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BID Initiative topic page now live!

The BID Initiative is excited to announce a new topics page that compiles the resources, tools, publications, and webinars we've developed or contributed to over the years! BID is led by PATH and grounded in the belief that better data, plus better decisions, will lead to better health outcomes. Since 2013, BID has been partnering with the governments of Tanzania and Zambia to address the most critical routine immunization service delivery problems through improved data collection, quality, and use. In both countries we have designed, introduced, and scaled an electronic immunization registry. We're committed to sharing our learnings with other countries interested in similar digital and data solutions and so hope that the tools, reports, publications, and webinars we've compiled will be of use to other digital health and immunization stakeholders. Keep an eye on our topics page for more resources and additions to the page over the coming weeks!  

VVM Webinar video and presentation now available

Dear Community, The video and presentation of the great webinar on Vaccine Vial Monitor (VVM) that took place on Tuesday 21 are now available! Link to the presentation: https://www.technet-21.org/en/library/main/6160-vvm-based-vacine-management-technet-21-webinar Link to the video: https://www.youtube.com/watch?v=tpBs5_tZP10&t=20s (don't forget to like and/or comment the video and sucribe to the TechNet Youtube channel!) The discussion is still open, so if you have questions related to the content of this webinar or VVM in general, please reply to this post; the webinar panelists Umit Kartoglu, Ted Prusik and Debbie Kristensen will be happy to help and answer. Thanks to all participants, and we look forward to seeing you at the next TechNet webinar in February!

"THE BOOK OF VVM: Yesterday-today-and-tomorrow" is now available for free download

The story of a time and temperature indicator (vaccine vial monitor) that has dramatically changed the course of vaccine management practices as well as shaped the future of cold chain, THE BOOK OF VVM: YESTERDAY-TODAY-and-TOMORROW is now available for free download in ePUB3 and PDF formats. http://kartoglu.ch/vvm We may ask ourselves where humanity might be without some of the greatest inventions that have come to pass. Great ideas have continuously changed the path of human civilization over time with vaccination being widely considered one of the greatest medical achievements of modern civilization. Many commonplace and preventable childhood diseases are now increasingly rare because of vaccines. The concerted human effort to bring the vaccines to the ones who need them at the right time is remarkable. Just one example of the dedication and self-sacrifice involved was the 1925 ‘Serum Run’ between the settlements of Nenana and Nome in Alaska also known as the Great Race of Mercy. This involved a famously grueling winter expedition across the frozen Alaskan interior using dog-sled relays to take diphtheria antitoxin to the beleaguered township of Nome where an outbreak of diphtheria was threatening around 10,000 local Alaskan natives who had no natural immunity to this lethal disease. The epic journey took 20 mushers and about 150 sled dogs just five and a half days to cover the 1,085 km route. This display of bravery and determination was how the small town of Nome and the communities surrounding it were saved from an incipient epidemic. Balto, the lead sled dog on the final leg into Nome, became the most famous canine celebrity of the era. Balto’s statue became a popular tourist attraction both in New York City’s Central Park and downtown Anchorage in Alaska. The vaccine vial monitor (VVM) is one of the most important inventions of the last century; one that has dramatically changed vaccine management practices and continues to shape the cold chain. In 1996, when VVMs started to get to countries with the oral polio vaccine (OPV), I was the health officer for the UNICEF Central Asian Republics and Kazakhstan Area Office. I remember one particularly cold night going to the airport in Almaty at 03.00 am to receive the very first shipment of OPV with VVMs. For years, I was a humble VVM user and advocate in the field. Things started to change when I was hired by the WHO Headquarters ‘Access to Technologies’ team in 2001 and VVM became one of my prime responsibilities. That was at a time when vaccine manufacturers were dragging their feet about incorporating VVM onto vaccines other than OPV. My brief was to overcome this resistance from the manufacturers, an objective that formed the basis for my plans for the historic 2002 VVM technical consultation meeting. In 2007, I immensely enjoyed organizing the event to celebrate the 10th year anniversary of VVM introduction. Visiting Niger, Indonesia, and Vietnam for the shooting of the “Five Senses” video is full of cherished moments. Towards my retirement in August 2018, I conceived the idea of writing this book. I was one of the few people who had witnessed the decades-long programme of VVM development from its birth to its maturity. I had worked with sweat and tears to get VVMs onto all vaccines as well as tirelessly helping vaccine managers and health staff to excel in using the VVMs to their utmost potential. Today, it is a great pleasure to see one of my e-VVM based vaccine management course graduates (2015), Junaidu Adamu Barde from Nigeria, working for the Clinton Health Access Initiative, using the course learning materials to duplicate efforts in his country. I worked on this book from September 2018 to August 2019. I went through every single published and unpublished work on VVMs, watched all available videos about VVMs and the early contending products, talked to key people, some face to face, others over the phone. I visited the U.S., Albania, Burkina Faso, and Sierra Leone. Unfortunately, there were some people I just could not reach despite all my efforts with email and phone messages. And, although I considered myself highly knowledgeable about VVM, I was simply amazed at the volume of new information I discovered and the knowledge I gained. I had originally wanted this book to be a concise, structured, globally-relevant manual that provided comprehensive information on a wide scope of issues; in other words, an ‘A-Z of VVM’. In the event, it turned out to be more voluminous than I thought. I did not want to restrict myself when there are so many clever, dedicated and selfless individuals that have made this near-miraculous innovation a reality and in doing so contributed to saving, literally, the lives of millions. So, I am happy that it became a celebration of all the efforts of individuals, organizations, agencies, donors, and manufacturers involved in the development, scaling, applying, advocating for, enforcing, helping health workers to excel in their practice, and using it. As with my previous books, I have again licensed this work under the Creative Commons (CC) Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0). The book can be reproduced, remixed, tweaked or built upon non-commercially. I am grateful to Temptime Corporation, and especially to Renaat Van den Hooff and Ted Prusik for sponsoring the creation of this book. I thank Emily Moore for the VVM literature list she put together, it eased my search enormously. I also thank all the individuals I have interviewed for their time and everything they have shared with me. I am thankful to all my colleagues who sent me photographs, and documents. Many thanks to Kadir Abbas for making again an excellent job on the cover and page design, print, and ePUB3 conversion. Gencer Yurttas deserves a special thank you for his immaculate VVM photography. I deeply appreciate Alan Kennedy for his editing work, and Umran and Gokhan Akaalp's help in developing the book’s website. I am grateful to my wife Nellie and daughter Deniz Nala who supported me with love. Deniz Nala was already helping me at the age of 14 measuring VVMs with a spectrodensitometer and entering data into an Excel sheet to calculate optical density differences during a VVM based vaccine management eLearning course. I never imagined that for something only 0.38 cm2 in size that I could write a book of 424 pages. This ‘little big thing’, now reinventing itself with the incorporation of a peak threshold indicator as well as entering the digitized supply chain with the integration of 2D barcodes, never ceases to amaze me. For download please visit http://kartoglu.ch/vvm The book is available both in interactive PDF (32.9 MB) and ePUB3 (24.4 MB) versions. 424 pages...  

