneumonia morbidity and
mortality will be evaluated by 2003.
4.3. Disease burden and cost effectiveness
Disease burden estimates for pneumococcal, Hib, rotavirus and hepatitis b
will be available for use by regions and countries by 2000, and revised
estimates based on ongoing burden studies by 2002.
Cost effectiveness data and methods will be made available to regions and
countries for prioritization of vaccine needs by 2000.
4.4. Recommendations on production and control of Hib conjugate vaccines
will be available by 1999.
Recommendations on production and control of Hib conjugate vaccines will be
available by 1999.
The process of development of recommendations on pneumococcal will be
initiated by 1999.
Financing and supply
National vaccine supply plans will have been developed in 30% of all band
A and B countries by 2000.
New financing mechanisms will be in place in A and B band countries by
2000.
Hepatitis b vaccine will have been introduced in 40% of band A and B
countries with 70% coverage by 2000.
Hib conjugate vaccine will be introduced in five band A and B countries by
2000.
INTRODUCTION
Develop five and ten year prioritization plans for new vaccine introduction
(including hepatitis b, Hib, pneumococcus and rotavirus vaccines) for
regions by 2000, and countries by 2001.
Provide technical support to countries by:
developing generic introduction guidelines
developing introduction and financing plans
monitoring impact
Reaching out
New vaccine introduction requires action of a wide variety of partners in
immunization, including industry; international organizations such as
UNICEF, the World Bank, WHO and IVI; PATH; Bill and Melinda Gates
Children's Vaccine Program (CVP), national development agencies including
JICA; USAID, CIDA and others such as CDC. Most critically, the countries
involved must make the essential decisions to adopt, and implement
additional vaccines on a national level.
WHO will play both a coordinating role, and in the areas noted above,
provide technical input and guidance, but must work closely with its
partners if the ultimate goal of timely introduction of vaccines is to be
achieved.
____________________________________*______________________________________
3. DOWNLOAD GUIDELINES AND FORMS: ASSESSMENT OF IMMUNIZATION SERVICES
The Guidelines and Forms for the assessment of immunization services are
available for download on the web at:
http://www.who.int/vaccines-access/Restructuring/Vaccines/vaccinesindex.html
* If Technet Forum subscribers request copies via the Technet Forum, the
moderator will make them available via email and ftp. Please let us know!
Contributions, comments and additions please: [[email protected]][email protected][/email]
or use your reply button
___________________________________________________________________________
ASSESSMENT OF IMMUNIZATION SERVICES
PURPOSE OF THE GUIDELINES
The purpose of these guidelines is to describe a methodology for collecting
data on the strengths and weaknesses of immunization services, how they can
be improved, and how improvements can be sustained. These data can be used
in planning to:
Increase the accessibility and use of routine immunization services,
especially for people who are not now reached;
Improve the quality of immunization services;
Introduce new vaccines and new technologies in countries that have the
capacity to integrate them;
Ensure adequate and reliable financing of immunization services; and,
Support health system development.
Assessments carried out under these guidelines should provide sufficient
information to develop or update national plans or to prepare proposals for
securing the support of partners.
INTENDED USERS
The guidelines are primarily for:
National managers who are responsible for planning, implementing, and
evaluating immunization services.
Partners that provide financial, technical, or other assistance.
With adaptation, local health workers and sub-national staff can use them
for assessing day-to-day operations and resource management in their areas
of responsibility.
WHY THESE GUIDELINES ARE NEEDED
* The environment in which immunization services operate is changing.
Health system structure, the location of authority and responsibility, and
the mix of public and private participation are changing significantly in
many countries. The methodology proposed in these guidelines examines the
health system and the external environment in which immunization services
operate as well as the services themselves.
* New vaccines and technologies are available.
As new vaccines and technologies become available, the need increases to
assess the readiness of existing services to introduce and sustain such
innovations.
* Disease control goals must be met.
Polio eradication, neonatal tetanus elimination, and yellow fever and
measles control goals require new strategies and improved execution of old
ones. The capacity of existing services must be assessed to determine
whether disease control plans can be implemented.
* A common assessment tool is needed.
Health sector officials, managers of services, development partners, and
non-governmental organizations have asked for a common assessment tool to
identify where improvements are needed. They seek agreement on what the
needs are in order to plan individual and joint inputs.
