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Regional Immunization Program in the Americas: A Regional Public Success

Regional Immunization Program in the Americas: A Regional Public Success. Dra. Gina Tambini Area Manager Family and Community Health Pan American Health Organization . Vaccination Coverage of Children*, Region of the Americas**, 1978-2001. Source: Country data

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Regional Immunization Program in the Americas: A Regional Public Success

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  1. Regional Immunization Program in the Americas: A Regional Public Success Dra. Gina Tambini Area Manager Family and Community Health Pan American Health Organization

  2. Vaccination Coverage of Children*, Region of the Americas**, 1978-2001 Source: Country data *Coverage for BCG, OPV3 & DTP3 among children <1year of age. For measles, coverage among children 1 year of age. **Excluding Canada and Argentina. Data for USA for years 1999 & 2000. For USA, polio coverage for 2 doses only as third dose generally given during second year of life. USA does not vaccinate with BCG.

  3. Initial Efforts Towards a Regional Program • Early 1970s • Low immunization coverage (25% - 30%) • Separated efforts by disease • Isolated and few national programs • Discontinuity of national efforts • Mid 1970s • WHA 1974: Establishment of EPI • WHA 1977: Global goal: 80% coverage by 1990 • WHO/PAHO and UNICEF 1977: support to EPI globally and in the Americas • WHO 1978 Alma Ata: Declaration on PHC

  4. Launching a Regional Program • Countries and PAHO • Resolution to establish EPI 1977 • Revolving Fund 1979 • Resolution on Regional Polio Eradication /EPI 1985 • Goal: no more cases of polio by 1990 • Plan of Action • Promote accelerated EPI in all countries • Training of field epidemiologists and program managers • Standardized national and regional surveillance and response systems • Regional Commitments • PAHO, USAID, IDB, Rotary Intl, UNICEF, CPHA

  5. Institutional Structure for a Regional Program • National • Similar - adapted to country • Political commitment (92% national resources) • ICC: national and international members • Technical Advisory Committee on Immunization Practices • EPI Division at MOH • Public delivery system at MOH • Strong civil society involvement

  6. Institutional Structure for a Regional Program • International • ICC: PAHO, UNICEF, USAID, Rotary Int, IDB, CPHA Plus “Child Survival”: UNDP and World Bank • TAG: Technical support to ICC 9 experts on immunization and disease control • PAHO’s technical Secretariat: HVP Division • Surveillance and Laboratory Regional Network • Regional Revolving Fund for Vaccine Procurement (PAHO)

  7. Features of a Regional Response • Standardized multi-disciplinary evaluation of national immunization programs (at least every 5 years) • Standardized five-year National Plans of Action • Permanent technical cooperation at the regional and national levels, and among countries (horizontal)

  8. Features of a Regional Response • Technical know-how in immunization, cold chain, vaccine procurement, R&D and quality control • Inter-country surveillance networksand cross learning through multiple instances • Record tracking of best practices and lessons learned • Regional Revolving Fund for vaccine procurement

  9. Benefits of a Regional Response Independent Evaluation:Taylor Commission, 1995 • Objective: Identify the impact of polio eradication on countries’ health systems. • Members:Carl Taylor, Hesio Cordero, Felicity Cutts, Dean Jamison, Julio Frenk, Efraín Otero, Julia Walsh • Method:Rapid Assessment Procedures (RAP) • Universe:6 countries ( Mex, Guat, Col, Par, Bra, and Bol). 544 interviews.

  10. Benefits of a Regional Response Conclusions of Taylor Commission, 1995 • Overall strengthening of health systems in the Americas • Improved management of health service delivery • Developed a “culture of prevention”, ensuring resource allocation for immunization programs • Achieved social mobilization and intersectoral cooperation

  11. More benefits Taylor Commission conclusions (cont) • Human resource development: training and skills improvement • Useful information systems: tailored to program needs, standardized indicators, use of data for decision-making and systematic monitoring. • Effective epidemiological surveillance methods. • Cross-fertilization with other health programs: innovative joint interventions

  12. Type 1 vaccine derived virus in 2000 and 2001 * Coverage data for children <1 year of age * Data as of 26 October 2002 -2,539 confirmed cases # Coverage data for children <1 year of age Countries with cases in the last 3 years: Argentina, Bolivia, Brazil, Colombia, Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru and Venezuela * Data as of June 2002 # Coverage data for children <1 year of age Impact of Immunization in the Americas

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