* New WHO Publications * available: Global Vaccine Market Report, Vaccine Purchases data & HPV market study

Johanna FIHMAN Publié dans :
Vaccine Purchase Data Note for Countries (2019): provides an overview of 2018 vaccine purchase data (including vaccine products and vaccine prices) as reported by countries in the WHO/UNICEF Joint Reporting Form (JRF). The complete database is also available on the WHO Website. This dataset provides reference points on prices paid for vaccines in countries across all regions. This can provide a reference for EPI managers, procurement and budget officers adding to existing public data sets.   NEW FOR 2019: The document now also includes a complete list of vaccine products available for procurement – including non-prequalified-vaccines (building on reported vaccines and other public sources) . This is also available in excel to filter and narrow your searches. Global Vaccine Market Report (2019): a snapshot view of the global vaccine market covering all vaccines and countries and complementing existing resources focused on specific market segments.  HPV Global Market Study (2019 update): provides the most updated understanding of current and future global trends and drivers of supply and demand of HPV vaccines - and was updated following the SAGE discussions in October 2019. Please do send us your feedback or questions! Understanding and monitoring the impact of market information use in countries is critical. Please share your experience with us by completing this short survey: https://www.surveymonkey.com/r/2RWL98W For any questions or comments or for help accessing or using the data, please contact MI4A: MI4A@who.int

Pre Pulse Polio Day Procession

Narayana Holla Publié dans :
Dear viewers We the KVG team wish to share the following, a few photos also attached. India has seen its last polio case in Jan 2011, got the eradication certificate in March 2014 – a mile stone event in public health. All countries have threat of resurgence until global eradication is achieved. Currently the threat is not only from the WPV (163 in 2019) but also from cVDPV (259) occurring in both endemic and non-endemic countries, for containing both, achieving and sustaining very high vaccination coverage is mandatory. Since the first round of Pulse Polio held on 9th Dec 1995, India is conducting National Immunization Days, this year is on 19th Jan 2020: 50th round. Every year since 1995, before the first round, KVG Medical College and all other educational institutions in collaboration with Government regularly and jubilantly conducted the “Jatha”. Dr Subramanya, Taulka Health officer, Dr Narayana Holla, Professor from Community Medicine, KVG Medical College highlighted the importance of pulse polio. Dr KV Chidanada, Medical Director of KVG Medical College is a surgeon, appealed the parents / public to get their below 5 year children to get vaccinated with OPV in the nearest booth and lead the procession. We hope today (19th Jan 2020) and in the next 2 days we will be able to administer Oral Polio Vaccine to all the under 5 year children including newborns. Best wishes Dr Holla n Team    

Upcoming webinar on VVM-based vaccine management - January 21st @ 4pm CET

Please join us for a webinar on vaccine vial monitor (VVM)-based vaccine management, on the occasion of publishing of “The Book of VVM: Yesterday-today-and-tomorrow” by Umit Kartoglu. The webinar will take place on Tuesday, January 21st at 4pm CET. During the webinar, the presenters will discuss the critical role of VVM in vaccine management policies as well as the VVM shaping the future of the (digitized) cold chain. The presenters will be: Umit Kartoglu, Co-founder and CEO, Extensio et Progressio, Collonge-Bellerive, Switzerland (author of The Book of VVM) Debbie Kristensen, Director of Vaccine Technology, Strategy, and Policy / Medical Devices and Health Technologies, PATH, Geneva, Switzerland Ted Prusik, Co-founder and Senior Vice President, Temptime Corporation, Morris Plains, NJ, USA For presenter biographies, refer to the attached document. It is not an overstatement to say that VVM is one of the most important recent innovations in the area of public health, providing health workers with advisable and dependable means of ensuring that the administered vaccine has not been damaged by heat. Amongst all the temperature monitoring devices and tools, VVM is the only one that has dramatically changed the course of vaccine management practices as well as shaped the future of the cold chain. Some critical approaches we have today in vaccine management have only been made possible with the help of VVM, and others have been made more effective. For a quick review of VVM-induced vaccine management policies and VVM based vaccine management, refer to pages 201 and 245 in The Book of VVM (free download in PDF and ePUB3 formats from http://kartoglu.ch/vvm). Registration at: https://who-meeting.webex.com/who-meeting/onstage/g.php?MTID=e27289500ca959052459c45ec0e2540e1

Effective Vaccine Management assessment tools

Dear TechNet colleagues

i'm looking for the updated version of the Effective Vaccine Management assessment “EVM” tools, if anyone has it; appreciate if shared it with me   Advanced Thanks 

Enroll Now- Registration Start for Online PGD in Global Health PSM_March 2020

Empower's 22nd Batch of the Online Post Graduate Diploma Course in Global Health Procurement and Supply Chain Management, in collaboration with Kent State University, USA, is scheduled to launch in MARCH 2020 . This is an 11-month online program which includes 9 extensive modules structured to address one topic per month Key Takeaways from the course: - its global orientation ¬ sharing of experiences from across countries, - a practical and applied approach to the extensive use of exercises, case studies, projects and internships - technical assistance for one-year offered which includes Mentoring/Coaching from the Subject Matter Experts - an online competency assessment tool (CAT) - a community of practice (through Empower’s Big Learning Platform) - use of cutting-edge e-learning technologies and instructional design to make learning easy and impactful Kindly click on this link to register - http://bit.ly/2UzLGnf For any query email me at info@empowerschoolofhealth.org

