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PRESENTATION TO ICC ON URGENT IMMUNIZATION ACTIVITIES

PRESENTATION TO ICC ON URGENT IMMUNIZATION ACTIVITIES. 4 th ICC meeting 8 th November 2012. Outline. Proposal to GAVI on Measles follow up campaign Update on Yellow Fever preventive campaign proposal. Proposal to GAVI on Measles follow up campaign. Purpose of presentation.

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PRESENTATION TO ICC ON URGENT IMMUNIZATION ACTIVITIES

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  1. PRESENTATION TO ICC ON URGENT IMMUNIZATION ACTIVITIES 4thICC meeting 8th November 2012

  2. Outline • Proposal to GAVI on Measles follow up campaign • Update on Yellow Fever preventive campaign proposal

  3. Proposal to GAVI on Measles follow up campaign

  4. Purpose of presentation • To present the national plan for measles mortality reduction in line with the global elimination goals. • To obtain ICC approval in seeking and accessing GAVI support for the national plan being proposed. • To mobilize resources from partners to support GoN contribution for the plan in lieu of the lean purse, time available to mobilise the required resources and the risk of outbreaks in 2013.

  5. Expectations • Buy in by local and international partners into the plan. • ICC approval obtained to meet the deadline of submission of proposal to GAVI. • Measles is a target indicator for MDG 4 . MDG debt relief grant has funded immunisation (all measles campaigns in the past) excellently well. We look forward to all partners contributions.

  6. Context • Measles global elimination plan is to reduce mortality by 95% compared with 2000 estimates (91% already achieved) • In-order to achieve MDG 4 by 2015, measles vaccination is a major contributor towards reducing childhood mortality. • The success of Govt’s program of saving a million lives will rely extensively on quality measles vaccination. • There is therefore the need to take advantage of the opportunity of GAVI’s support for Measles SIAs that will strengthen the health system.

  7. Elements in the Proposal • Introduction and Background Information • Health sector indices especially measles vaccination coverage trends • Recent outbreaks and risk of resurgence • Goals and Objectives • Justification • Population at Risk • Phasing of the campaign • System strengthening activities • Experience from previous campaigns • Lessons learnt from previous campaigns • Media plan • Coordination • Monitoring and evaluation • Budget and financial analysis

  8. KeY HIGHLIGHTS OF THE PROPOSAL

  9. TREND OF MEASLES AND CONTROL EFFORTS 2005 - 2012 Catch up 1st follow up

  10. Trend of Measles and Control Efforts 2006 - 2012

  11. Routine Measles Vaccination Coverage 2003-2010 (Nics)

  12. Goal for Measles in the proposal • VISION To achieve and maintain a country free from the burden of measles. • GOAL The goal of the measles follow up campaign is to contribute significantly and rapidly to the attainment of the global measles elimination target by 2020

  13. Objectives for Measles in the proposal • OBJECTIVES • Provide periodically (2013 and 2016) a second dose measles vaccine integrated with OPV to children 9-59m regardless of their previous vaccination status • Minimize measles outbreaks by ensuring the highest quality coverage of 95% in every local government area of the country(mop ups after follow ups is a necessity) • Use the measles follow up campaigns to strengthen the health system in the broader context (outreach services, facility cold chain capacity and supply chain, waste management, strengthen case detection and investigation, laboratory , data reporting and analysis, micro-planning at LGA/Ward/Health facility levels). • Strengthen case based surveillance system for measles especially the laboratory expansion and integration with YF • Strengthen the pharmaco-vigilance system for monitoring adverse events following immunization

  14. Justification • Measles immunity gaps exist • Poor RI coverage • 2011 Post follow up campaign coverage is poor in 299 LGAs • Recurrent outbreaks post- follow up campaigns • SIAs could help with strengthening health systems (outreaches, lab, cold chain, data) • Integrated with OPV in Nigeria gives better coverage for OPV • Golden opportunity in the window of support coming from GAVI

  15. Follow up campaign plan in 2013 PHASE 1 – August 2013 19 Northern states Target population : 19,592,468 PHASE 2 - September 2013 • Southern states Target population : 14,671,414 Vaccines required – 37m doses Vaccination strategy – fixed and mobile Field guide needs a review in view of innovations (vaccination cards, mop ups, keep ups, coverage survey, ----)

