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Update on WHO GAVI European Regional Working Group and hepatitis B Immunization Viral Hepatitis Prevention Board Meeting 7-8 November 2002 Catania, Italy WHO Regional Office for Europe 100 % Reported immunization coverage rate WHO/EURO, 1990-2001 80 60 40 20 BCG WHO Regional Office for Europe Years OPV3/DTP3 MCV 01 20 00 20 99 98 97 96 95 94 93 92 91 90 0 HepB3 1991 Coverage for DTP3/OPV3 vaccine at 12 months of age Administrative data: 1991 Cisid >95% 90-95% >80 % 80-90% <80% no data reported WHO Regional Office for Europe 2001 Coverage for DTP3/OPV-IPV3 vaccine at 12 months of age Administrative data: 2001 Joint Reporting Form >95% 90-95% 80-90% <80% no data reported WHO Regional Office for Europe Introduction of new/underutilized vaccines • Substantial progress in introducing HepB • 41 countries already included into routine immunization programme – 37 infant & routine – 4 adolescent • Hib; widely used in W. Europe, limited in other areas – Need for burden assessment • Improvement in implementation WHO Regional Office for Europe Hep B immunization programmes, WHO European Region, 2002 Routine infant Routine newborn Adolescent only Selective HepB immun.. WHO Regional Office for Europe Al ba Ar ni a m en Au i a s Bu tria lg a Be ria la G rus eo rg i Ky Is a rg rae Ka yzs l za ta kh n Li sta th n ua ni La a M tvia ol do v Po a l Po and rtu g R al u Sl ssi a ov a Tu kia rk U ey U kra zb i n ek e is ta n Reported DTP3 and HepB3 coverage WHO/EURO, 2001 100 90 80 70 60 50 40 30 20 10 0 DTP3 WHO Regional Office for Europe HepB3 Data from JRF Objectives of GAVI Immunization is the right of every child to be protected against VPDs • Improve access to sustainable immunization services • Expand use of all existing vaccines • Accelerate research and development of vaccines, with special focus to developing country needs • Immunization an integral part of health systems and international development WHO Regional Office for Europe GAVI Vaccine Fund support * new and under-used vaccines – Hep B – Hib – Yellow fever; bundled with safety equipment * immunization services support * injection safety support WHO Regional Office for Europe What will the FUND finance ? DTP3 coverage <50% Immunization services and injection safety Basic Conditions GNP/capita < US$ 1000 ICC or equivalent Immunization assessment in last 3 years Multi-year plan for Immunization Injection safety strategy WHO Regional Office for Europe DTP3 coverage 50% - 80% Immunization services, new and under-used vaccines and injection safety DTP3 coverage >80% New and underused vaccines and injection safety Countries eligible for support from the GAVI Vaccine Fund Eleven out of 51 countries: • • • • • • Albania Armenia Azerbaijan Bosnia & Herzegovina Georgia Kyrgyzstan WHO Regional Office for Europe • • • • • Moldova Tajikistan Turkmenistan Ukraine Uzbekistan Status of country applications for GAVI / VF support, October 2002 Status of country applications Countries SIS Albania Hep B Hib Inject.Safety Inject.Safety Assessment Approved Conditional re-submit 2000 Not yet Approved 2003 Armenia Approved Approved Azerbaijan Approved Approved Conditional 2003 Approved re-submit Postponed Approved Approved Oct-02 Bosnia & Herzegovina Georgia Approved Kyrgyzstan Approved Approved Conditional 2001 Moldova Approved Not yet re-submit 2000 Approved re-submit 2002 Turkmenistan Approved re-submit 2003 Ukraine Approved Not yet Sep-02 Uzbekistan Approved Approved 2001 Tajikistan WHO Regional Office for Europe Approved Not yet Status of HepB introduction in GAVI / VF eligible countries (# 1) Country 1st GAVI supply Status of HepB introduction ALB October 2001 Continued; started in 1994 ARM June 2001 Continued; started in 1999 AZE June 2001 Started in October 2001 BiH Not yet Started in 1999 GEO August 2002 Started in 2000 (USAID) KGZ March 2001 Started in 1999; since May 2001 in whole country WHO Regional Office for Europe Status of HepB introduction in GAVI / VF eligible countries (# 2) Country 1st GAVI supply Status of HepB introduction MDA June 2002 Started in 1995 (JICA) TJK December 2001 Started in February 2002 TKM November 2001 Started in January 2002 UKR Not yet Started in 1996 UZB August 2001 Started in October 2001 WHO Regional Office for Europe GAVI related activities WHO/EURO • Immunization and cold chain reviews • Disease burden assessments • Planning – Multi-year national immunization plans including new vaccine introduction – Safety of immunization – Financial sustainability • Implementation – Training at national and subnational levels – Supervision • Coordination – National ICCs WHO Regional Office for Europe GAVI related activities WHO/EURO Monitor progress – Annual progress reports and joint reporting from – Data quality audits • Subregional immunization programme managers meetings • St Petersburg 2001 • Vienna 2002 • Kyiv 2003 (planned) • Expansion to other countries – policies and strategies – training programmes and material – support for vaccine procurement WHO Regional Office for Europe Technical support to GAVI countries, 2000-2002 Areas of technical support Countries ALB ARM AZE BIH GEO KGZ MDA TJK TKM UKR UZB GAVI documents National plans x x x x x x x x x x x x x x x x x x x x x x WHO Regional Office for Europe MLM+HepB training x x x x x Injection safety assessment Cold chain assesment Immunization safety planning x x x x x x x x x x x x x x x x x x x x x x x x x European GAVI Regional Working Group • Established and regularly met since 2001 • Members: WHO, UNICEF, World Bank, CVP/PATH, Vaccine Fund, VHPB and CDC/Atlanta • Coordinate GAVI partners’ support and activities • Ensure timely and appropriate technical and financial support to countries • Identify needs for strengthening immunization services and capacities for introduction of new vaccines • Strengthen National ICCs • Provide input to the Regional ICC WHO Regional Office for Europe GAVI initiative and lessons learned WHO European Region • Opportunity for accelerating new vaccine introduction • Impact on strengthening immunization services – – – – programme assessments multi-year immunization plans resource mobilization, coordination (national ICCs) emphasis on injection safety • Expand infrastructure, build capacity – Access (80/80 district goal) • Apply lessons learned to other countries WHO Regional Office for Europe Areas for future action • Strengthen immunization service delivery • Provide policy guidelines • Use national multi-year plans as a managerial tool • Monitor implementation/exchange information • Support mid-term reviews and development of FSP • Technical support for Hib burden assessments • Support training, also for introduction of new vaccines • Apply lessons learned/experience gained to “non-GAVI” countries WHO Regional Office for Europe