Job Opportunity: Supply Chain Workforce Strengthening Specialist, IntraHealth, Washington DC

Andrew Brown Publié dans :
Dear Colleagues,

IntraHealth is seeking a Supply Chain Workforce Strengthening Specialist to work on the USAID-funded Global Health Supply Chain project. The Specialist provides strategic leadership and technical support through a holistic organizational and human resources systems approach to improve and sustain the performance of the supply chain workforce, with reference to private sector approaches. This position is based at the project headquarters in Crystal City, Arlington, Virginia, with travel internationally as needed, approximately 30% of the time. Applicants must have authorization to work in the United States at the time of application.
For more information go to: https://recruiting.ultipro.com/INT1028/JobBoard/e2116091-25aa-2eb8-64d2-db11ee75b469/OpportunityDetail?opportunityId=0f4f6d99-ce1d-4c05-b273-1722b8caeaae Regards,
Andrew Dr Andrew Brown | Senior Director, Health Workforce Development
(Adjunct Associate Professor, University of Canberra)
IntraHealth International | Because Health Workers Save Lives.
t. +61 (0)411137625 | abrown@intrahealth.org
skype. andrew.brown.uc

Country vaccination policies worldwide

Dear all, I am a researcher at the University of Oxford working on a project to compare country vaccination policies worldwide and was wondering if you could help me with finding some information. Could you please tell me whether any of the vaccines recommended in the national immunisation schedule in your country are mandatory, such as in order to enter school? And do you know of any legislation on which this is based? I will of course acknowledge any contributions. Any pointers would be greatly appreciated! You can see in the map below I'm slowly starting to get country data but I still have some gaps. I intend this to be an open-access resource for people to provide the first comprehensive list of vaccination policies worldwide. Kind regards, Samantha Vanderslott Dr Samantha Vanderslott Social Sciences Researcher, Oxford Vaccine Group 34 Broad St, OX1 3BD University of Oxford https://samanthavanderslott.com/

Innovative Best Clinical Practice for replication in the Medical Community.

Dear techNet community viewers Greetings from KVG Medical Coillege team. We wish to share the following on going success story with the viewers for further contribution and also a PPT is attached on the same. Hope you will enjoy. What is the innovative practice: Established “nursing station” for administering tuberculin as per CDC / RNTCP guidelines. Since tuberculin is an antigen, inducing / detecting cell mediated immunity, supplied in multi dose vial like Injectable Polio Vaccine for which Open Vial Policy is applicable; meant for administering to different beneficiaries, CDC recommends establishment of a “nursing station” for providing quality service for obtaining reliable result1. Margaret Good et.al expressed that developing a “better” test or “better” test reagent remains a perpetual challenge for the scientists, till such time administering tuberculin with potency will remain the most widely used means of determining the Mycobacterial infection2.       “Knowledge is of no value unless you put it into practice, Practice till you are the best, Practice to remain the best.” Our innovation is to strengthen RNTCP by religiously practicing existing guidelines regarding Mantoux test [Tuberculin Skin Test –TST]. Senior chairpersons in the ZTF aptly called End TB stakeholders to get involved proactively. TST needs to be “approached with respect, administered with care, read with deliberation, interpreted with sentient discrimination”. Once a “Demo-Site” is established, replication for acceleration is much easier through cross learning visits and regular retro visits for sustenance.         What is happening: Proactively and opportunistically, we found a few good practices of dedicated skilled persons administering tuberculin and designated Doctor reading the test result with minimal loss to follow-up deserving felicitation. Though TST is in practice since 1907, many avoidable programmatic errors are occurring in all the thematic areas from cold-chain to documenting, reading and interpreting the results in all the institutions (>20) in four states visited by the author in the last two years. These may grievously affect decision making [Picture2]. Charity begins at home. We established nursing station, operationalized standard guidelines, totally eliminated programmatic errors through hands on training and sustaining through supportive supervision till date. How established: On appraising Medical Director regarding ongoing programmatic errors, we were asked to rectify. In response, author studied CDC / RNTCP guidelines and product specific manufacturer’s notes in depth. All the CDC rights to be observed while administering vaccines are applicable to tuberculin also3, in addition two more are added: the do’s and don’ts by the beneficiary and ii) ensuring reading of the test between 48 and 72 hours without fail by the team. Through “learning; both by doing & working together approach”, We developed a comprehensive job-aid including standard operating procedure, indications / contraindications / limitations / interpretation of results with scientific discrimination, displayed in the nursing station as a ready reckoner [Picture1]. This is used for educating the nursing students, medical students, interns bringing the case for testing, post graduates, faculties, visiting faculties from other institutions, shared with the inviting medical colleges for release in the CMEW on TST as a public health event for similar purposes in their institution [Pictures 2 to 15].  We also developed the following TST specific novel form / format and tool: A) Supportive Supervision checklist for multiple purposes of concurrent recording of existing practices, hands-on training for capacity building, instant cessation of wrong practices, on the spot initiation of right practices, capacity building of key personnel for long term sustenance – [Appenix1] B) Universal register for adequate and uniform documentation – [Appendix 2] C) The tool for capturing related core data for deriving specific indicators for submitting along with monthly report, facilitating operational research. [Appendix 3] We regularly shared our progressive experiences with End TB stakeholders from local to global viewers for additional inputs.        We are blessed; establishing nursing station was a cake walk in our institution as we are already running dedicated vaccination clinic as per WHO/GOI guidelines, taking care of all the “rights”. To this we added 2 more “rights”, one comprehensive job-aid and a novel form of supportive supervision, a format for standard register for documenting and a tool providing denominator, recording numerator for deriving the indicators. We have the right cold-chain equipment – the Ice-lined refrigerator for keeping tuberculin. Recently H&FW department fixed temperature logger which displays temperature between 2.50C and 40C. [Picture11] In the regular Academic Society Meeting and the RNTCP core committee we presented the Standard Operating Procedure [SOP] for valuable suggestions and additional inputs which we incorporated and started functioning since April 2017. We won the hearts of all clinical departments through quality service including no lost to follow-up case. This is the nodal learning centre for nursing students, medical students, interns, Post Graduates, faculties and even the external examiners.                                                                                   Impact: Referral for TST from the clinical departments has drastically increased. Lost to follow-up greatly reduced to almost zero except a death before 48hrs. We regularly shared our experiences with End TB stakeholders up to global viewers through techNet-21. For the Medical Colleges of home district we arranged two workshops. After disseminating our experience on 7th June 2019 in the State Task Force meeting with RNTCP nodal officers of medical colleges of Karnataka, till date six Medical Colleges organized CMEW for sensitizing on “The Diagnostic role and the rights to be observed with TST” – in short TST workshop, others will hopefully follow.               Currently, DTO invited the author to conduct workshops for the lab technicians of Dakshinakannada district in two batches, first batch held on 19th Dec 2019.   Thus we not only identified the problems but eliminated and replicating the elimination in a wider area across the state with stakeholder’s support, hoping to replicate across the country.          In 2018, India shared 27% incidences of TB & MDR/RR-TB, 11.2% of TB-HIV co-infection and 35.48% deaths of Global TB burden4. Director General WHO iterated that Elimination of TB from the world is a social justice. India is committed; eradicated polio and got the certificate on 2th March 2014, a milestone public health event5. India advanced the goal of End TB by 5 years aiming to lower prevalence, incidence, mortality of TB from ~300/L; 199/L; 32/L of 2018 to 65/L, 44/L, 3/L respectively and zero catastrophic cost by 20256. GoI has also committed to screen ~250 million less than 18 year population both for TB & Leprosy and to put them on treatment if required7. As per WHO, BCG vaccination and effective curative services are the two important areas of TB prevention.   In this regard Mantoux test has a definite role to play as a diagnostic adjunct in early diagnosis.         Way forward: Uniform and universal all time practicing of CDC / RNTCP guidelines for administering tuberculin in all service delivery points, both in public and private sectors by establishing standard “nursing station” and regular retro-visits (monthly once for 4 consecutive months, quarterly once thereafter) by KVG team for reinforcement to sustain right practices through sustained supportive supervision, hands on training, especially to the “non viable” testers.        Acknowledgement: With government support, this nursing station can be upgraded to TST Clinic; making it a hub for the effective implementation of newer tests / vaccine on introduction, additional TB related activities like quality newborn BCG vaccination, active case search for early diagnosis, piloting any new innovative interventions, Advocacy Communication Social Mobilization [ACSM], follow-up for treatment adherence both in the college and attached RHTC / PHCs, hand in glove with the government for attaining and sustaining “Zero TB” area. Best wishes Holla n Team