Download the documents (in MS Word format) on methodologies without the
Health Systems component
Booklet 1 - Methodology
Booklet 2 - Advance Team Instructions
Booklet 3 - Data Collection Worksheets (National Level)
Booklet 4 - Data Collection Worksheets (Sub-national Level)
Booklet 5 - Data Collection Worksheets (Service Delivery Level)
Booklet 6 - Basic Questions (Service Delivery Level and Sub-national Level)
Download documents (in MS Word format) on methodologies with the Health
Systems component
Booklet 1 and HSR - Methodology
Booklet 2 and HSR - System approach to immunization assessment and plan of
action
Booklet 3 and HSR - Data Collection Worksheets (National Level)
Booklet 4 and HSR - Data Collection Worksheets (Sub-national Level)
Booklet 5 and HSR - Data Collection Worksheets (Service Delivery Level)
"The Immunization Services Assessment Guidelines now have two forms, with
and without a Health Systems Component.
* We would therefore appreciate your comments and feedback.
Please contact Carol Francis, e-mail: [[email protected]][email protected][/email]. Thank you."
____________________________________*______________________________________
4. GAVI & GFCV INFORMATION UPDATE 8 SEPTEMBER 2000
Contributions, comments and additions please: [[email protected]][email protected][/email]
or use your reply button
___________________________________________________________________________
From: [[email protected]][email protected][/email]
Date: Thu, 14 Sep 2000 13:24:51 +0200
Subject: GAVI & GFCV Information Update
Please find herewith the Information Update on country-level GAVI and
GFCV-related issues.
Please send any information you would like included in this fortnightly
update directly to me.
Gill Mayers
Technical Officer
World Health Organization
HTP/V&B/EPI
Tel: 00.41.22.791.4674
Fax. 00.41.22.791.4193
[email protected]
___________________________________________________________________________
UPDATE ON COUNTRY-LEVEL GAVI & GFCV RELATED ACTIVITIES
As at 8/9/00
Update since last issue highlighted *** with date of update
GENERAL NOTE ON THE GFCV APPLICATION PROCESS
The country activities listed below are those which have been initiated by
various Partners of the Alliance.
The application process is an ongoing one throughout the year, the 1st July
deadline was for the first round of application reviews.
Applications received by 15 October will be reviewed during November.
An additional application and review session has been scheduled for the end
of January to review those applications submitted by the 15 January
deadline for, amongst others, those countries in West Africa participating
in the coordinated Polio NIDs in September/October to ensure their
attention is not diverted from the Polio Eradication Initiative by efforts
to meet the 15th October deadline.
REVIEW PROCESS:
22/08 from WHO/HQ: Of the applications reviewed, following is a summary of
the results of the requests for assistance. Those applications that
received "Approval with Clarification" need to provide accurate coverage
data and other information by 1 September 2000, upon satisfactory receipt
of which approval will be granted. Those that received "Conditional
Approval" need to provide extensive additional information by 1 October
2000 and an independent review committee will then reassess these
proposals.
Immunization Services - 8 Approval with Clarification
New Vaccines - 10 Approval with Clarification, and 4 Conditional Approval.
A total of 10 other applications were requested to be resubmitted by
15.10.00 or 15.1.01.
18/07from WHO/HQ:
Applications for assistance from the GFCV were received from a total of 24
countries: Bhutan, Cambodia, Central African Republic, Chad, C?d'Ivoire, Ghana, Guinea, Guyana, Haiti, Kenya, Kyrgyzstan, Lao PDR,
Liberia, Madagascar, Malawi, Mali, Mozambique, Pakistan, Rwanda, Sierra
Leone, Sudan, Tanzania, Yemen, Zimbabwe.
The GAVI Secretariat and GAVI Working Group learned through the review
process that amendments need to be made to the Guidelines for Applications,
and to the Application Forms themselves in order to clarify certain aspects
that led to problems in the application process. These are being
distributed during August and can be obtained from [[email protected]][email protected][/email].
Letters were sent at the beginning of August to all those countries that
applied in the 1st tranche informing them of the Review Committee's
recommendations, and the GAVI Task Force for Advocacy will be scheduling
official announcements at the country level.
COUNTRY COORDINATION:
*** 08/09 from GAVI Secretariat: At the 7-8 September consultation with
countries approved for immunization services support (detailed below),
consensus was reached on the following:
The preferred option is that immunization services support be channelled
directly to the respective government/ministry of health, with subsequent
disbursements to district-level operations.
