Transcript Conclusions of the meeting and closing remarks

Conclusions of the meeting
and
closing remarks
Chronology
1981
1991
1996
2000
2001
2001
Hepatitis B vaccine becomes available
World Health Assembly resolution call for the inclusion of
hepatitis B Immunisation of infants in all national immunization
programmes
Conference on prevention and control of hepatitis B in
countries of central and eastern Europe and the Newly
Independent States, Siofok, Hungary
Global Alliance for Vaccines and Immunization
launched
GAVI Board decision on fourth round of proposals to the
Vaccine Fund
Conference on strengthening immunisation systems and
introduction of hepatitis B vaccine in central and eastern
Europe, St Petersburg
Emerging themes and results
• Progress since Siofok
– better country specific epidemiological
picture
– broad range of partners
– GAVI/The Vaccine Fund
– Multi-year plans
– 21 countries with HB immunisation
programmes
Coordination and planning
• Inter-Agency Coordinating
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Committee
Tools for financial planning
Vaccine procurement
Increasing recognition of hepatitis C
Clinical diagnosis and serological
testing
Programmatic aspects (1)
• Immunization schedules/birth dose
• Programmes for adolescents/risk
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groups
Integrated programmes
Evaluation of immunisation
programmes
Programmatic aspects (2)
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Nosocomial transmission
Safe injections
Cold chain
Surveillance
Cross-cutting themes
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Political commitment
Advocacy and education
Media/anti-vaccine groups
Safety of hepatitis B vaccine
Build on existing systems and create
networks
Feedback from the country
workshops
Global health context
• New, broad partnerships
• Health rising up the political agenda
• Increasing international attention to
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strengthening health systems
Viral hepatitis must be on those
agendas
Issues (1)
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Several countries still do not have
universal infant or adolescent
immunization programmes
Unclear strategies for HB vaccine use in
some countries
Severe resource constraints still present
in the region
Ineffective procurement leads to relatively
high and inconsistent HB vaccine prices
Financial sustainability of immunization
big issue in this region
Issues (2)
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Lack of effective advocacy for this region
at the global level
Relatively small pool of donors interested
in immunization
National level ICC’s not common in region
Anti-vaccination ideas are beginning to
spread in parts of the region
Cold chain upgrading required in certain
countries
Technical Issues (1)
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Epidemic of HBV, HCV and HIV among
injecting drug users in many countries in
region
Nosocomial transmission of HBV, HCV
and HIV huge problem in region
Safe immunization, injection safety (need
to transition to autodisable syringes in
most countries)
Medical waste management big problem
Information systems need to become
much more effective management tools
Technical Issues (2)
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Surveillance for hepatitis (with standard
definitions and procedures) needs
strengthening
Laboratory support for hepatitis diagnosis
lacking
Huge need for training (and documents) at
all levels for immunization and
surveillance
Burden of Hib disease not well established
in region
Next Steps (1)
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Next meeting in 2 years to ensure GAVI
resources well used and plans for
sustainability progressing
Regional GAVI Working Group should
coordinate provision of technical support
Regional Working Group should be a
liaison to the Regional ICC for
mobilization of additional resources
All countries, even non-Fund-eligible
should undergo process of assessment,
multi-year plan and establishment of ICCs
Next Steps (2)
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The options for more rational procurement of
vaccines such as HB and Hib should be
explored (focus low population countries).
These should include investigation of
innovative procurement (a PAHO like
revolving fund) mechanism for the region
The limited funding and partner support in
the region should be presented and
discussed at a meeting of the GAVI Board
Next Steps (3)
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Financial sustainability of immunization
including HB and Hib vaccines is of
highest priority in the region, and all
countries and partners should be working
on these issues.
The region, working with the SIGN, and
other partners, should work to reduce
nosocomial transmission. This should
include transition to auto-disable
syringes, training, and social mobilization
issues
Next Steps (4)
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Information systems in the region should
be used as more effective management
tools, including vaccine management.
The region should study the possibility of
expanding the Ukraine Information System
to other countries in the region
Next Steps (5)
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Transparent district level monitoring of
immunization coverage should be
reviewed monthly and immediate action
should be taken if reports are missing or
inconsistent with previous reports.
Similarly surveillance data should also be
used for active management of the
programme
The region should support countries for
Hib burden assessments, and coordinate
the work with the GAVI R&D group
Next Steps (6)
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Advocacy
– Support to countries to counter the
activities of anti-vaccine groups
• seminars
• information on a website
– Countries should engage in social
mobilisation