Updated Gavi CCEOP Technology Guide

Hi all, Gavi, the Vaccine Alliancce has updated the Cold Chain Equipment ‘Technology Guide’, to support the appropriate selection of modern, efficient and reliable technologies. We wanted to let you know the updated CCEOP Technology Guide is available here (and attached) and will permanently be hosted on this page of the Gavi website.    The Technology Guide, which was complied through inputs from Alliance partners and technical asistance providers, provides an overview of equipment that is eligble for support through Gavi's Cold Chain Equipment Optimisation Platform (CCEOP). It also provides guidance on identifying the most appropriate equipment choices for each health facility to help ensure more facilities have adequate cold chain capacity from higher performing equipment that stays functional for longer periods of time. Equipment included in the Guide is PQS certified and meets additional platform eligibility requirements. The Guide is intended in particular for use in identifying CCE needs and solutions for health facilities and at lower levels of the cold chain.    The Technology Guide will be updated twice a year. Please contact Karuna Luthra (Gavi Market Shaping) with any questions. 

LAST CHANCE: Have your say about global estimates of national immunization coverage (WUENIC and more))

Please have your say about the GLOBAL ESTIMATES OF IMMUNIZATION COVERAGE (WUENIC) by completing this online survey focusing on data quality, data use and decision-making. The direct link to the survey (15 minutes) is: https://forms.gle/ifX9TsAGqWbLBrY77 - it is in English, but you can add your comments in French or Spanish.  The objectives of this stakeholder analysis are to explore the different uses of the WUENIC coverage estimates for decision-making as well as their usefulness for those purposes. As we enter in the next decade of immunization and the Immunization Agenda 2030 (IA2030), a consultation and stakeholder analysis on the WHO/UNICEF estimates of national immunization coverage (WUENIC) https://www.who.int/immunization/monitoring_surveillance/routine/coverage/en/index4.html and underlying data is being conducted by the Swiss Tropical Public Health Institute (Swiss TPH). In case you missed it, there was also an earlier survey on perceptions about the credibility, accuracy and quality of coverage estimates (WUENIC and others). The direct link to that earlier survey is: https://forms.gle/9dUMZb1zABRdbkmb8. If you have time, you can still complete this one in addition to the main online survey listed above.  Please share this survey broadly with other members of the immunization community.   If you have questions about this survey, please contact vpdata@who.int

GHSC-PSM Publishes Supply Chain Management Professionalization Framework Whitepaper

Dear Colleagues, Competent, qualified supply chain management (SCM) professionals are increasingly in-demand in both the private and public sectors – how can we ensure all needs are met?
GHSC-PSM believes a “whole of SCM labor market” approach is needed, starting with a competency framework.
Please find attached and see here ( https://www.ghsupplychain.org/comprehensive-workforce-systems-approach ) our recently published study, with People That Deliver (PtD) and SAPICS, that explores perceived needs as well as the similarities and differences between existing government and private sector SCM competency frameworks, which could serve as the core of an SCM professionalization framework. We are continuing to move this work forward with PtD and SAPICS in 2020. Should you have any questions then please contact me. Kind regards, Andrew Dr. Andrew N Brown
Workforce Development Specialist
Team Lead for: Workforce Development and Enabling Environment
Contractor for USAID Global Health Supply Chain Program
Procurement and Supply Management
251 18th Street South, Suite 1200
Arlington, VA 22202
United States
m:+1.571.665.8319 +61.411.137.625
e: abrown@ghsc-psm.org
Skype: andrew.brown.uc

New WHO publication on effective communication of immunization data

Many people depend on data related to vaccines and vaccine-preventable diseases to guide their decisions, from setting health system budgets to choosing whether to vaccinate their children. Those who compile and analyse data work hard to ensure the timeliness, accuracy and consistency of the numbers. But when (and if) the numbers are communicated beyond the immunization programme, this tends to be with little thought or resources invested in making sure it is communicated in a way that speaks to the target audience.    WHO/Europe’s new publication “Effective communication of immunization data” aims to generate more interest and build capacities in data communication as a means to support decision making and achievement of immunization targets and goals. It covers a range of topics including defining the objective and target audience, shaping the message accordingly and choosing colours and format to increase clarity and impact. 

