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Many thanks to Simona Zipursky for sharing this with TechNet21 readers. Please note that the full report of the November 2010 meeting of WHO's Strategic Advisory Group of Experts (SAGE) on Immunization was published in English and French in the WHO Weekly Epidemiological Record (WER) today and can be accessed through http://www.who.int/immunization/newsroom/newsstory_sage_report_jan2011/en/index.html (direct link: http://www.who.int/wer/2011/wer8601_02.pdf ) The Arabic, Chinese, Russian and Spanish translations of the report will be posted on the appropriate language pages (click on tabs at top right of page) of http://www.who.int/immunization/sage_conclusions/en/index.html in due course. A summary of some of the key issues covered in the report is below. Kind regards. Alison Mrs Alison Brunier, MBA Communications Officer Immunization, Vaccines and Biologicals World Health Organization Measles efforts to focus on strengthening routine immunization SAGE concluded that measles can and should be eradicated but proposed that demonstration of sufficient progress towards regional measles elimination targets be made a precursor to establishing a target date for global eradication. Furthermore, all efforts should be carried out in the context of strengthening routine immunization programmes. Recognizing the fragility of gains in measles mortality reduction, apparent through outbreaks affecting 28 countries in the African Region since 2009, the Group highlighted the growing risk that the contribution of the reduction in measles mortality to achieving Millennium Development Goal 4 (approximately 25% of the overall reduction) will be lost because of declining political and financial commitment to measles control. SAGE members welcomed the news that India has begun implementing strategies to provide a second opportunity for measles immunization and encouraged the South-East Asia Region to establish a target date for measles elimination. Timely establishment and implementation of corrective action plans key to polio eradication SAGE recognized the considerable progress made towards eradicating polio since its April meeting but noted with deep concern that some countries had either missed their relevant milestone in the new Strategic Plan or were at very high risk of doing so. SAGE emphasized the importance of strengthening surveillance in critical areas at the subnational level. The Group strongly supports the role of the Independent Monitoring Board established in October 2010 to monitor progress in meeting the goals of the Strategic Plan, noting that its most critical contribution will be to suggest urgent plans for corrective action in close coordination with ministries of health and country and regional-level technical advisory groups. Gender as a determinant of immunization status SAGE noted that there is no evidence to suggest a significant difference between the coverage of routine immunization in boys and girls at the global level. However, in some countries, such differences have been reported at the subnational level. Local surveys clearly provide valid data that can be used to address local barriers to immunization, including gender. SAGE also noted that in some settings, the low status of women prevents them from accessing immunization services for their children. Supporting lower-middle-income countries SAGE was presented with the outcome of a study on the adoption of new vaccines by lower-middle-income countries not eligible for support from the GAVI Alliance. SAGE noted that price continues to be a major barrier. The Group encouraged continuation and expansion of data collection activities and asked WHO to facilitate further work to support countries in this income bracket. Also discussed were influenza and typhoid vaccination, optimization of immunization schedules, and improving the accessibility of affordable vaccines.


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