For those countries without systems for this type of financial management
of funds already in place, WHO and UNICEF country offices will assist in
the channelling of funds and in supporting the countries to establish the
required capacity. These countries should approach the appropriate
partners to agree on the required assistance and consequent mechanism for
channelling the financial support
Subject to the approval of the GAVI Board on 11 September 2000 a formal
letter will be forwarded to the Ministers of Health of the countries
concerned. All countries should formally communicate the requested channel
as well as necessary administrative information.
22/08 from WHO/HQ: The GAVI Secretariat is organising the "Consultation
with ICC, WHO and UNICEF on GAVI Cooperation" to be held in Geneva from 7-8
September. Invitations have been issued to WHO and UNICEF Representatives
and the ICC Chairpersons from the eight countries whose applications for
support for strengthening immunization services were approved. Objectives
of the consultation include: ensuring that all partners involved in the
GFCV application process for support for immunization services understand
and work together on the best solution for disbursement of funds on a
country-by-country basis; ensuring close collaboration at the country
level between ICC members to facilitate optimal implementation of funds;
and fostering high-level political links at the country level to contribute
to the overall objectives of the project.
18/07 from the Task Force on Country Coordination: A meeting of the TFCC
is scheduled for 21-22 September 2000 in Geneva. The objective of the
meeting will be to develop the group's workplan. Focal points have
volunteered to prepare background materials for the meeting in the areas of
country coordination, national capacity building and monitoring &
evaluation.
FINANCING
22/08 from Julie Milstein, WHO/HQ: The Financing Task Force, co-chaired by
Amie Batson, World Bank, and Steve Landry, USAID, and coordinated by
Violaine Mitchell, will meet in an expanded group in Washington from 20-21
September. The agenda will include updates on the Global Fund, the other
GAVI Task Forces, Financing Task Force activities, the GAVI application
process, and reports on the key work of the Task Force, i.e. UNICEF
procurement of fund vaccines, immunization database to be housed at WHO,
financial sustainability, selected financing mechanisms, new financing
options, capacity building, and accelerating R&D of new vaccines. These
discussions will be followed by break-out groups in three priority areas:
financial sustainability; capacity building; and pull, which will then
report back for a wrap up discussion of next steps.
ASSESSMENT TOOL
18//07 from WHO/HQ: A Meeting entitled "Briefing on GAVI Operations &
Country Support for Immunization" is scheduled for approximately 50
participants for 29-30 August in Geneva destined to brief prospective
consultants on GAVI operations, the GFCV application process and provide
them with an update on the common immunization programme assessment tool
and other materials for planning new vaccine introduction. It is
anticipated that this meeting will lead to the creation of a roster of
prospective consultants who can provide technical assistance in the areas
of performance of reviews, introduction of specific new vaccines and the
preparation of GFCV applications and be deployed in response to requests
for technical assistance from national programmes.
30/06 from WHO/HQ: An updated version of the "Immunization Services
Assessment Guidelines" for use in conducting EPI Assessments is now
available on the world wide web - www.who.int/vaccines-
diseases/service/immsystemassess. Alternatively, if internet access is not
an option, copies can be obtained from WHO/EPI. Comments from people using
the Guidelines are welcome and will be incorporated into a revised version
in 2001.
AFGHANISTAN
30/06 from Dr. Mohsni, WHO/EMRO: Afghanistan is preparing to submit an
application for assistance for immunization services improvement in the 3rd
tranche of applications (15 January). The authorities will be coordinating
with EMRO the kind of assistance needed to finalize their application.
Taking into consideration their political situation, some technical issues
will need to be clarified.
ALBANIA
22/08: Second tranche application expected.
16/06 from Denis Maire WHO/EURO: Dr. Stanislava Popova undertook a
consultancy in mid-July to assess the status of the EPI Programme, review
the epidemiological situation, identify the programme needs for the five
coming years, and develop a 5-year plan, 2001-2005. The plan will include
measles and HepB components of the EPI Programme, since a plan of action on
measles elimination has been developed and Hep B has already been
introduced.
ARMENIA
22//08 from Denis Maire, WHO/EURO: Dr. Stanislava Popova undertook a
consultancy from 19 June - 11 July to assist in the development of a 5-year
plan, and in the preparation of the first draft of the plan for measles
elimination.
18/07: Application will be submitted by will be submitted by 15 October
deadline.
*** AZERBAIJAN
08/09 from WHO/HQ: A four-person CDC consultancy will take place to
coincide with the National EPI Review being carried out from 25 September
through 6 October. Dr Ching and Ms Kolasa will be assisting with the EPI
Review, development of a five-year plan and facilitating the establishment
of an ICC. Drs Bell and Buffington will undertake the HepB component of
the assessment in addition to that component of the five-year plan.