Last Cochrane Review on Needle size for vaccination

Dear all - Happy 2020!! I came across a relatively recent update to the Cochrane Review of Needle sizes for vaccination. I thought I'd share it with the TechNet Community. The full report is here: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010720.pub3/full Cochrane Database Syst Rev. 2018 Aug 9;8:CD010720. doi: 10.1002/14651858.CD010720.pub3. "Authors conclusions: Using 25 mm needles (either 23 G or 25 G) for intramuscular vaccination procedures in the anterolateral thigh of infants using the WHO injection technique probably reduces the occurrence of local reactions while achieving a comparable immune response to 25 G 16 mm needles. These findings are applicable to healthy infants aged two to six months receiving combination DTwP vaccines with a reactogenic whole-cell pertussis antigen component. These vaccines are predominantly used in low- and middle-income countries. The applicability of the findings to vaccines with acellular pertussis components and other vaccines with different reactogenicity profiles is uncertain."

Power Quality Challenges in LMICs - Data and Analysis

Dear TechNet community, Poor power conditions are a major challenge to maintaining the vaccine cold chain in many LMICs, necessitating the development of specialized CCE such as ILRs and SDD refrigerators to help keep vaccines at safe temperatures in areas with limited or no mains power.  Even in places with an electrical grid connection or a generator, intermittent power can lead to ILRs running out of holdover, and erratic voltages can damage many types of medical devices and equipment. Despite these well-known issues, to date, data on power conditions in LMIC health facilities have been largely anecdotal or small-scale, which impedes evidence-based policymaking.  To quantify power availability and quality challenges, Global Good – in close partnership with Nigeria’s National Primary Health Care Development Agency (NPHCDA) and Kenya’s National Vaccines and Immunization Program (NVIP) – has compiled an analysis of mains power data reported over nearly 18 months by WHO-prequalified ILRs operating in health facilities across Nigeria and Kenya.  We are sharing this analysis in hopes of informing tangible improvements in both the performance and reliability of mains-powered CCE, as well as other priority medical devices and equipment utilized in health facilities within LMICs.

This analysis, co-authored by NPHCDA and NVIP officials, is based on approximately 96,000 facility-days of mains power data collected over a nearly 18-month period from ILRs operating in more than 300 health facilities spanning both countries.  These power data and other information collected by the ILRs belong to the respective countries; Global Good has been granted access to the data to enable collaboration with pertinent national and global stakeholders on tools to better utilize CCE data and make it actionable.  This overview of grid quality realities on the ground shows that multi-day interruptions are common, and that proper protection for medical equipment is essential given the widely varying line voltages experienced at most health facilities.   The initial analysis in this paper focuses on general power availability and quality at health facilities, with a few specific implications for CCE at those facilities including: 68% of the monitored devices in Kenya and 92% of those in Nigeria experienced power outages in excess of 48 hours. Therefore, long holdover times provide additional safety, even at those facilities with generally reliable mains power. Voltages fluctuate significantly, and stabilization can increase the ‘usable power’ availability at many health facilities – only 32% of the devices in Nigeria had access to in-range power (i.e., within 10% of nominal voltage) more than 30% of the time. However, with PQS-defined extended range voltage stabilization (i.e., 110 to 278 V), 58% of devices would have access to ‘usable power’ more than 30% of the time. Damaging high voltage events are common and can persist for hours or days – the graphs below show example voltage profiles from Kenya and Nigeria that would require protection between the socket and CCE (or other medical devices and equipment) to prevent damage to the electronic controls over time. These traces show data measured every 10 seconds, illustrating sustained voltages both above 400 V and below 100 V, and rapid fluctuations in and out of the CCE’s usable voltage range. Additional graphics and discussion are in the full document, and Global Good will continue analyzing data and sharing conclusions as more information is collected.  We hope this analysis will prove valuable for specifications- and standards-setting bodies, equipment designers and equipment purchasers, and we look forward to a vibrant discussion with the TechNet-21 community via this forum. We wish to acknowledge and extend our sincere appreciation to NPHCDA and NVIP for supporting and co-authoring this analysis.  We also want to acknowledge Qingdao Aucma Global Medical Co. for producing the WHO-prequalified ILRs that collected the study data, and eHealth Africa, Caroga Pharma Kenya Ltd, and Fenlab Ltd. for installation and service support in the two countries. The document is also availble here: http://power.2to8.cc/Power_Quality_Challenges_In_Low_Resource_Settings_2019.pdf    Best regards, Jenny Hu Senior Engineering Lead Global Good

Polio resurgence

Last Friday (Dec 6), The Star reported the country’s Health Ministry confirming that a three-month-old boy from Tuaran, Sabah, has been infected with vaccine-derived poliovirus type 1 (VDPV1) after being admitted into a hospital’s intensive care unit. The Star quoted health director-general Dr Noor Hisham Abdullah who said on Sunday (Dec 8): “The patient is currently undergoing treatment in an isolation ward and is in stable condition but needs respiratory support.” He added that the poliovirus is classified as a circulating vaccine-derived poliovirus type 1 (VDPV1), which originates from a poliovirus that has been weakened by the orally-administered polio vaccine. The Star reported that Dr Hisham said the weakened virus excretes from the body through faeces. However, in unsanitary environments, the virus can infect others who have not been immunised against polio and will “thus spread in communities whose polio immunisation rates are less than 95 per cent”. He warned that if the disease is left uncontrolled, it can genetically mutate until it once again becomes an active virus. In an article on Monday (Dec 9), The Associated Press (AP) quoted Dr Hisham as saying that vaccination will be stepped up after an investigation in the infant’s home village showed that 25 out of 204 children, aged between two months and 15 years, were not vaccinated against polio.
Link: https://www.businessinsider.my/malaysias-first-polio-case-in-27-years-is-a-child-who-wasnt-vaccinated-here-are-3-things-to-know-about-the-incurable-virus/

