Post00370 GAVI UPDATE 23 August2001 CONTENTS 1. GAVI INFORMATION UPDATE From: [[email protected]][email protected][/email] To: [[email protected]][email protected][/email] Subject: Information Update Date: Mon, 20 Aug 2001 Please find attached, the latest Information Update on GAVI and Vaccine Fund related country activities. If you have any information or modifications you would like included in the next issue, please send it to me before Tuesday 28 August 2001. Please do not hesitate to contact me if you have any queries. Sincerely, Hemanthi Dassanayake Hemanthi Dassanayake Technical Officer GAVI Task Force on Country Coordination phone: 41.22.791.1312 fax: 41.22.791.4227 ___________________________________________________________________________ Update on Country-Level GAVI & Vaccine Fund Related Activities 17 August 2001 * The information contained in this Update depends upon your inputs. Please send succinct inputs for inclusion to: [[email protected]][email protected][/email] ____________________________________________________________________________ GENERAL NOTE ON THE VACCINE FUND APPLICATION PROCESS * The country activities listed below are those that have been initiated by various Partners of the Alliance. * The application process is an ongoing one throughout the year. The last (4th) round was 1 May, and the 5th round deadline is 1 October. GAVI BOARD 02/08/01 from GAVI Board: The GAVI Board met in London on 21-22 June 2001. Some outcomes from the meeting include: * As of 1 July 2001, UNICEF Executive Director, Dr. Carol Bellamy will assume a two-year term as Chair of the GAVI Board, taking over from WHO Director-General, Dr. Gro Harlem Brundtland. * The Board endorsed all recommendations of the Independent Review Committee for 4th round applications. * Endorsed the name change of the Global Fund for Children's Vaccines (GFCV) to the 'The Vaccine Fund'. * Two new GAVI Board members were welcomed; UN Foundation represented by President Tim Wirth to replace the Rockefeller Foundation, and Pasteur Institute represented by General Director Philippe Kourilsky to replace NIH for the Research Institute seat. * The Board also accepted the offer of the United Kingdom to replace Canada on the GAVI Board, after Canada's two year term ended at the end of June 2001. * Approved a new Fund policy that countries which receive approval for support from either Sub-Account are eligible for three years' supply of auto-disable (AD) syringes and safety boxes for all traditional routine EPI vaccines or the equivalent amount of money. * Agreed that funds for AD syringes should be awarded based on a review of the injection safety plan component of the country application to GAVI. Countries that have already been approved will be assessed retroactively. * Approved new Fund policy indicating that countries which receive approval for the introduction of new vaccines from The Vaccine Fund but have >80% DTP3 coverage and are therefore not eligible to receive funding from the Immunization Services Sub-Account, are provided a fixed amount of $100,000 to support costs associated with vaccine introduction activities. Financial implications of this recommendation would be approximately $2 million in total. * Approved a cap for funding support to three big countries (China, India and Indonesia), of $40 million each over the five year period. * In countries where governments are weak or non-functional, the Board emphasized that GAVI will consider proposals submitted by an operational partner or partners such as WHO and UNICEF, engaging the multiple partners most suited to reach all parts of the countries with those partners taking responsibility for implementation. * In order to better align GAVI objectives with accelerated disease control projects, a new objective and milestone were established: Objective - to support the national and international accelerated disease control targets for vaccine-preventable diseases. Milestone - by 2005, the world will be certified polio-free. The Working Group was requested to consult with the partners to identify disease outcome indicators (polio, measles, MNT and vitamin A). * Approved the proposed definition of financial sustainability: "Although self-sufficiency is the ultimate goal, in the nearer term, sustainable financing is the ability of a country to mobilize and efficiently use domestic and supplementary external resources on a reliable basis to achieve target levels of immunization of performance". * The next meeting of the GAVI Board will be in Ottawa, Canada on 17 October, 2001. Background papers for this meeting can be found at http://www.vaccinealliance.org/reference/fifth_board/fifth_boardmeeting.html REVIEW PROCESS 6/07/01 from WHO/HQ: * Out of the 17 countries that applied in the fourth round, three countries applied for Immunization Services support, seven for New Vaccines support, and seven for support from both sub-accounts. * The final results of the Independent Review Committee's deliberation from the 24 applications from the 17 countries that applied in round 4 show: four were approved, eleven received approval with clarification, three received conditional approval, and six were requested to be resubmitted. * At present, after the 1st, 2nd, 3rd and 4th rounds, 90 applications for Vaccine Fund assistance from 54 countries have been reviewed with the following results: 51 applications have been approved from 36 countries. Ten countries have been approved for Immunization Services support, 11 for New Vaccines support and 15 for support from both Sub-Accounts. ADVOCACY TASK FORCE 17/08/01 from Gugu Agha, WHO/HQ: The GAVI Advocacy Task Force met on 9-10 August 2001 in Seattle, USA. A workplan for the next year was developed and will be presented to the GAVI Working Group. There was also a presentation by the Branding Group for the Vaccine Fund. The Vaccine Fund will launch its new name on 20 September 2001 to coincide with their first Vaccine Fund Board Meeting. 02/08/01 from Heidi Larson, GAVI Advocacy Task Force: The GAVI Immunization Advocacy Resource Kit is a collection of documents, video clips, and computer presentations which have proven useful when explaining about, and advocating for, stronger immunization programmes. The online version of the Kit is currently posted on the following web-site: http://www.childrensvaccine.org/html/gavi-ark.htm COUNTRY COORDINATION & TECHNICAL SUPPORT 02/08/01 from the Task Force on Country Coordination: The Full TFCC Meeting will be held in Geneva, Switzerland on 3-4 October 2001. The Meeting for the Core TFCC will be held in Geneva, Switzerland on 2 October 2001. 