BANGLADESH
*** 08/09 from David Sniadack, WHO Bangladesh: An application for
introduction of HepB will be submitted in 2001. The World Bank is
assisting in conducting the EPI review and preparing the GFCV application.
There is an ICC for polio that needs to be strengthened to include all EPI
activities. There is ongoing discussion with WHO to conduct a Hib burden
study.
22/08 from WHO/HQ: Roland Sutter, CDC, and Ann Levin, PHR, will visit in
early September to assist MoH with developing a 5-year plan. Two other
consultants, Eric Mast, WHO, and Ian Williams, CDC, will visit 10-15
September to assist in developing an introduction plan for HepB.
18/07: Application will be submitted by will be submitted by 15 October
deadline.
18/07 from Abdulaziz Adish, WHO/SEARO: The WHO Representative in
Bangladesh is in the process of hiring two consultants to assist the
country with the EPI Review and preparation of its application for
assistance from the GFCV.
BHUTAN
22/08: Application for support for New Vaccines received Conditional
Approval.
*** BOSNIA & HERZEGOVINA
08/09 from Denis Maire, WHO/EURO: Technical assistance has been requested
with conducting the EPI assessment, and WHO will provide a consultant once
the timing of the visit is confirmed.
BURKINA FASO
30/06 from Deo Nshimirimana, WHO/AFRO: Application will be submitted by
15 October deadline.
CAMBODIA
22/08: Application for support for New Vaccines received Approval with
Clarification.
26/05 from Andy Tucker, WHO Consultant: MoH and TWG rescheduled the
immunization assessment for 22 May - 6 June. Grace Chee is the health
economist to be provided by Abt Associates. CVP/University of Melbourne
participated, providing one person, and assisted throughout the process,
including with the formulation of the five-year plan of action.
CAMEROON
*** 08/09 from WHO/AFRO: WHO/AFRO and a consultant from CDC plan to visit
2nd week of October to assist with HepB introduction plan and preparation
of GFCV application.
30/06: Application will be submitted by 15 January deadline.
CENTRAL AFRICAN REPUBLIC
22/08: Requested to resubmit proposal by 15.10.00 or 15.1.01.
CHAD
22/08: Requested to resubmit proposal by 15.10.00 or 15.1.01.
CHINA
*** 08/09 from GAVI Secretariat: Request received from MoH for GAVI for a
visit, tentatively scheduled for 11 December. The following issues will be
discussed: General China/GAVI collaboration; possibility of conducting
large-scale studies with the new pneumococcal vaccine; discussions on the
use and policy of HBV in China; and specific studies relating to Hib
disease burden and vaccine testing.
26/05 from WHO/HQ: During the World Health Assembly, a meeting was held
with Wang Zhao, Director General, Department of Disease Control, and Liu
Peilong, Director General, Department of International Cooperation. The
general concept of GAVI was discussed and supported. Additional discussion
centred on the interest for the MOH and GAVI partners in evaluating
impact/burden for several new vaccines, specifically Hib and pneumococcus.
The concept of a burden study using vaccine impact on pneumonia to clarify
the usefulness of these vaccines was discussed, as well as having a meeting
with MOH and GAVI partners to discuss this issue. The government was
positive about the meeting, and suggested it follow the meeting on polio
certification in October. Finally the impact of the imported case of polio
on polio certification was clarified.
CÔ”E D'IVOIRE
22/08: Application for support for New Vaccines received Conditional
Approval and their application for support for Immunization Services
received Approval with Clarification.
*** DPR KOREA
*** 08/09 from Bjorn Melgaard, WHO/HQ: An invitation for a GAVI visit has
been received. During the visit, the importance of addressing the three
requirements for GFCV funding prior to submitting an application should be
stressed.
*** 08/09 from Drs Lyabo Olusanmi, UNICEF and Du Yuping, WHO: A draft
proposal is ready and an application will be submitted in 2001. The ICC
has been organized and will work on all EPI activities. There is a recent
review (1999) which might need some additional work. There is a 5-year
plan of action for EPI. The current polio surveillance activities are
encouraging and have to be further strengthened and the laboratory made
ready for accreditation. Historically, DTP3 coverage has varied according
to vaccine availability, thus coverages over several years have to be
considered to determine actual coverage. It is strongly recommended that
GAVI tie strengthening of polio surveillance and eradication activities to
funding from the GFCV.