Mantoux Test Workshop for sensitizing Lab Technicinans

Dear Viewers Happy Christmas to techNet community. I wish to share the following as a preparedness strategy. Recently, District TB Officer – Dr Badrudeen MN, in collaboration with state WHO consultant – Dr Shazia Anjum, and all other stakeholders of bordering district of Kerala State conducted a cross border meeting as the disease agent – Mtb knows no border. For eliminating TB, drastic reduction of population infection [human reservoir] comprising the LTBIs pool has to be achieved and sustained. World has ⅓ of population infected with Mtb ~2 billion. As per WHO; TB control has two areas, 1. BCG vaccination & 2. Early diagnosis and prompt treatment. People who have infection today are the future TB cases, from this reservoir,  5 to 10% develop disease in their life time and an estimated 10% of them die of TB. India had 27% each of global incidence of TB and MDR/RR-TB, contributed 35.48% of TB deaths in 2018. India is committed to eliminate TB by 2025 by reducing prevalence to ≤65, incidence to ≤44 and TB death to ≤3 per lakh per year with zero catastrophic cost. India also rolled out a plan to screen below 18 year both for TB and Leprosy and to put them on treatment if required.        In this regard, TST helps in screening for which operational knowledge about Tuberculin and its administration is very important. Hence DTO organized this workshop to the testers – the frontline service providers in advance for sensitization. First batch was held on 19th Dec 2019.   This will be followed by 2nd batch shortly. On 19th test could not be demonstrated as the neighboring pediatric institution had 10TU / 0.1mL reagent. DTO is funding the 8 Medical Colleges of his district also for organizing similar workshops for eliminating programmatic errors of which 2 have organized. Acknowledgement: I thank DTO and his team and the participants (>30) of the workshop who profusely thanked for updating their knowledge regarding Mantoux test. with best wishes Dr Holla       

Buffered Cold Chain a new approach

After reading Umit's book my interest in what I call the "buffered Cold Chain" BCC, was renewed.In his book I found the history and the description of the obstacles which were overcome very interesting.
By BCC I mean a cold chain which will maintain temperatures between 20 degC and 25 degC . These higher temperatures could be maintained with simple low cost systems. The life of a vaccine will be shortened at these higher temperatures however in many instances the reduced life will be adequate. The time to end point at these temperatures can be determined form the the graphs on pg 183 of Umit's book. At 20 degC the life of a VVM 2 vaccine will be 22 days and the life of a VVM 7 will be considerably longer 89 daysand the life of the less sensitive vaccines will be even longer.
An interesting point is that a 5 degC change in temperature will change the life of all
vaccines by a factor of aproximately two, this can be seen form the graphs on pg 183 of Umit's book. For example if the storage temperature of a VVM 14 vaccine increases from 15 degC to 20 degC it's  life will decrease from about 400 days to 200 days, for a VVM2 vaccine if the storage temperature increases from 20 degC to 25 degC the life of the vaccine will decrease from about 20 days to 10 days.
Storage temperatures in the 20 degC to 25 degC are easily attained by thermal electric cooling.These solid state devices are reliable, low in cost and light weight, unfortunately at lower temperatures
they are very inefficient. However in the 20 degC to 25 degC temperature range they can provide reliable refrigeration.
A thermal electric cooled refrigerator can be purchased for less than $100 and with slight modifications the cooler could be connected directly to a solar module.The installed system cost of SDD thermal electric cooler would be about one fifth the cost of a standard compression driven SDD system. The thermal storage required to maintain adequate temperatures at night will be considerably less than what is required in standard SDD refrigerators because the storage temperature will be close to the night time temperature.
Thermal storage requirements could be further reduced by incorporating "Time Temperature Integration"in the monitoring device. On pg 150 of Umit's book he points out how MKT temperatures can fulfill this function. The MKT temperature is a weighted average which counts higher temperatures more than lower temperatures.Details of how MKT temperature is used to determine the impact of a temperature excursion are detailed in the Science section of Umit's book. If for example at night the temperature climbs to 28 degC,and during the day the cooling system reduces the temperature to 12 degC the MKT temperature may be about 22 degC; with this temperature excursion the life of the vaccine willbe the same as a vaccine which is constantly kept at 22 degC. A small electronic device could be built which would display the MKT temperature and also the loss of life of the stored vaccines. The loss of life could be displayed for vaccines of different sensitivities. the results displayed would be consistent the change of life indicated by VVM's.
The Buffered Cold Chain is another tool to expand the cold chain in a low cost manner.
If there is further interest in this concept, please contact me.   Larry Schlussler Phd
Sun Frost  

Recommendations from SAGE Oct 2019 - published today- Data Use and Quality highlighted

WER with recommendations from SAGE Oct 2019 was published today (attached). Below I highlight two areas related to immunization data use and quality. Enjoy the reading, Carolina “[Immunization Agenda 20330] IA2030 envisions a world in which “everyone, everywhere, at every age, fully benefits from vaccines for good health and well-being”. To achieve this vision, a balance is struck between a disease-specific and a systems approach, with commitment to existing goals for eradication and elimination, new goals for the next decade and alignment as closely as possible with the GVAP review. The 7 strategic priorities of the IA2030 framework are: 1) immunization for primary health care and universal health coverage, 2) commitment and demand, 3) coverage and equity, 4) life-course and integration, 5) outbreaks and emergencies, 6) supply and sustainability and 7) research and innovation. These priorities will be achieved on the basis of 4 core principles: people-focused, country-owned, partnership-based and data-enabled” __________________________________ “SAGE endorsed the following recommendations: Embed monitoring of data quality into global, regional and national monitoring of the surveillance of immunization and [vaccine-preventable diseases] VPDs. Increase the capacity and capability of the workforce for ensuring data quality and use, starting at the level at which data are collected. Improve the accuracy of denominators. Enhance use of all available data for tailored action, including programme planning, management and decision-making. Adopt a data-driven continuous quality improvement approach as part of health system strengthening at all levels. Strengthen governance of the pilot-testing and use of new tools for collection and use of immunization and surveillance data. Improve data-sharing and knowledge management among areas and organizations for greater transparency and efficiency. WHO and UNICEF should strengthen global reporting and data monitoring through a periodic needs assessment and revision process. These recommendations should be added to the IA2030, and regions and countries should include multi-component interventions for improving data quality and use in their regional 2021–2030 strategies. These recommendations should also be integrated into the broader efforts of [Universal Health Coverage] UHC and [Primary Health Care] PHC.”

