Networking activities 2007

• 15th Task Force on Immunisation in Africa Annual Meeting and 14th
  African Regional Inter-Agency Coordination Committee Annual Meeting.
  Antananarivo, Madagascar, 11 - 13 December 2007
• Immunisation and health in Africa; CSO consultation meeting and GlaxoSmithKline Biologicals consultation on Meningococcal Meningitis in Africa ‘Ending the cycle of epidemics'.
  Nairobi, Kenya, 2 - 4 May 2007
• EPI managers meeting Eastern and Southern Africa
  Harare, Zimbabwe, 14-16 March 2007
• Training Partnership Meeting
  New York, USA, 16 February 2007
• 12th meeting of the Eastern Mediterranean Regional Working Group on the Global Alliance for Vaccines and Immunization (GAVI) and first meeting on Health Systems Strengthening
  Cairo, Egypt, 21 – 23 January 2007

Networking 2007

15th Task Force on Immunisation in Africa Annual Meeting and 14th African Regional Inter-Agency Coordination Committee Annual Meeting
Antananarivo, Madagascar, 11 - 14 December 2007

The Task Force on Immunisation in Africa (TFI) and the Regional Inter-Agency Coordinating Committee (ARICC) for WHO/AFRO meet once every year to review lessons learnt in implementing the EPI programme in the region, to make recommendations, to guide priority actions, and to obtain commitment of partners to support the programme.

The TFI meeting reviewed the progress achieved and the constraints faced in 2007. Most important, this meeting gave orientations for priority activities in 2008 and was followed by the ARICC meeting aimed at obtaining partners commitment to support priority actions for 2008. These meetings provide an important venue where different partners meet to review progress and make recommendations for the ensuing year and pledge commitments that are integrated into an annual action plan for the WHO/AFRO Department of Vaccines and Biologicals, which guides all training activities for Africa.

The specific objectives of the meeting included: (1) follow-up on the resolutions of the previous TFI meeting (out of the 22 recommendations of the previous TFI, 15 have been achieved while 7 have been partially achieved); (2) provide updates on the global immunisation situation and specifically in the AFRO Region; (3) look into performance of routine immunisation and the RED strategy; (4) update on the global, regional and specific national polio situations, and communication for polio eradication; (5) immunisation financing and systems strengthening; (6) provide un update on integration of immunisation and other child survival strategies as well as integrated pre- and in-service training on child survival; (7) give an update on the status of introduction of HepB and Hib vaccine, and recent developments in the area of new vaccines.

Immunisation and health in Africa; CSO consultation meeting and GlaxoSmithKline Biologicals consultation on Meningococcal Meningitis in Africa ‘Ending the cycle of epidemics’
Nairobi, Kenya, 2 - 4 May 2007

The meeting on Immunisation and Health in Africa was convened by AMREF and supported by GSK and drew participants from governments, CSOs and pharmaceutical industry in the region.

The objectives of the meeting included: (1) to inform the vaccine research and development community on the role and potential of CSOs in immunisation; (2) to inform CSOs on benefits of existing and new vaccines, and the potential of their increased involvement; (3) to strengthen the link between communities and health systems, through CSO involvement in immunisation; (4) to explore ways civil society and communities can be party to shaping immunisation policies and interventions in Africa; and (5) to identify priority areas of action to ensure that immunisation is available to everyone. Prof Andre Meheus was invited to present on ‘Value of Immunisation’.

The vaccine R&D community acknowledges that health systems are well below the desired capacity. Having commended the existing CSO involvement in the delivery of immunisation services, it was agreed that there is great potential for expanding civil society’s role. CSOs could assist in strengthening the capacity of health systems as well as influencing the immunisation policy-making process across the African continent.

Universal immunisation is a key factor in achieving the UN MDGs which underwrite Africa’s future development. All existing and new vaccines must be made available on a sustainable basis to those who need them. All African governments must be held to account for the commitments they made at the Abuja 2000 meeting. Likewise, the OECD countries must fulfil their pledge to commit 0.7% of their GDPs to aid for the developing world. Adequate, quality health care and immunisation services must also be placed high on the agenda of Africa’s ministries of health and finance.

The GSK consultation on meningococcal meningitis in Africa was an opportunity to discuss in-depth the broader themes that emerged during the AMREF meeting ‘Immunisation and health in Africa’. Recommendations of the consultation included: (1) to continue to expand research on the economic impact of meningococcal meningitis, launching a network of advocates working in the meningitis belt, identifying existing resources, and working closely with WHO to set up a sub-regional forum; (2) to include as potential partner the Francophone Regional Institute for Public Health in Benin, and the ECOWAS Ministers meeting as an advocacy opportunity; and (3) to share information on meningitis advocacy efforts and identity the best way to engage in collective advocacy efforts.

