Supporting countries in establishing and strengthening NITAGs: Lessons learned from 5 years of the SIVAC initiative

To empower governments to formulate rational policies without pressure from any group, and to increasethe use of evidence-based decision-making to adapt global recommendations on immunization to theirlocal context, the WHO has recommended on multiple occasions that countries should establish National Immunization Technical Advisory Groups (NITAGs). The World Health Assembly (WHA) reinforced those recommendations in 2012 when Member States endorsed the Decade of Vaccines Global Vaccine ActionPlan (GVAP). NITAGs are multidisciplinary groups of national experts responsible for providing indepen-dent, evidence-informed advice to health authorities on all policy-related issues for all vaccines across allpopulations. In 2012, according to the WHO–UNICEF Joint Reporting Form, among 57 countries eligiblefor immunization program financial support from the GAVI Alliance, only 9 reported having a functionalNITAG. Since 2008, the Supporting Independent Immunization and Vaccine Advisory Committees (SIVAC)Initiative (at the Agence de Médecine Préventive or AMP) in close collaboration with the WHO and otherpartners has been working to accelerate and systematize the establishment of NITAGs in low- and middle-income countries. In addition to providing direct support to countries to establish advisory groups, theinitiative also supports existing NITAGs to strengthen their capacity in the use of evidence-based pro-cesses for decision-making aligned with international standards. After 5 years of implementation andbased on lessons learned, we recommend that future efforts should target both expanding new NITAGsand strengthening existing NITAGs in individual countries, along three strategic lines: (i) reinforce NITAG institutional integration to promote sustainability and credibility, (ii) build technical capacity withinNITAG secretariats and evaluate NITAG performance, and (iii) increase networking and regional collabo-rations. These should be done through the development and dissemination of tools and guidelines, and information through a variety of adapted mechanisms.