WHO/UNICEF National Immunisation Coverage Estimates: Have your say!

Hi everyone :) We are now circulating the final survey for this study on national vaccination coverage estimates.   Grateful for any time you can spare to complete and share. Many thanks, Caitlin ________________________ Project: World Health Organization (WHO) / United Nations Children’s Fund (UNICEF) Estimates of National Immunization Coverage (WUENIC): a study to explore (i) the use and usefulness of estimates for decision making, and (ii) methodological approaches to improve estimates of national immunization coverage WHO/UNICEF National Immunisation Coverage Estimates: Have your say! Can we BELIEVE in vaccination coverage DATA? Is data QUALITY good enough? Are DECISIONS about vaccination jeopardised by data issues? HAVE YOUR SAY IN THESE DEBATES, across multilateral organisations, ministries of health, donors, academia and NGOs! As an expert in vaccination and/or data, we need your views to inform future vaccination coverage data issues. Online survey (15 minutes): https://forms.gle/ifX9TsAGqWbLBrY77  

Drones for Health, exploring immunization supply chain solutions in DRC

Dear TechNet Community, I have an exciting milestone to share on behalf of the VillageReach Drones for Health team: Since 2015, VillageReach has collaborated with stakeholders at local, regional and global levels to support supply chain solutions, including exploring the use of unmanned aircraft systems (UAS) for health to speed up deliveries and to reduce costs in logistically challenging, low-resource environments. In the Democratic Republic of Congo (DRC), we are working with the Government and Gavi on a phased approach to test and integrate drones into the existing immunization supply chain in Équateur, a large and logistically challenging province in northwestern DRC. The aim is to integrate a new transportation solution to supply vaccines more quickly and efficiently to the most inaccessible health centres in the province. VillageReach with Swoop Aero, national and provincial government stakeholders in DRC hit an exciting milestone – repeated, safe transport of vaccines and other products, via drone, in Equateur province. In summer 2019, Swoop Aero conducted a series of test and demonstration drone flights to deliver vaccines, syringes, medicines and other supplies from Mbandaka town to the village of Widjifake, which is 3 hours away by road, but 20 minutes by drone. Flights were conducted across the Congo River, forests and the populated area of Mbandaka. In just 5 days, Swoop’s drones conducted 50 flights to and from the health centre, covering a total of 2000 km in the air and transporting over 25 kg of health products for Widjifake and three other neighbouring health centres. The results from DRC will help to inform programming and decision making regarding the next phase, including the integration of UAVs in the routine vaccine transport system to deliver immunization products in the Équateur. Through collaboration with governments, the private sector and non-governmental organizations, VillageReach is an expert in managing proof-of-concept flights that can further guide the decision to invest in the implementation of integrated supply chains. I welcome and feedback or questions from those who are working with or interested in using drones for immunization delivery. If you would like any more information, do not hesitate to reach out. Best, Gabriella Ailstock VillageReach, Drones for Health Team https://www.villagereach.org/work/drones-for-health/

Keeping the promise

Dear viewers, we wish to share the attached with the techNet community          This year on 14th November 2019, we celebrated “EuVac award ceremony” in our college to felicitate the parents for getting their children graduated timely with primary vaccination before first birth day and booster before 2nd birthday. On 14th It was decided to felicitate the parents throughout the year on the day of vaccination with DPT & OPV 1st booster and MR 2nd dose. This is adding jubilance both to the service provider and the beneficiaries though it incurs a little extra to the management. Vaccination service is free as the essential vaccines of National Immunization Schedule is supplied free on a regular basis by the district health and family welfare services and administered free. Regards KVG team  

05 days International training programme on “Logistics Management of Vaccines with special focus on Strengthening Cold chain ” during April 20-24,2020 at The IIHMR University, Jaipur, India .

Respected Sir/Madam  
Greetings from IIHMR UNIVERSITY, JAIPUR , INDIA I take immense pleasure to share with you that School of Pharmaceutical Management; The IIHMR University is organizing a 05 days International training programme on “Logistics Management of Vaccines with special focus on Strengthening Cold chain ” during April 20-24,2020 at The IIHMR University, Jaipur, India. The program is designed primarily with a focus to assist the countries/national health system programs to address the challenges in vaccine management thus ensuring access to quality vaccines in the immunization program. The program contents are as below PROGRAM CONTENTS: -
Introduction to immunization basics and Universal Immunization Program (UIP) Procurement of vaccines Cold chain management Key elements of cold chain system Cold chain Equipment’s and their maintenance Monitoring the cold chain temperature Vaccines Management Demand estimation Indenting Stock Management Storage & Distribution Supportive supervision Reporting/Documentation & MIS AEFI and Immunization Waste Management eVIN- Effectively managing vaccine logistics Social mobilization, advocacy and communication for EPI Field visit to cold chain point  Hands on training on temperature monitoring devices Link for brochure https://www.iihmr.edu.in/files/training/brochure/170/logistics-management-of-vaccines.pdf PROGRAMME FEE Foreign Nationals: USD 700 per participant plus 18% GST Indian Nationals: Rs 37,500 per participant plus 18% GST The fees cover tuition fees, training material, stay in air-conditioning room (twin-sharing basis), breakfast, lunch, dinner, tea/coffee during the program and pick-up and drop from Jaipur airport/railway station/bus stand. Welcome dinner and short-trip to historical and cultural importance places in Jaipur would be offered by the University in honor of the participants. Participants would be encouraged to use library facilities. Around the clock internet facility (Wi-Fi) is available for the participants. The travel tickets from the country of origin to Jaipur and vice versa are to be borne by the participant/sponsoring agency.  DISCOUNTS ON THE FEE
Early Bird Discount: Nominations received with payments on/before 4-weeks (23rd March 2020) will be entitled to an early bird discount of 10%. Group Discount: Any organization sponsoring four or more participants to the program will be entitled for a discount of 20% on the total fee payable provided that at least four participants attend the program. Maximum Discount: Organization can avail themselves of both the discount subject to maximum discount of 20%. I am sure that you will find it useful for the organization/national health system program. I would be grateful, if you could participate/nominate interested candidates in the training program. You may forward to concerned department also Kindly send the filled and scanned nomination form (attached) to the program coordinator at saurabh@iihmr.edu.in    Looking forward for your kind cooperation and support to make the program success. A word of response would be appreciated. Regards   Dr.Saurabh kumar Banerjee  M.Pharm, Ph.D., MBA Associate  Professor and Program Coordinator The IIHMR University, 1 Prabhu Dayal Marg, Near Sanganer Airport Jaipur (Pin-302029), Rajasthan, INDIA Office: +91 141 3924700, Ext: 789,  Fax: +91 141 3924738, Mobile - +91-8890398067 Email: saurabh@iihmr.edu.in