02/08 from the Task Force on Country Coordination: 17th July Conference Call: Update from the Inter-Task Force (ITF) Meeting: The ITF Group met to outline how to advance the Capacity Building Strategy in a practical manner. A workplan was defined which includes strengthening of human resources, development of indicators, mapping of training and operationalization in the country context. It was agreed that this group will meet on a regular basis, but will not form a distinct task force and will instead encompass its work under the TFCC. Additionally, the Capacity Building Strategy paper will be restructured from a 'communications' perspective. Proposal to Review Operations of the TFCC and RWGs: The written proposal to review the operations of the TFCC and RWGs as requested by the GAVI Board was discussed. The proposal delineates the purpose behind this review, proposed process and corresponding global/regional tasks. The Core TFCC supported the utility of this review in assessing strengths and weaknesses, in order to improve functioning and linkages with GAVI Secretariat, GAVI Working Group and other Task Forces. The Group emphasized the following points: * Although group self-analysis is useful, there is a need for an external individual to facilitate/oversee the data collection, analysis and write-up - in terms of both capacity and outside perspective. This person should be knowledgeable on the Alliance and have a strong management background. * RWGs, as bodies integral to the TFCC, should be actively involved in the process, examining their TORs and functioning, as well as providing critique on TFCC's performance in supporting their work to support countries. Getting countries' perspectives on how well they are served by RWGs would be valuable. * The process should combine a balance of group self-analysis as well as input from surrounding peers in the Alliance, to better identify and address perceptions about the progress and functioning of the TFCC. * The proposed timeline for this exercise is very tight, therefore an interim paper or update on the process could be presented to the GAVI Board on October 17, with a fuller presentation at a later date. * As well as the TFCC and RWG mechanisms, the entire GAVI structure should be examined so no individual unit is assessed in a vacuum. Action Points: * Compose draft TORs for external facilitator and identify candidates * Names of possible facilitator candidates to be forwarded to Core TFCC * Provide update on proposed process to the Regional Working Groups * Development of draft questionnaire * Review options for "two track process" before October 17th Board Meeting Update on Shares Options Group (SOG): The SOG document was discussed, outlining the initial thinking on options for calculating share rewards, particularly in context of the utility of the DQA. Several issues were raised, such as use of DQA correction factors as a pass/fail measure rather than a precise reward calculation tool, and incorporation of more qualitative measures of programme performance. It may be possible to use a hybrid approach, focusing on a combination of demonstrated progress in: (a) improvement in DTP3 coverage; (b) implementation of annual workplan; and (c) efforts toward mobilising sustainable resources. Action Points: * Incorporate new ideas and further refine concepts of the paper for distribution to SOGs * SOG sub-group to hold teleconference week of 13th August and coordinate with the Interim Review Group 02/08/01 from the Task Force on Country Coordination: 3rd July Conference Call: Update on Participation from the Americas Region: Dr. Gina Tambini of PAHO has agreed to participate in TFCC activities to the extent possible, primarily at the TFCC Core and Full meetings. She will also contribute to TFCC phone calls relevant to the region or where the region can contribute to expertise. Update from GAVI Board Meeting: Next Board agenda to include review of roles, responsibilities and modus operandi of various task forces, GAVI, Working Group, RWGs, and the Fund. The Board requested that WHO and UNICEF jointly examine current human resource structure in countries and develop a human resource plan for immunization. Action: A TFCC representative should attend the Board meeting on October 17 to serve as an information point and present progress of the TFCC. Update on Interim Review: The response by the Working Group was positive on the direction of the proposal, but the Interim Review sub-group still needs responses to specific questions in order to move ahead as outlined in the proposal. Action: Working Group to re-discuss proposal and provide written responses on questions asked so the sub-group can proceed with actions. Update on Proposed Country Visits: The GAVI Secretariat has proposed a calendar of country visits between August-October, in lieu of inviting representatives from countries to Geneva, after they have received Fund approval. It is agreed by TFCC that RWGs' involvement in these country visits is essential. These visits are to be undertaken by regional and sub- regional agency partners wherein the Secretariat staff can also participate. Roles and responsibilities of each partner in the visit must be very clear, and in principle the visit is not to work on technical issues, but to meet with the ICC and interface on GAVI/Vaccine Fund related issues. Action Points: * Calendar to be circulated to RWGs and responses coordinated. * RWGs to review calendar, propose dates when existing country visits or activities are already taking place, and work towards coordinating with the Secretariat on the most appropriate window of time for the visit. Should avoid high activity times already scheduled in the country. Update from Immunization Data Quality Audit (DQA): The training of auditors was held in Nairobi three weeks ago, and the DQA was tested in Uganda and Pakistan. It was agreed that the DQA was globally beneficial to serve as a monitoring tool for reporting mechanisms and to improve accuracy of data. The correction factors for Uganda and Pakistan were 71% and 64% respectively (meaning that only 71% of Uganda's and 64% of Pakistan's reported data could be administratively verified). The DQA has the capability to identify the context in which the differences in reported data and validation could be explained, be it missing information or deliberate inflation of numbers. Summary meeting to review results after all field tests are completed will be held 24-26 September 2001. Action: Outcomes to be presented at TFCC Core at 2 October meeting. FINANCING 02/08/01 from Violaine Mitchell, GAVI Financing Task Force: The Financial Task Force Forum Meeting will be held on 24-25 September 2001 at the World Bank in Washington D.C. For more information, please contact, Violaine Mitchell, Coordinator, GAVI FTF ([[email protected]][email protected][/email]) 18/06/01 from Violaine Mitchell, GAVI Financing Task Force: On June 4-6, 2001, the FTF convened a WHO-CVP-USAID sponsored Workshop on Financial Sustainability with country teams that included representatives of the MoH, MoF, and in-country partners from Bangladesh, Benin, Ukraine, and Zimbabwe. The objectives of the meeting included: development of a consensus definition of financial sustainability, preliminary financial sustainability plans, and an initial exploration of financial indicators and targets. Traditionally, financial sustainability has been