  16. Cold chain capacity • Requirement for measles campaign vaccine at national level would be about 72m3. This would require measles vaccine to be sent IMMEDIATELY to zonal stores upon arrival and will need one cold room at each zonal store to accommodate this vaccine. • Campaign vaccine would need 30% of extra space compared to RI load. With recently concluded assessment, the capacity of LGA stores can accommodate RI+Penta+Pneumo+ Rota (which is 350% of present RI storage volume requirement. This would mean that measles vaccine for campaign can easily be accommodated at LGA level. Similar rule applies for state vaccine stores.

  17. Cold chain status analysis

  18. Partnerships, Coordination and Communication • Consolidating Lion’s club and bring in new partners like BMGF etc • National Measles committee will coordinate the activities within the ICC working groups on a permanent basis • Sustained media plan for measles building on elimination theme – highlighting of measles threat and branding measles efforts as ‘Keep Us Alive’ • Engagement of Nigerian Governor’s Forum

  19. Lessons learnt from past campaigns • Planning well ahead (9months as in 2005) • Proper timing of campaign • Epidemiologically the low season of transmission is August –September • Climatic/social considerations that will allow better access and coverage of children • Timely availability of resources • Better coverage for Polio when integrated • Documentation and planning for recoveries

  20. Benefits • Strengthening of the Health System- outreach services, data, micro-planning at LGA/Ward /HF levels • Strengthening of case based surveillance – integrated laboratory network with YF • Increase/improve cold chain capacity • Expand waste management for Nigeria • Enhances the potential to introducing MCV2 as a combination vaccine (MR) into the routine immunization schedule

  21. Budget • Vaccine costs- USD 14,618,563 • Operational costs - USD 32,079,209 • Follow up in 2013 – USD 30,369,319 • Mop ups in 2013- USD 1,084,051 • Keep up vaccinations up to 2015- USD 627,839 • Other HSS strengthening : USD 7,116,414 • Expected contribution from GAVI - USD 22,271,535 • Expected contribution from GoN – USD9,807,673

  22. Financial analysis • Average cost per immunised child projected is $1.36 • Secured funding is not available yet – missed 2013 budget cycle • Probable funding • GAVI • MDGs • Local Partners • Resource mobilization through PPPs and others like the National Vaccine Summit call to action.

  23. Prayers • Call for ICCs inputs and endorsement of the Measles follow up campaign plan • ICC to request for partners support and contribution • Endorse the proposal of support to GAVI as presented by endorsing the application page

  24. Acknowledgements • HMH, HMSH • ED NPHCDA • GAVI • WHO: HQ, AFRO, IST and Nigeria • BMGF • UNICEF • JHU

  25. Update on Yellow Fever preventive campaign proposal

  26. Background The ICC will recall that Yellow Fever preventive campaign proposal was stepped down during the ICC meeting of 16th August 2012 In line with the suggestion of the ICC the proposal was revised and virtual endorsement obtained from ICC members (8 members) The IRC reviewed the proposal and gave a conditional approval

  27. IRC Findings • Programme issues • Period covered by the proposal (Online application tool does not allow country to go beyond the end year of the cMYP 2015) • Budgeting issues • Double counting of personnel costs • Endorsement procedure not very clear to GAVI so therefore requesting a ratification of that endorsement

  28. What we have done • The Yellow Fever plan was based on the availability of vaccines. This has been explained to GAVI and the cMYP will be revised in 2013 to capture the 2016 and 2017 Yellow Fever campaigns • ICC Finance committee have revised the budget to USD 38,853,128 (N6,022,234,913) from USD 49,662,908 which has been circulated to all members • We are hoping this ICC will ratify their earlier endorsement of the Yellow Fever Proposal

  29. 2013 - 2016 -Nigeria: Yellow Fever Mass Vaccination Campaign summary budget

  30. Prayers • Urge the ICC to ratify their endorsement of the YF proposal and the revised budget • ICC to agree with our plans to revise the cMYP by next year 2013 to capture 2016 and 2017 campaigns • Agree on the clarifications to be submitted to GAVI on the conditions

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