RFP for Project Management support for "Immunization Agenda 2030"

Ebru Ekeman Publié dans :
Wellcome Trust has issued the enclosed RFP to seek project management support to support the development of the new immunization vision and strategy for the next decade - "Immunization Agenda 2030 (IA2030)" The post will be based in Geneva, WHO HQ. The proposal shall be submitted by close of business Dec 9th, 2019 directly to Genevieve Hughes at Wellcome (G.Hughes@wellcome.ac.uk)

Looking for Health Supply Chain and logistics advocacy materials targeted to decision-makers

Dear TechNet members, With the purpose of promoting strong health supply chain systems, I am looking for recent advocacy materials targeted to senior leadership on the benefits of implementing good supply chain strategies and practices to fully serve the needs of public sector facilities and their population. Thanks so much for sharing materials, guidance tools and experience at country level. Best wishes. Dorothy

Efficiency of Influenza vaccine

What is the efficiency of Influenza vaccine?

Join us on Thursday! Webinar: Five proven strategies to improve immunization data use

Join us for a webinar: Five proven strategies to improve immunization data use (Findings from the Immunization Data: Evidence for Action Review) Date: Thursday, December 5, 2019 3:00 pm
Europe Time (Paris, GMT+01:00) The use of high-quality data is widely understood in the global health community to be a cornerstone of well-functioning health systems. However, despite continuous growth in the amount of health data available, the actual use of data in immunization program decision-making remains a challenge. Part of the challenge has been a limited understanding of what tools and approaches actually are effective in increasing the use of immunization data to support improvements in vaccine delivery and access. The Immunization Data: Evidence for Action (IDEA) Review was undertaken to identify the existing evidence on what works to improve the use of immunization data, and to synthesize that evidence into actionable steps that implementers, policymakers and funders can take to design better data use interventions.

During this webinar, the presenters from PATH will share the methodology used to identify and review 549 pieces of evidence and five proven strategies to improve data use that were uncovered. They also will discuss the evidence gap map that was developed and how the global immunization community can work together to increase the quality of evidence available on best practices for data use to help further the work started by the IDEA team.


Discussion panelists

Laurie Werner- Director of Program, Center of Digital and Data Excellence, PATH
Allison Osterman- Program Officer, Health Systems Innovation and Delivery, PATH

Save the date and please join us! Link to register: https://who-meeting.webex.com/who-meeting/onstage/g.php?MTID=ec0039a66d95132ed3f30c6988ade4314

Intensified Mission Indradhanush [IMI 2.0] Participation by private sector

Dear viewers India is committed and consistently trying to improve and sustain vaccination coverage. Despite the best efforts; we have to go only a few more miles to achieve and sustain >90% from the current 87% vaccination coverage for which GoI launched Intensified Mission Indradhanush [IMI 2.0]. In addition to the universal reasons which the country is addressing, good performing districts have additional district specific problems too which can be easily and locally addressed by the district task force [DTF] with proactive involvement of stakeholders, specifically private sector through simple doable measures. The attached is shared with the stakeholders of Dakshinakannada district. We wish to share with the global viewers as some of the issues like quality of vaccination service with regard to mainly the potency of the vaccine are questionable in the private sector. Once vaccinated by a private service provider, the babies permanently loose the opportunity of getting vaccines with known potency. For example, as of now, child has only one opportunity in its life time to receive BCG vaccine, if not administered properly adhering to the 8 rights of CDC before administering the vaccine, these children will not develop “Immunogenic scar”. More than 75% of births are taking place in private birthing facilities in Dakshinakannada and the neighboring district Udupi. As of now India has the dubious distinction of having highest number of Tuberculosis cases: ~27% of the world and ~35% of TB deaths. BCG vaccination is the oldest and the cheapest public health intervention but needs to be administered properly – one of the two areas of TB prevention. Now the district / state and the country are well galvanized, ready to receive an appropriate dent in the programme. Private Service providers too are keen to participate actively, proactively with proper direction and channelization by the public sector. Hence we wish to share the success story with global viewers. With best wishes Holla n KVG team EDIT: The hypothetical example had projection up to state level. On suggestion and request, I have projected it to the country level (n=26 million). The attachment has been replaced with relevant editing. 

Upcoming webinar on 5 Dec 2019: Five proven strategies to improve immunization data use

Join us for a webinar: Five proven strategies to improve immunization data use (Findings from the Immunization Data: Evidence for Action Review) Date: Thursday, December 5, 2019 3:00 pm
Europe Time (Paris, GMT+01:00) The use of high-quality data is widely understood in the global health community to be a cornerstone of well-functioning health systems. However, despite continuous growth in the amount of health data available, the actual use of data in immunization program decision-making remains a challenge. Part of the challenge has been a limited understanding of what tools and approaches actually are effective in increasing the use of immunization data to support improvements in vaccine delivery and access. The Immunization Data: Evidence for Action (IDEA) Review was undertaken to identify the existing evidence on what works to improve the use of immunization data, and to synthesize that evidence into actionable steps that implementers, policymakers and funders can take to design better data use interventions.

During this webinar, the presenters from PATH will share the methodology used to identify and review 549 pieces of evidence and five proven strategies to improve data use that were uncovered. They also will discuss the evidence gap map that was developed and how the global immunization community can work together to increase the quality of evidence available on best practices for data use to help further the work started by the IDEA team.


Discussion panelists

Laurie Werner- Director of Program, Center of Digital and Data Excellence, PATH
Allison Osterman- Program Officer, Health Systems Innovation and Delivery, PATH

Save the date and please join us! Link to register: https://who-meeting.webex.com/who-meeting/onstage/g.php?MTID=ec0039a66d95132ed3f30c6988ade4314


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