synonymous with 'self-sufficiency'. Although recognising self- sufficiency to be the ultimate goal, the meeting participants moved away from this definition toward how to enable countries to mobilize and efficiently use domestic and supplementary external resources on a reliable basis to achieve target levels of immunization performance. Meeting participants outlined key elements to be included in financial sustainability guidelines, proposed a number of financial indicators for consideration, and proposed a process to develop global financing targets for countries and for donors. For more information on the meeting, please contact Brenda Candries ([[email protected]][email protected][/email]). For information on on-going FTF work in the area of financial sustainability, please contact Violaine Mitchell ([[email protected]][email protected][/email]). Meeting notes will be posted on the GAVI website: http://www.vaccinealliance.org The FTF Forum will be held in September 24-25 with an FTF Core Meeting on September 26th at the World Bank in Washington D.C. NEW AND UNDERUTILIZED VACCINES 02/08/01 from Tarande Manzila, WHO/AFRO: The workshop to review and revise action plans for strengthening routine immunization and introduction of new vaccines was held in Abuja, Nigeria from 10-13 July, for approximately 35 participants from the Africa Region. The regional objectives for the five- year plan of immunization are to strengthen routine immunization, accelerate disease control and introduce innovations. The main outcomes of the workshop are: To target every country in the African region to increase immunization coverage by 1-10% every year over the next five years so that at least 80% coverage by 2005 will be achieved in the region. It was recommended that advocacy be done at all levels, i.e.: politicians and health workers, combined with regular communication with all levels and presentation of data on the programme with feedback, in order to make immunization a priority. While projecting a target date for introduction of a new vaccine is useful in principle, countries believe that it is wiser to wait until the first shipment of vaccine has arrived in the country before setting the official date for its introduction. This will avoid negative effects caused by non- availability of the new vaccine on the inaugural date. Training has been recognized as a general need for the improvement of performance of EPI managers at all levels and a central activity related to the new vaccines introduction. While the new MLM material will be used to update the health professional on all aspects of immunization, the introduction of a new vaccine is a revolution that will bring about a lot of new practices including the use of a vaccine as a diluent to another vaccine. It is therefore recommended that supporting materials for training in the introduction of new vaccines be provided to countries to allow timely and effective training of health personnel. These should be available within the countries preferably 4-6 months prior to the date of vaccine arrival. Countries are advised to develop communication and social mobilization for routine immunization. These should include information on the introduction of new vaccines and a methodology for getting messages to the community, producing the needed impact. Countries are advised to review their plans for adequate dry storage space, especially those receiving the pentavalent vaccine. Countries are advised to monitor coverage by district and support low performing districts. Vaccine wastage rate is known to be high in most countries. Ways to reduce wastage include proper forecasting, proper logistic management, and proper training of health staff. The use of smaller dose vials especially for BCG and yellow fever is perceived to reduce wastage but may increase overall cost and cold chain requirements. Reducing drop-out rates will drastically improve immunization coverage. It is essential that mothers and caretakers receive the correct messages. Efforts should be made to improve communication skills of health workers, to improve access and reduced missed opportunities by tracing defaulters. Annual five year action plans should have quantifiable indicators that are tied to measuring impact towards achieving of programme objectives. YELLOW FEVER 6/07/01 from Alya Dabbagh, WHO/HQ: On 25-29 June, an inter-country workshop on laboratory diagnosis of yellow fever and measles was held at the Pasteur Institute, Dakar, Senegal. In this, 17 participants from West and Central African countries were trained. The workshop was designed to train and help the effective implementation of the yellow fever/measles laboratory network. Each participant was provided with ELISA kits to test for both measles and yellow fever IgM, and trained on both the theoretical and practical aspects of performing ELISA assays. The participants were informed of the new sensitive case definition of yellow fever and the importance of yellow fever laboratory confirmation as a tool for differential diagnosis; for early detection and control of outbreaks; for the determination of the disease burden; and given the current vaccine shortage, the importance of early detection and confirmation in reducing the number of doses needed to contain an outbreak. The participants were also trained in the use of EPI information for data recording and reporting. STRENGTHENING IMMUNIZATION SERVICES 17/08/01 from Tom O'Connell, WHO/HQ: The next meeting of the Advisory Panel for the Immunization Management Strengthening Project will take place from 23-24 August 2001, at WHO/HQ in Geneva. During this two-day meeting, WHO/HQ, WHO/Regional; UNICEF and BASICS representatives will review and critique project components, as well as discuss next steps. A second task for the advisory panel will be the defining and evaluation of various options for supporting technical and managerial training efforts within various regions and countries. For example, discussions will occur on the need for an updated, global version of the Mid-Level Managers (MLM) modules. Some issues to be decided are the respective roles of WHO/HQ, the Regions, and other partners in training; what are the differences and similarities in Regional training needs; and what topics such modules should address. A main issue will be the need for HQ to develop reference and resource materials versus actual training materials; one option is for the Regions to take over adaptation of resource materials into locally appropriate training materials. 