DJIBOUTI
30/06 from Dr. Mohsni, WHO/EMRO: Djibouti is very interested in requesting
assistance for immunization services improvement and is planning to submit
an application by 15th October. They are also requesting technical
assistance in preparing their application. In the interim, EMRO is
managing to ensure some immediate support from other sources.
*** ETHIOPIA
*** 08/09 from Ivone Rizzo, GAVI Secretariat: In light of the country's
interest in applying for support from the GFCV, steps are beginning to be
taken to prepare the country for submitting an application. Ethiopia's
application to the GFCV has to be supported and documented with a multi-
year immunization plan that specifically includes goals for polio
eradication, increased access to routine immunization and introduction of
new vaccines. It is important for an EPI review to be carried out in order
to identify fully the areas of need, and the constraints and opportunities
for improving EPI coverage and services in the context of the
decentralization process and health sector reform currently taking place.
GHANA
22/08: Both applications for support for New Vaccines and Immunization
Services received Approval with Clarification.
16/06 from WHO/HQ: Beth Bell, CDC, visited from 6-10 June to review
progress in preparing the GAVI application for hepatitis B vaccine
introduction. Also reviewed other issues such as the ICC and financing.
GUINEA
22/08: Requested to resubmit proposal by 15.10.00 or 15.1.01.
GUINEA-BISSAU
30/06: Application postponed to 15 October deadline.
GUYANA
22/08: Application for support for New Vaccines received Approval with
Clarification.
HAITI
22/08: Requested to resubmit proposal by 15.10.00 or 15.1.01.
**** INDIA
*** 08/09 from Dr. Kim-Farley, WHO: Discussions were held in Calcutta on
25 August between WHO, UNICEF, World Bank and MoH on "Immunization and
GAVI-related Issues". Salient points included:
A proposal for $7 million to support a large HBV introduction field trial
will be submitted to the GFCV for review by the 15 January deadline. Other
proposals for strengthening routine immunization, injection safety and
introduction of HepB may be submitted in future depending upon the needs
identified in the five-year plan. Disease burden studies have been noted
as other activities for potential support from the GFCV.
In order to satisfy the three GFCV pre-requisites for provision of support
the following actions will take place:
The current "Polio" ICC will expand its TORs to include all EPI.
Information from recent EPI reviews carried out by the WHO, World Bank and
UNICEF will be compiled into a composite review.
The current multi-year EPI plan will be developed for three years taking
advantage of the World Bank-supported project.
An ICC will meet at the end of this year to endorse the MYP and the GFCV
proposal.
MoH&FW will develop a 5-year plan for EPI with support from UNICEF, World
Bank and WHO, with UNICEF supporting a national officer and WHO/HQ
supporting an external short-term consultant and a national officer.
22/08 from Brent Burkholder, WHO/SEARO:
At the request of the GoI, Dr. Craig Shapiro, CDC, visited Delhi from 19-28
July for a consultation on the introduction of HepB into the national
immunization programme. The resulting disease burden analysis and
recommendations have been forwarded to the GoI.
At the latest TCG and ICC, Calcutta, 24-26 August, there will be several
sessions dedicated to discussing the introduction of new vaccines and
financing these initiatives. The discussions on organizing the Regional
Task Force on Immunization will also be furthered.
The next ICC for India will be held in Delhi on 15 September. Prior to the
meeting, SEARO will hold discussions with high-level GoI officials on their
plans for new vaccines, particularly HepB.
INDONESIA
*** 08/09 from Sarah England, WHO/HQ: A draft proposal has been presented
to the GAVI Secretariat for possible assistance with a number of different
initiatives: production of quadravalent rHepB-DTwP; combined packaging of
HepB and DTwP; and HepB in Uniject. The proposal will be reviewed and
recommendations forwarded to the GAVI Working Group.
16/06 from Sarah England, WHO: Joint WHO/CVP visit took place as planned
from 25-27 May. Indonesia will be requesting assistance for Hepatitis B
vaccine production, equipment for filling and finishing UniJect prefilled
injection devices and for Hib and pentavalent vaccine development.
KENYA
22/08: Both applications for support for New Vaccines and Immunization
Services received Approval with Clarification.
16/06 from WHO/HQ: Susan Goldstein, CDC, visited 16-26 June to assist in
formulating the plan for the introduction of Hepatitis B.