EPI managers meeting Eastern and Southern Africa
Harare, Zimbabwe, 14-16 March 2007

The EPI programme managers meeting for the Eastern and Southern block was organised by WHO/AFRO with the support of UNICEF and other partners. The objectives of the meeting were to update EPI staff on resolutions taken during several key meetings in 2006 (previous programme managers meetings in Lilongwe and Mombasa, TFI and ARICC meeting in Maputo), to receive technical updates (for example on the new protocol for polio surveillance and on the progress in malaria vaccination), to review the progress in EPI programme implementation in particular regarding polio eradication, measles control and elimination of maternal and neonatal tetanus, to discuss different approaches and best practices in the implementation of integrated activities (such as child health days and outreach services) as well as opportunities for health service strengthening (such as data quality self assessments and use of hand held computers for data capturing during supervision), to presentation of specific components of country programmes as well as comprehensive discussions on country programmes, to financing mechanisms for vaccine purchase, vaccine logistics and transport management.

Training Partnership Meeting
New York, USA, 16 February 2007

The 5th training partnership meeting was held in New York on 16 February 2007. The meeting involved public and private partners and academia, focusing on the identification of training needs and coordination of training activities to match the needs.

The meeting started with the analysis of the web-based survey among partners. The main outcome of the survey was that: most partners provide a comprehensive package of training that includes disease and vaccine specific information, the RED approach, new vaccines, AEFI and disease surveillance, cold chain, monitoring immunisation programmes, injections safety, waste disposal; some partners are focusing more on specific components such as logistics, including transport management, conducting programme evaluation and the introduction of vaccination against Japanese Encephalitis, which are not included by most partners; areas to be further strengthened include social mobilisation and advocacy, disease surveillance; about 3 out of 4 respondents provide face to face training, and 1 out of 4 mentioned blended training including a combination of face to face and information technology. Most of the training activities focused at senior, mid-level management and health workers.

Each organisation made a presentation on the objectives of their organisation, the achievements in 2006 and the plans for 2007, followed by a discussion. Web-based and “blended” learning was prominent in the presentations of AMP and PATH.  Merck has been focusing on collaboration with a university in Mali and the Moi University in Kenya. A call for proposals has been opened by the Merck Foundation to include other universities.

The initial objective of the meeting was to decide on the need for an overall immunisation training framework and agreement on a process for developing such a framework including priority areas and the optimisation of training activities, while cognisant of some of the broader integration challenges. The Framework for training presented by WHO is important as a global standard as well as for individual countries. It is absolutely essential to use this framework as an instrument for comprehensive Multi-Year Planning and budgeting. The framework should therefore urgently be finalised and disseminated.

The partnership meeting is an important opportunity for exchange of experiences and material and promotes networking between UNICEF, WHO, GAVI, Academic and private partners. The 2007 action plan of NESI seems to respond to the needs and is closely coordinated with WHO/AFRO and WHO/EMRO and there is no overlap with initiatives of other partners.

12th meeting of the Eastern Mediterranean Regional Working Group on the Global Alliance for Vaccines and Immunization (GAVI) and first meeting on Health Systems Strengthening
Cairo, Egypt, 21 – 23 January 2007

The objectives of the meeting were: to review country progress in finalising the national financial sustainability plans and to discuss the main constraints and support needed to assist countries submitting acceptable financial sustainability plans on time; to review country progress in implementing RED approach, and monitoring and evaluation of district performance; to discuss new vaccine introduction in Sudan (HepB) and Yemen (Pentavalent); to discuss country multi-year plans and; and to brief participants on the new GAVI window HSS (Health System Strengthening) and draft 2007 work plan relating to coordination of country’s support for HSS.

The meeting was convened by WHO/EMRO and was attended by participants from member states in the EMRO Region: Afghanistan, Djibouti, Pakistan, Somalia, Sudan and South Sudan. Other participants were from WHO/EMRO, WHO/HQ, WHO/country offices, GAVI, UNICEF, African Development Bank and NESI. Out of 22 countries in the EMRO Region, only 6 countries receive GAVI support.

The first day and a half focused on immunisation services support (ISS). Dr. Mohsni from WHO/EMRO gave an overview of the regional progress, constraints and perspectives. The main targets for the Region are to eradicate polio, eliminate measles by 2010, eliminate maternal and neonatal tetanus (MNT) by 2007, eliminate congenital rubella syndrome (CRS) by 2010 in countries that have introduced rubella vaccine, introduce HepB vaccine in all countries by 2007, introduce Hib vaccine in all countries that have demonstrated disease burden by 2010. By 2010, all countries should reach more than 90% DTP3 coverage  at national level and more than 80% coverage in every district. The regional priority is to increase routine coverage in the 6 priority countries (GAVI support). Country progress regarding improving access to routine EPI and introducing new vaccines was presented by the respective EPI managers from Afghanistan, Djibouti, Pakistan, Somalia, Sudan and South Sudan.

The second part of the meeting focused on Health System Strengthening (HSS). Any GAVI eligible country can apply for HSS support. HSS funding is based on the number of newborn children. The time period is based on the national planning cycle and till 2010. Expenditure can be spread over the agreed funding period as required. Three themes were suggested for HSS, but are not exclusive: health workforce, primary care infrastructure, organisation and management of services at district level and below. Requirements for HSS funding include: active health sector coordination committee, immunisation cMYP, health sector strategic plan description of main areas HSS will support, annual action plans. GAVI-HSS vision: to achieve and sustain increased immunisation coverage in all GAVI eligible countries, through strengthening the capacity of the health system to provide immunisation and other health services. Each country presented on health system challenges, strategies and vision, and their drafting country plans for HSS.