18/06/01 from Tom O'Connell, WHO/HQ: The WHO/UNICEF/WHO-AFRO management strengthening project has begun a biweekly newsletter to discuss project activities and goals. Those interested in being placed on the mailing list can send a request to ([[email protected]][email protected][/email]). Training workshops based on a five-step problem solving approach, will be designed over the next two months. National staff will be assisted in customising the basic 'problem solving' workshop to be consistent with national goals for the health sector. National trainers will actually run the workshops, with project staff being present as facilitators to both the national trainers and the participants. Initial field testing of the resource manual and reference guide for immunization managers, as well as the accompanying problem-solving workshop for managers is planned for early September. A meeting of the project advisory panel, with WHO and UNICEF representatives and other partners, is planned for 23-24 August in Geneva. IMMUNIZATION SERVICES COMMON ASSESSMENT TOOL 17/08/01 from Carole Francis, WHO/ HQ: The timeline for the completion of the Assessment Guidelines is as follows: * June 2001 - A revised draft including all the feedback received to date was completed. * July to September 2001 - The design company is editing the tool, preparing a user-friendly layout and will submit a final draft for revision. * September 2001 - The edited-designated draft will be circulated to identify any gaps. * September to October 2001 - Comments will be incorporated and a new version will be made available on the web. 18/06/01 from Carole Francis, WHO/HQ: A final version of the assessment tool will be produced shortly. It will be translated into French and made available on CD-ROM and diskette. This will be distributed widely for use in conducting EPI assessments. Available on: http://www.who.int/vaccines-diseases/service/ immsystemassess. IMMUNIZATION DATA QUALITY AUDIT 17/08/01 from Olivier Ronveaux, WHO/HQ: The Data Quality Audit (DQA) Testing Evaluation Meeting is scheduled for 23-24 October 2001 in Geneva, Switzerland. The proposed schedule for the follow-up of the pilot DQA and planning for the year 2002 DQAs is as follows: * August-September 2001: Eight countries are requested by WHO to provide their experience of the DQA exercise * September 2001: DQAs in the eight countries are completed * 10 October 2001: Consultants requested to submit their draft country and synthesis reports, which are subsequently forwarded to scientific experts who will present their conclusion regarding the scientific validity of the DQA tool and of possible adjustments that may be necessary * 15 November 2001: Consultants submit their final country and synthesis reports. These will be distributed to the partners and regional working groups * 15 November to 10 December 2001: Consultations with countries, regional working groups, and TFCC * Mid-December 2001: GAVI Working Group presentation and discussion. GAVI will decide how to implement and use the DQA * February 2002: DQA tool is available in its final form COUNTRY-SPECIFIC INFORMATION AFGHANISTAN 6/07/01 from GAVI Secretariat: Application for Immunization Services Strengthening Support was approved. ALBANIA 17/08/01 from the European Regional Working Group: Dr. Jay Wenger (WHO/HQ) visited in July 2001 to assist with the evaluation of Hib burden and the developmental plan for the introduction of Hib vaccine. Their application for Hib is expected to be submitted in October 2001. 6/07/01 from GAVI Secretariat: Application for New Vaccines , HepB introduction received approval with clarifications ANGOLA ARMENIA 16/03/01: Application for HepB was approved. Application for Hib has not yet been resubmitted. 8/12/00: Application for Immunization Services Approved. Application for Hib is to be re-submitted. AZERBAIJAN 23/02/01: Applications for Immunization Services and New Vaccines approved. BANGLADESH 17/08/01 from South East Asia Regional Working Group: Immunization Advisor expected by November 2001 once government clearance and TORs have been received. 6/07/01 from GAVI Secretariat: Applications for Immunization Services Strengthening and New Vaccines for HepB introduction received approval with clarifications. 18/06/01 from South East Asia Regional Working Group: * Immunization Advisor was expected in July 2001 and a HepB vaccine introduction workshop is planned for September 2001. * A local consultant has been requested for nine months to assist in the implementation of GAVI activities in the initial nine months of funding. BENIN 17/08/01 from West and Central Africa Sub-Regional Working Group: Consultant from AMP visited to assist with drafting the plan for reducing vaccine wastage. 18/06/01: from West and Central Africa Regional Working Group: Technical assistance given by WHO and CVP in May 2001 to help with new vaccines introduction, stock capacity and AD syringes. 16/03/01: Application for New Vaccines (HepB and YF) received Conditional Approval in January 2001 reviews. BHUTAN 17/08/01 from South East Asia Regional Working Group: ICC meeting was conducted and a detailed plan has been drawn to conduct the EPI review and multi-year plan of action before the end of the year. Hib burden study has been rescheduled for 2002. 23/02: Application for support for New Vaccines approved. BOLIVIA BOSNIA & HERZEGOVINA 17/08/01 from the European Regional Working Group: The revision to the application for New Vaccines is in its process, and a national workshop on HepB will be organised on 7 September 2001 led by Dr. Van Damme from the Viral Hepatitis Prevention Board. 6/07/01 from GAVI Secretariat: Application for New Vaccines for HepB introduction received conditional approval. 6/07/01 from European Regional Working Group: Dr. Popova is scheduled to visit from 31 July to 11 August 2001 to discuss the results of the Review Committee and revise the application. Dr. P. Van Damme is scheduled to visit from 3-5 September 2001 to discuss the HepB plan. BURKINA FASO 16/03/01: Application for Immunization Services Approved BURUNDI 6/07/01 from Rudi Eggers, WHO/AFRO: The mission to conduct the comprehensive EPI Review has been completed, including the injection safety aspects at policy and operational level. The country will now evaluate their multi-year plan and figure out which areas still need support prior to their application in October 2001. Technical assistance was requested from AFRO. CAMBODIA 17/08/01 from Asia Pacific Regional Working Group: Visit scheduled by Dr. Osman Mansoor from WHO/WPRO to attend the ICC meeting held on 31 August 2001. 17/08/01 from Heidi Larson, Advocacy Task Force: The Vaccine Fund is organising a visit to Cambodia from 18-20 August 2001 to encourage United States contribution to the Fund. Confirmed members of the delegation include: Congressman Jim Kolbe of Arizona, Carol Bellamy, UNICEF Executive Director and GAVI Board Chair, and Jacques Francois Martin, President of the Vaccine Fund. 18/06/01 from Osman Mansoor, WHO/WPRO: * Dr. Rosemary Lester (WHO/WPRO Consultant) visited to assist in the planning for the country's Immunisation Services Strengthening application. * Drs. Richard Duncan and Gordon Larsen visited to advise on cold chain needs. 22/08/00: Application for support for New Vaccines approved. CAMEROON 11/05/01 from WHO/HQ: Application for Immunization Services now approved. 