KYRGYZSTAN
22/08 from Denis Maire, WHO/EURO: Dr. Sergei Deshevoy, WHO/EURO, visiting
28-31 August to provide support for new 5-year plan and HepB introduction
plan.
22/08: Application for support for New Vaccines received Approval with
Clarification.
16/06 from WHO HQ: Michael Favarov, CDC, reviewed the hepatitis B proposal
and the GFCV application.
LAO PDR
22/08: Application for support for New Vaccines received Approval with
Clarification.
LESOTHO
30/06: Application will be submitted by 15 October deadline.
LIBERIA
22/08: Requested to resubmit proposal by 15.10.00 or 15.1.01.
MADAGASCAR
22/08: Both applications for support for New Vaccines and Immunization
Services received Approval with Clarification.
16/06 from WHO/HQ: ICC Meeting held 31 May to complete the application.
Dr. Manzila visited 21-23 June to assist in its finalization.
MALAWI
22/08: Application for support for New Vaccines received Approval with
Clarification.
16/06 from WHO/HQ: Robin Biellik visited 19-21 June to review application.
ICC held during his visit.
MALI
22/08: Application for New Vaccines received Conditional Approval.
Application for support for Immunization Services received Approval with
Clarification.
MOZAMBIQUE
22/08: Both applications for support for New Vaccines and Immunization
Services received Approval with Clarification.
16/06 from WHO/HQ: Ivone Rizzo, Eric Mast and Amadou Fall (WHO/AFRO)
visited 29 May - 2 June. A summary of the findings follows:
ICC has been constituted, but functions mainly for Polio NIDs. MoH and
GAVI Partners identified the need to strengthen its role and expand its
membership.
Last assessment of immunization services was in 1998. All Partners agree
present coverage data is an overestimate, due to difficulties in assessing
the denominator after the war. An immunization coverage survey and
assessment of immunization safety status are planned in the next few
months.
Although recent floods damaged infrastructure, emergency aid has adequately
responded to the needs. MoH plans to introduce routine DTP-Hep B
vaccination schedule in the whole country.
Hepatitis B vaccine is planned to be introduced in 2001, but more details
need to be developed and documented.
MYANMAR
*** 08/09 from Jos Vandelaer, WHO Myanmar: Myanmar will apply for support
from both sub-accounts during 2001. Assistance will also be requested to
improve local production of HepB. PATH has identified two consultants to
work on the EPI review and assist in preparing the GFCV application.
NEPAL
22/08 from Tirtha Rana, World Bank: The Government of Nepal is currently
working on its tenth 5-year (medium-term 2002-2007) health programme to be
financed jointly by HMGN and its external development partners. Its focus
on essential health care services (EHCS) which contains EPI as a critical
element opens up opportunities for synergy with potential GFCV funds under
the GAVI immunization initiative.
22/08 from WHO/HQ:
Two consultants, Alasdair Wylie and Rachel Feilden have been recruited by
WHO/SEARO and USAID/BASICS respectively, to assist in conducting the EPI
field assessment.
Additionally, Dr. Craig Shapiro, CDC, is available for a HepB visit in the
near future. Specifically this will include assessing available study
data, making recommendations on the need for additional studies, and
outlining issues related to a HepB introduction plan.
It is hoped that the EPI Assessment, HepB introduction plan and multi-year
plan resulting from the EPI Assessment will lead to an application for
assistance from the GFCV by the 15 January deadline.
18/07 from Abdulaziz Adish, WHO/SEARO: At the present time, Nepal has not
had a recent EPI Review, its ICC is currently mainly oriented towards the
Polio Eradication Initiative, and the country does not have a comprehensive
5-year plan. Efforts are being made to recruit a consultant to assist in
the EPI Review. The WHO Representative and other partners in Nepal are
working on strengthening the ICC which, once strengthened, will hopefully
assist in formulating a 5-year plan.
30/06: Application will be submitted by 15 October deadline.
NIGERIA
*** 08/09 from Bjorn Melgaard, WHO/HQ: The ICC, which is very active, has
established a sub-committee for GAVI. It is currently collecting
additional information from selected state sites to prepare an assessment
of the NIP due for completion mid-September. A National Plan exists
through 2003 which will be updated to 2005 based on the results of the
assessment. An application for strengthening immunization systems will be
submitted by 15 October deadline. In addition, Nigeria has been encouraged
to make enquiries to the GAVI Secretariat about the benefits of being
included in the "big country" group and to request a special visit from
GAVI as the situation is unique in this country. Current population is
estimated at 120 million.