16/03/01: Application for New Vaccines received Conditional Approval in January 2001 reviews. CENTRAL AFRICAN REPUBLIC 17/08/01 from West and Central Africa Sub-Regional Working Group: Consultant requested to review the TORs of the assessment planned for October. Technical assistance for the EPI review has been rescheduled for January 2002 in order to encompass the synchronised NIDs scheduled for November and December 2001. 22/08: Requested to resubmit proposal. CHAD 18/06/01 from West and Central Africa Regional Working Group: Need EPI review and multi year plan. 16/03: Immunization Services application requested to be resubmitted after January 2001 reviews. CHINA 17/08/01 from WHO/HQ: Application for New Vaccines Introduction has been submitted for review. The Review Committee decision is expected in September 2001. 11/05/01 from WHO/HQ: Application for New Vaccines (HepB, Hib and YF) submitted in 4th round. COMOROS CONGO 18/06/01 from West and Central Africa Regional Working Group: Technical assistance by WHO scheduled in October 2001 for EPI review. IVORY COSTE 02/08/01 from GAVI Secretariat: Drs Bo Stenson and Umberto Cancellieri visited in July to discuss the funding situation with the Ministry of Health. Funds for Immunizations Services have been received. 8/12/00: Application for New Vaccines approved. 27/10/00: Application for support for Immunization Services approved. CUBA 8/12/00: Application for support for New Vaccines not accepted as this would replace current support. Not eligible for support for Immunization Services. DJIBOUTI 6/07/01 from GAVI Secretariat: Requested to resubmit proposal for Immunization Services Strengthening. DPR KOREA 02/08/01 from South East Asia Regional Working Group: EPI review, MYPoA, and Hepatitis B plan of action has been completed. Application will be sent in October. 18/06/01 from South East Asia Regional Working Group: * A consultant from Pakistan is in DPR Korea for three months, to assist with writing the multi year plan and GFCV application. The RWG has identified a consultant to review the existing data on HepB, and draft a plan of action for its introduction into the EPI routine programme. Planning to apply for both sub-accounts before the end of 2001. * A short-term consultant/medical officer is expected in July for assistance with the HepB plan of action. 11/04/01 from SEAR Immunization Working Group: A draft application has been completed and circulated to Regional Working Group for review. ICC established and three meetings have been held. Using AD syringes for all routine immunizations. Consultant may be requested to assist with further developing the proposal for Immunization Services. Hope to be locally producing HepB vaccine by 2006 and propose to request assistance from R&D sub-account to develop local production of rotavirus vaccine. Would be interested in receiving support for JE instead of Hib and YF. DEMOCRATIC REPUBLIC OF CONGO ERITREA 17/08/01 from Emmanuel Taylor, WHO/AFRO: Injection Safety Assessment planned from 17 to 27 September 2001 by Dr. Gordon Larsen, WHO/HQ and Dr. Emmanuel Taylor, WHO/AFRO. 17/08/01 from GAVI Secretariat: Potential visit scheduled by Dr. Ivone Rizzo, GAVI Secretariat in September 2001 to: * Inform GAVI Secretariat of specific country issues * Update the Government and ICC members about recent policy decisions by the GAVI Board and Vaccine Fund, new GAVI policies and guidelines, and GAVI monitoring and reporting including DQA and inception report * Respond to questions/concerns by GAVI Partners 6/07/01 from GAVI Secretariat: Application for New Vaccines for HepB introduction received approval with clarifications. Requested to resubmit proposal for Immunization Services Strengthening. 6/07/01 from Rudi Eggers, WHO/AFRO: Injection safety assessment scheduled for 10-22 September 2001. ETHIOPIA 11/05/01 from EPI Managers Meeting: Interested in ISS sub-account and in introducing DTP-HepB and yellow fever by 2003. Strong ICC. Recent EPI Review. MYP to be prepared soon. Need assistance with GAVI Application process. GAMBIA 8/12/00: Application for New Vaccines to be re-submitted. Applied but not eligible for support for Immunization Services. GEORGIA 17/08/01 from Denis Maire, WHO/EURO: Two consultants from CDC (Drs. S. Goldstein and Pam Ching) are scheduled for HepB mission from 8-22 September 2001, and to assist the MOH in the development of a 5-year plan for immunization. One cold chain expert is expected from 10-28 September 2001. 18/06 from Denis Maire, WHO/EURO: Aiming to resubmit applications for Immunization Services and New Vaccines for the 5th round of applications in October 2001. GHANA 17/08/01 from Chris Nelson, WHO/HQ: The Ghanaian Ministry of Health (MOH) has received Vaccine Fund support for the introduction of pentavalent DTP- HepB-Hib vaccine (two-dose vials of DTP-HepB and vials of lyophilized Hib) and is preparing to receive the first vaccine shipment in September 2001. Preparations and training for introduction later in the year are being made. As a participant in the AFRO Hib-PBM Surveillance Network, Ghana requested technical assistance to conduct a rapid assessment of Hib disease burden and evaluate clinical and laboratory capacity for conducting sentinel surveillance of paediatric bacterial meningitis in Accra, Kumasi and Tamale. The disease burden assessment conducted from 22-27 July 2001 estimated that Hib meningitis incidence among children under five years of age is 72 per 100,000. Results of the surveillance assessment indicate that a paediatric ward, laboratory, and medical records need to be integrated to facilitate surveillance activities. In addition, external quality assessment of microbiology laboratories by the national public health and reference laboratory should be implemented. 27/10/00: Both applications for support for New Vaccines and Immunization Services approved. GUINEA 22/08/00: Requested to resubmit proposal. GUINEA-BISSAU GUYANA 27/10/00: Application for support for New Vaccines approved. HAITI 23/02/01: Application for Immunization Services Approved. 8/12/00: Application for New Vaccines to be re-submitted. HONDURAS 8/12/00: Applied but not currently eligible for Immunization Services support. INDIA 17/08/01 from Satish Gupta, WHO/SEARO: The Government of India is in consultation with WHO, UNICEF, World Bank and others to embark on a focused training programme for mid-level managers (district and state programme officers). The training curriculum is designed to empower the mid-level managers to effectively implement the immunization programme. The training modules for this programme are based on WHO modules for mid-level managers, and cover technical, operational and managerial aspects of the programme. Fifty master trainers have been identified in the country who will be trained in two batches at the central level of eight days duration. These master trainers would be assigned to 5 pre-identified training institutes in the country. A work load of approximately 2000 mid-level managers-trainees is envisaged to be completed within 18 months through the peripheral training institutes. The first training of trainers (TOT) was held from 24 July to 1 August 2001. 18/06/01 from South East Asia Regional Working Group: Need long-term consultant to assist in the implementation of phased introduction of hepatitis B vaccine into routine EPI. India will apply only for the New Vaccines sub-account, but will use World Bank funds to strengthen its immunization services. A HepB vaccine introduction advisor is expected in August 2001. INDONESIA 17/08/01 from John Lloyd, PATH/CVP: Programme assessment will now be carried out in four provinces instead of the initial two. All four provinces will apply for immunization services support. The assessments have been rescheduled for January 2002. 18/06/01 from South East Asia Regional Working Group: * Provincial level review of an initial two provinces is scheduled for July/August. * Expected to submit a GFCV application in October 2001. * Coordinated by PATH/CVP, a team of international and local consultants conducted the national level EPI review and assisted in the drafting of MYPoA in June 2001. KENYA 17/08/01 from Lisa Jacobs, GAVI Secretariat: Ms. Rachel Zimmerman from the Wall Street Journal is visiting in August 2001 to write a story on GAVI and its impact on the field of global public health, with a particular emphasis on performance monitoring and the Immunization Data Quality Audit. She is accompanied by Ms. Lisa Jacobs from the GAVI Secretariat. 11/05/01 from EPI Managers Meeting: Need assistance with: carrying out baseline coverage survey, strengthening EPI supervision, and establishing disease burden on yellow fever. 27/10/00: Both applications for support for New Vaccines and Immunization approved. KYRGYZSTAN 17/08/01 from the European Regional Working Group: Cold chain review and rapid assessment on waste management have been completed between 7-26 May 2001. Although the main purpose of the review was for the preparation for the measles campaign due late 2001, it encompassed more long-term aspects as well. The first urgent need will be covered by a UNICEF procurement this year, and a plan has been developed to renovate the whole chain. The survey on injection safety has been carried out, and the analysis is still under process. 27/10/00: Application for support for New Vaccines approved. LAO PDR 17/08/01 from Asia Pacific Regional Working Group: Visit by Dr. Osman Mansoor from WHO/WPRO on 4 September 2001 for two weeks to assist with HepB introduction, application for Immunization Services Strengthening, AD syringes, and potentially to promote the need for a functional ICC. 27/10/00: Application for support for New Vaccines approved. LESOTHO 02/08/01 from Robin Biellik, WHO/AFRO: National EPI review was completed in July 2001 in preparation for the GAVI application. 18/06/01 from East and South Africa Regional Working Group: Technical assistance scheduled in July 2001 to review multi year plan. 8/12/00: Applications for New Vaccines and Immunization Services to be re- submitted. LIBERIA 6/07/01 from GAVI Secretariat: Application for New Vaccines for Yellow Fever introduction received approval with clarifications. 23/02/01: Application for Immunization Services Approved. MADAGASCAR 27/10/00: Both applications for support for New Vaccines and Immunization Services approved. MALAWI 27/10/00: Application for support for New Vaccines approved. MALI 27/10/00: Application for New Vaccines received Conditional Approval. Application for support for Immunization Services approved. MAURITANIA 16/03/01: Application for support for Immunization Services was requested to be resubmitted. MOLDOVA 17/08/01 from European Regional Working Group: A detailed EPI review was undertaken by the MOH, and is now at the stage of computer data entry. The analysis will be finalized by the end of the month. MONGOLIA 18/06/01 from Osman Mansoor, WHO/HQ: A meeting of partners and EPI met on 15th June 2001 in Mongolia and agreed to recommend to the Ministry to establish an ICC. They will also make an application for Hib disease burden assessment. MOZAMBIQUE 11/04/01 from Amie Batson, World Bank: The first vaccines financed by the GFCV were delivered on 6 April 2001 in Maputo, Mozambique. Ms. Carol Bellamy, Executive Director of UNICEF, William Gates, Senior, Jacques- Martin, GFCV President and Dr Tore Godal, Executive Secretary, GAVI Secretariat, witnessed the event. 27/10/00: Both applications for support for New Vaccines and Immunization Services approved. MYANMAR 18/06/01 from South East Asia Regional Working Group: * Two consultants are in place for nine months to assist with the Vaccine Fund application. Expected to apply for both sub-accounts before end 2001. Need a long-term consultant to assist in the implementation of GAVI activities in the initial phase of funding. * Four teams of international and local consultants are currently conducting an EPI review in four different regions of the country. NEPAL 17/08/01 from South East Asia Regional Working Group: EPI financial review and injection safety review conducted in July 2001. 18/06/01 from South East Asia Regional Working Group: * Two consultants have been identified to work on the financial sustainability plan and assist in finalizing the EPI review and the multi year plan of action for resubmission. They are currently awaiting government clearance. Need long-term consultant to assist with the implementation of GAVI activities for the initial few months of funding. Planning to apply for the ISS sub-account to improve its EPI. Re-submission for New Vaccines planned for October 2001. * A short-term consultant was expected in July 2001 to finalize the Plan of Action and review. An Immunization Advisor is expected in September 2001. NICARAGUA NIGER 17/08/01 from West and Central Africa Sub-Regional Working Group: Consultant has been requested to assist with the multi-year plan and the application for support for Immunization Services. 16/03/01: Application for support for Immunization Services requested to be resubmitted. NIGERIA 6/07/01 from GAVI Secretariat: Application for Immunization Services Strengthening Support received approval with clarifications. Application for New Vaccines introduction of Yellow Fever received conditional approval. PAKISTAN 18/06/01 from Ezzeddine Mohsni, WHO/EMRO: An STC (Dr. Steve Hadler) has been recruited from 1-29 July, to assist the MoH in introducing HepB vaccine, as well as in preparing to receive and utilize GAVI funds for strengthening routine immunization. Still seeking a longer-term consultant for assistance in HepB vaccine introduction, immunization services improvement, and conducting Hib disease burden rapid assessment and introduction. 11/05/01 from WHO/HQ: Application for Immunization Services Strengthening support Approved. 8/12/00: Application for New Vaccines approved. PAPUA NEW GUINEA 17/08/01 from the Asia Pacific Regional Working Group: EPI Assessment is tentatively planned for November 2001. RWANDA 11/05/01 from EPI Managers Meeting: Active and committed ICC. Need HepB and Hib disease burden assessments. Need training for new vaccines introduction. Need an injection safety assessment. 