18/07 from WHO/HQ: An informal GAVI Working Group has been set up in-
country. It currently comprises representatives from UNICEF, WHO, USAID,
DFID and other partners. It is effectively an ad hoc sub-committee of the
ICC, convened to coordinate the development of the application to the GFCV.
However, before any proposal is submitted, it will have to be presented to
the National ICC for approval.
PAKISTAN
22/08: Application for support for New Vaccines received Conditional
Approval.
16/06 from Steve Hadler, CDC: From 3-24 May, two consultants, Dr Steve
Hadler (CDC) and Dr. Frank Mahoney (WHO Consultant) visited Pakistan to
assist Dr. Rehan Hafiz in developing a national 5-year plan for
immunization and in preparing a request for GAVI funding to introduce
hepatitis B vaccine during 2001. Dr. Rehan is planning to submit GAVI
proposals for hepatitis B funding by 1st July and for infrastructure
support by 15th October. Pakistan plans to introduce the combination DTP-
Hep B vaccine nation-wide by July 2001. A National ICC meeting was held on
20 May that endorsed the draft national plan and GAVI funding strategy. An
additional international consultant and several national consultants will
complete the 5-year immunization plan and GAVI proposal during June 2000.
RWANDA
22/08: Application for support for Immunization Services received Approval
with Clarification. Requested to resubmit proposal for support for New
Vaccines by 15.10.00 or 15.1.01.
SIERRA LEONE
22/08: Requested to resubmit proposal by 15.10.00 or 15.1.01.
SOMALIA
30/06 from Dr. Mohsni, WHO/EMRO: Somalia is very interest in submitting an
application for assistance in immunization services improvement, however,
their lack of recognised government is currently an obstacle to such a
submission. It is planned that WHO and UNICEF in-country staff will work
towards submitting an application by 15 October deadline, and that the GAVI
Board will take a decision by that time on this, and other applications,
received from countries with no formally recognised government.
SRI LANKA
*** 08/09 from Dr. Kulatilaka, EPI Manager: Sri Lanka is planning to
conduct a HepB burden study with assistance from WHO, and will apply for
introduction of HepB in April 2001. Although it does not qualify for
infrastructural support, there is great need to improve the cold chain, and
in collaboration with the ICC, the World Bank and JICA were approached to
assist in funding improvements to the cold chain. A meeting was conducted
to strengthen the ICC. Rabies is a major problem and enormous amounts of
funds are diverted from general EPI to vaccines, enquiries will be made
into the possibility of funding rabies vaccine not through the GFCV but
through GAVI Partners.
22/08 from Ivone Rizzo, GAVI Secretariat: Intend to hire a local
consultant to assist in conducting an EPI Review. Planning for a Review
meeting in February 2001, a strategy formulation and planning exercise for
March 2001 and a proposal submission for April 2001 for the introduction of
HepB and possibly Hib.
30/06: Application will be submitted by 1 April 2001 deadline.
30/06 from Jay Wenger, WHO/HQ: Abdulaziz Adish (WHO/SEARO) and Jay Wenger,
(WHO/Geneva) visited Sri Lanka from 22-26 June to discuss the GAVI
initiative with MOH and immunization partners. In light of the high
coverage levels, direct assistance from the GFCV is not being considered,
however, several gaps in the programme (cold chain improvement, assessment
of injection safety, and clarification of burden of diseases for which new
vaccines are available (specifically, HepB)) were identified by the MOH,
and ways in which to address them with GAVI partners were discussed. It
was agreed that taking steps towards an expanded ICC, and preparation of a
multiyear plan were ways to promote solutions to these issues. In
addition, a subgroup of the ICC and MOH will evaluate the need for an
overall EPI review.
SUDAN
22/08: Requested to resubmit proposal by 15.10.00 or 15.1.01.
TANZANIA
22/08: Both applications for support for New Vaccines and Immunization
Services received Approval with Clarification.
22/08 from Abt Associates: Ms. Bryn Sakagawa, Abt Associates Inc., will
provide technical assistance in immunization financing in Tanzania and
Zanzibar during the period 21 August - 1 September. The work is a follow-
up to the immunization programme assessment that was conducted in February
2000. This assignment is being conducted under Abt Associates' sub-
contract with the Bill & Melinda Gates Children's Vaccine Program
implemented by PATH.
16/06 from WHO/HQ: Dr. Manzila (WHO/AFRO) and Dr. Seward (CDC) visited
14-22 June to assist with preparation of application.