23/02/01: Application for New Vaccines approved. 27/10/00: Application for support for Immunization Services approved. SAO TOME & PRINCIPE 8/12/00: Application for Immunization Services approved. Application for support for New Vaccines to be re-submitted. SENEGAL 18/06/01 from Robert de Wolfe, PATH/CVP: Drs. de Wolfe and Da Silva visited in May 2001 for technical assistance to help complete GAVI application. 16/03: Application for support for Immunization Services received Conditional Approval. Application for New Vaccines requested to be resubmitted. SIERRA LEONE 17/08/01 from GAVI Secretariat: Visit by Dr. Ivone Rizzo from GAVI Secretariat and Dr. Francois from UNICEF scheduled for 18-22 August 2001 to: * Inform GAVI Secretariat of specific country issues * Update the Government and ICC members about recent policy decisions by the GAVI Board and Vaccine Fund, new GAVI policies and guidelines, and GAVI monitoring and reporting including DQA and inception report * Respond to questions/concerns by GAVI Partners 16/03/01: Application for Immunization Services Approved. SOLOMON ISLANDS SOMALIA 18/06/01 from Ezzeddine Mohsni, WHO/EMRO: Planning to send 1-2 consultants during the fourth quarter of 2001 in order to assist in preparing the documentation for the GAVI application. SRI LANKA 17/08/01 from South East Asia Regional Working Group: Dr. Goldstein from CDC and Dr. Xu from the EPI office in the Chinese Academy of Preventive Medicine in Beijing have assisted the MOH in drafting the HepB plan of action. Dr. Irtaza Ahmed is currently in Sri Lanka to assist the government with finalizing the multi-year plan of action and the application for New Vaccines. SUDAN 6/07/01 from GAVI Secretariat: Requested to resubmit proposals for Immunization Services Strengthening Support. TAJIKISTAN: 6/07/01 from GAVI Secretariat: Application for New vaccines introduction of HepB vaccine received approval with clarifications. 16/03/01: Application for New Vaccines received Conditional Approval. TANZANIA 17/08/01 from Rudi Eggers, WHO/AFRO: HepB vaccines are expected in October 2001 for introduction in January 2002. There are ongoing discussions with UNICEF regarding vaccines needed for the refugee population (estimated 800,000) at the western border. 17/08/01 from Chris Nelson, WHO/HQ: Rapid assessment for Hib disease burden scheduled for September 2001. A national Hib consensus meeting is being planned for December 2001. 11/05/01 from EPI Managers Meeting: New Vaccines to be introduced in January 2002. Pre-introduction activities of advocacy and social mobilisation to be carried out from May-December 2001. DPT stocks to be used up prior to switching to DPT-HepB. DQA scheduled for July 2001. Request assistance with monitoring progress and report writing and with training. 27/10/00: Both applications for support for New Vaccines and Immunization Services approved. TOGO 6/07/01 from GAVI Secretariat: Requested to resubmit proposals for Immunization Services Strengthening Support. New Vaccines introduction for HepB, Hib and Yellow Fever were also requested to be resubmitted. TURKMENISTAN 6/07/01 from GAVI Secretariat: Application for New Vaccines introduction for HepB received approval with clarifications. UKRAINE 16/03/01: Application for New Vaccines received Conditional Approval. UGANDA 02/08/01 from Rosamund Lewis, WHO/AFRO: * Cold chain capacity assessment was completed in May 2001, and there is sufficient capacity for the pentavalent vaccine. * A team of six DQA auditors were in Uganda for on-the-job training from 10-22 June 2001. * A workshop to develop the draft plan for the introduction of New Vaccines was held from 1-6 July 2001. 8/12/00: Applications for Immunization Services and for New Vaccines approved. UZBEKISTAN 6/07/01 from GAVI Secretariat: Application for New Vaccines (HepB monovalent) was approved. VIET NAM 6/07/01 from GAVI Secretariat: Application for New Vaccines introduction of HepB received approval. 8/12/00: Application for New Vaccines received Conditional Approval. YEMEN 17/08/01 from GAVI Secretariat: Potential visit scheduled by Dr. Ivone Rizzo, GAVI Secretariat in September 2001 to: * Inform GAVI Secretariat of specific country issues * Update the Government and ICC members about recent policy decisions by the GAVI Board and Vaccine Fund, new GAVI policies and guidelines, and GAVI monitoring and reporting including DQA and inception report * Respond to questions/concerns by GAVI Partners 6/07/01 from GAVI Secretariat: Application for Immunization Services Strengthening Support received approval with clarifications. Application for New Vaccines for introduction of DTP-HepB-Hib was requested to be resubmitted. ZAMBIA 6/07/01 from GAVI Secretariat: Application for Immunization Services Strengthening Support received approval with clarification. Application for New Vaccines for introduction of DTP-HepB-Hib received approval with clarifications. ZIMBABWE 6/07/01 from GAVI Secretariat: Application for Immunization Services Strengthening received approval. New vaccines introduction for DTP-HepB-Hib received conditional approval. REGIONAL ACTIVITIES AFRICA REGIONAL 11/05 from Modibo Dicko, WHO/AFRO: Main points of AFR RWG meeting held in Harare, 28-29 March 2001: * Modibo Dicko is replacing Dr Shodu as the Coordinator for the AFR RWG, as Dr Shodu is moving to the Global Fund in Lyon. * The AFR RWG has been split into 2 sub-regional groups: West/Central now lead by Deo Nshirimirimana and East/South by Rudi Eggers. It is planned that coordination between the 2 sub-groups will remain at regional level. Both sub-groups will be conducting monthly regional-level partner meetings, and quarterly meetings involving a broader range of partners. The entire group will meet once or twice a year. One meeting just before or after the Task Force for Immunization (TFI). West/Central African RWG has just had its first meeting with all regional partners present. They will be meeting the 2nd Saturday of each month, up through December 2001, at which time they will assess the need to continue in the same format. They have developed a work plan on how to support countries, particularly in area of technical assistance. AFRICA EAST & SOUTH 6/07/01 from the East and Southern Africa Sub-Regional Working Group: The East and Southern Africa SRWG plans to meet for the first time in Entebbe, Uganda on 8-10 October 2001. The draft agenda is as follows: * Feedback on status of implementation by country (application status and funding) * Status of bacterial lab surveillance network * Status of placement of Immunization Advisors * Feedback from Global meetings: Board, TFCC, and other * Status of vaccine and AD syringe supply * Overview of DQA, country experiences and time table for future DQA visits * Inception reports - country status and changes * Interim review - logistics * Input on financial sustainability AFRICA WEST & CENTRAL 17/08/01 from the West and Central Africa Sub-Regional Working