TURKMENISTAN
22/08 from Denis Maire, WHO/EURO: Dr. Stanislava Popova will visit 11-21
September to carry out the preparatory work in reviewing existing
documentation and identifying needs.
UKRAINE
22/08: Second tranche application expected.
22/08 from Denis Maire, WHO/EURO: Dr. D. Mercer, PATH/CVP, to visit 10-22
September, Drs. A. Battersby and R. Fielden, CVP, to visit 9-22 September.
UGANDA
22/08 from Eva Kabwongera, UNICEF Uganda: External assistance is being
requested for the last week of August/first week of September to analyse
the additional cold chain requirements in the event of introducing new
vaccines, and to assist UNEPI in finalising the Hepatitis B introduction
plan.
30/06: Application will be submitted by 15 October deadline.
16/06 from WHO/HQ: Ivone Rizzo visited 10-15 June to assist in preparation
of application. Final proposal planned for October.
UZBEKISTAN
22/08: Second tranche application expected.
22/08 from WHO/HQ: CDC to provide consultants to participate in the joint
GAVI, World Bank, Asian Development Bank mission to take place 4-15
September. The consultants will assist with developing a five-year plan
for routine immunization, and with developing a plan for HBV.
VIET NAM
30/06: Application will be submitted by 15 October deadline.
YEMEN
22/08: Requested to resubmit proposal by 15.10.00 or 15.1.01.
ZAMBIA
30/06: Application will be submitted by 15 October deadline.
ZIMBABWE
22/08: Requested to resubmit proposal by 15.10.00 or 15.1.01.
REGIONAL ACTIVITIES
AFRO
*** 08/09 from Tarande Manzila, WHO/AFRO: AFRO is planning a workshop on
the introduction of New Vaccines to be held in the region at the beginning
of next year. An Experts Briefing on the same subject is tentatively
scheduled for the beginning of October 2000. A retreat of regional office
staff and WHO country officers is being held from 13-16 September in
Victoria Falls, Zimbabwe.
*** 08/09: The next meeting of the AFRO Regional Working Group will be
held late - October. Actual dates and agenda to be advised.
30/06 from the African GAVI Working Group: At its recent meeting in
Nairobi, 26-27 June, the following tasks were completed or initiated:
Prepared draft workplan and TORs for the working group
Identified country contact persons
Developed more detailed TORs for country visits
Drafted ideas on strengthening national ICCs
Drafted TORs for the Working Group Coordinator
More news on these will follow later.
SEARO
*** 08/09 from Abdulaziz Adish, WHO/SEARO: The recent WHO/SEAR EPI TCG
meeting, Calcutta, 24-26 August 2000, was characterized by attendance by
more than 200 participants, from all countries in the region, often at
Secretary/Director level, accompanied by the EPI managers and with
increasing partner presence. A number of GAVI issues were discussed most
notably:
***
* A presentation of GAVI, its history and basic principles.
* An explanation of the GFCV including guidelines for eligibility of
countries.
* The GFCV application process was explained, including an update on the
revisions made following the first round of applications.
* The TCG endorsed the organization of the Regional Ad Hoc Working Group
for Immunization with the following recommendation:
"The initiation of GAVI has created wide opportunity for countries to
introduce new vaccines and improve immunization systems. In response to
this opportunity, WHO and UNCIEF have proposed to form a regional ad hoc
Working Group to determine an appropriate mechanism to facilitate
identification of consultants, coordinate scheduling of GAVI activities,
disseminate current information on vaccine development, assist in
strengthening ICCs and liaise on behalf of member countries at the global
level"
22/08 from Brent Burkholder, WHO/SEARO: The WHO/SEARO office, in
collaboration with several partners, organized a workshop in Delhi from
24-27 July on Financing Immunization and Introduction of New Vaccines. The
workshop included representatives from throughout the region and focused on
practical issues of financing and preparation of GAVI applications. This
was an initial step in efforts to formalize a Regional Task Force on
Immunization.
WPRO
*** 08/09 from Dr. Mansoor, WHO/WPRO: The WPRO Regional Working Group of
GAVI Partners was held in Manila from 4-5 September. It was agreed that a
person, based in Manila, should be recruited to act as focal point,
coordinate the activities of the WG and provide the "Secretariat" function,
which would include preparation of position papers for GAVI at the global
level, coordinate country activities, etc. A meeting may also be held in
the region with the aim of briefing officials on GAVI, sharing experiences
to date and to talk about improving different aspects of the quality of
programmes.
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