Group: The Sub-Regional Working Group met on 11 August 2001 in Abidjan. The objectives of the meeting were to: * Discuss the implementation of the outcomes presented at the previous meeting * Discuss the preparation of training for the GAVI process * Discuss strategies to control the Yellow Fever outbreak in the sub- region * Propose social mobilisation strategies for countries * Prepare for the synchronized NIDs in countries * Share information on the status of measles control strategies in the Western African Block * Discuss status of activities in countries: GAVI activities and application process, integrated surveillance, various missions, and other topics of relevance 17/08/01 from the West and Central Africa Sub-Regional Working Group: The West and Central African Sub-Regional Group met on 7 July in Yamoussoukro, Cote d'Ivoire. The main recommendations and summary proceedings from the meeting are as follows: * Organization of a Social Mobilisation Working Group where each representative of agencies concerned (BASICS, UNICEF and Red Cross) are invited to take the necessary action for the effective implementation of this decision. Social mobilisation activities in countries of the Block will be presented during the next meeting. * Need for greater involvement of WHO in activities of the Crisis Committee for the Yellow Fever situation in Cote d'Ivoire. * Submission of an operational budget for the secretariat of the Group and budgets for training workshops for consultants. * From the discussion of mechanisms to apply for Vaccine Fund Applications, it was suggested that partners who are actively providing support to the countries must use the advantage of their presence in those countries to be involved in submission exercises in order to avoid rejection from the country requests. Action must be taken to better inform decision-makers on the processes to follow. * Discussed the Sensitisation Meeting on vaccine management for decision-makers which is scheduled for September 2001. * Discussed the terms of reference for the conduct of a study on the epidemiological surveillance in the framework of the Regional Programme of support to Vaccine Independence Initiative in Africa. * Preparation for NIDs scheduled for September-November 2001 * Presented issues on taking a more significant role in the management of the Yellow Fever epidemic in Cote d'Ivoire. A meeting of Ministers needs to be scheduled to discuss the situation of yellow fever in the Block and to define a policy in the region. * The Group took note of the planned interventions of the Red Cross in countries. It was decided that a presentation be made on the strategies and current activities on measles in the Block at the next meeting. EASTERN MEDITERRANEAN 02/08/01 from Ezzedine Mohsni, WHO/EMRO: The EMRO inter-country meeting on Acceleration of Measles/Rubella control will be held on 25-27 August 2001 in Sanaa, Democratic Republic of Yemen. The EMRO inter-country meeting on the Elimination of Measles/Rubella control will be held on 1-3 September 2001 in Amman, Jordan. 6/07/01 from Julie Milstien, WHO/HQ: The Eastern Mediterranean Regional Working Group met in Dubai, (UAE) on 28 June 2001. They propose that immunization advisors should be placed in Pakistan and Afghanistan before end 2001. Pakistan has already identified a possible candidate and will send the TORs. Sudan and Yemen are proposed to have immunization advisors by 2002. Technical assistance will be provided to Yemen, Somalia and Sudan to complete GAVI submissions. It was suggested that Sudan could include a complementary section from the 'Operation Lifeline Sudan' (OLS) to cover the children of Sudan served by that group. The same principles will hold for Somalia. EUROPE 6/07/01 from European Regional Working Group: The European GAVI Working Group met in St. Petersburg (Russian Federation) on 28 June 2001. The meeting was organized jointly with WHO, VHPB, CVP, CDC and UNICEF. The agenda from the meeting included updates on country support activities, including results from the 4th round of applications, future plans for support, specific country activities, presentation of the Inception Report Template for follow up on HepB introduction, feedback on Core TFCC meeting, and updates from other Task Force activities. Minutes from the meeting will be available shortly. SOUTH EAST ASIA 17/08/01 from Abdulaziz Adish, WHO/SEARO: East Timor (currently in complex emergency situation) is interested in applying for support for Immunization Services Strengthening. Dr. S. Spanner and Dr. A. Adish from WHO/SEARO will visit in October 2001 for an initial needs assessment. Planning to conduct an EPI review and MYPoA in 2002. 17/08/01 from the South East Asian Regional Working Group: The next Regional Working Group meeting will be held on 25 October 2001 in Bali, Indonesia. 18/06/01 from Abdulaziz Adish, WHO/SEARO: WHO-SEARO had its Quarterly RWG meeting on 11th June 2001 in New Delhi. The meeting was attended by representatives from WHO, UNICEF, PATH/CVP, and 2 member countries. The following meeting objectives were covered: * Briefing on injection safety assessment planned in Bangladesh, Myanmar, Nepal and India * Briefing on the development of the Joint SEA/WP RWG concept paper on Japanese Encephalitis * Review of the TFCC core-group meeting report and responding to two action points concerning RWGs * Discussion on the strategic framework for assessing strengthening capacity of NIP * Discussion on the ToRs and assignment of Immunisation Advisors * Identifying and securing government concurrence from two countries to take part in the implementation of the strategic framework for Capacity Building: Bangladesh and Nepal * Status of GAVI applications in member countries * Mapping out GAVI activities for the 3rd quarter of 2001 WESTERN PACIFIC 17/08/01 from Asia Pacific Regional Working Group: The next Asian Pacific Regional Working Group Meeting will be held on 15 August 2001 in Manila, Philippines. The meeting will be attended by the RWG Core Group, representatives from JICA, AUSAID, CDC, and possibly USAID. The draft agenda for this meeting is as follows: * Confirmation of previous meeting minutes and arising matters * Evaluation of Regional Working Group * RWG Budget, funding shortfall & coordinating Agency Support * Hib in the Pacific * Individual Country discussion and plans * Annecy training * Joint SEA/RWG meeting/briefing for 2002 * GAVI Updates * Country fact Sheets: Content and Process * Japan Fund for Poverty Reduction * RWG future & fact sheet * Other related matters and plan for the next Asia Pacific RWG meeting ____________________________________*______________________________________ ____________________________________*______________________________________ All members of the TECHNET Forum are invited to send messages to all subscribers or to comment on any posting or to use the forum to request technical information in relation to EPI and logistics for health. 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