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Training IRC-Proposals-Team October 5 2012

Men A & Yellow Fever Preventive Campaigns: an essential part of a multifaceted strategy for disease control. Training IRC-Proposals-Team October 5 2012. Epidemic Meningitis & Yellow Fever.

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Training IRC-Proposals-Team October 5 2012

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  1. Men A & Yellow Fever Preventive Campaigns: an essential part of a multifaceted strategy for disease control Training IRC-Proposals-Team October 5 2012

  2. Epidemic Meningitis & Yellow Fever • Meningococcal Meningitis and Yellow fever are endemo-epidemic diseases mainly affecting Sub-Saharan African countries • Disease burden lower than for respiratory or diarrheal infections • Seasonal large scale & lethal epidemics occur regularly creating human distress and disrupting health services • Safe, effective and affordable vaccines are available to protect at risk populations

  3. Immunization Strategies for Epidemic Meningitis andYellow Fever Epidemic Meningitis • Rapid response to outbreaks • Outbreak containment - emergency stockpile • Large scale preventive mass campaigns • Rapidly inducing herd immunity – eliminate epidemics • Protect new birth cohorts • Within the EPI schedule or through follow-up mass campaigns Yellow Fever • Rapid response to outbreaks • Outbreak containment - emergency stockpile • Preventive campaigns for population at highest risk • Reduce/eliminate risk of epidemics • Protect birth cohorts • Routine infant immunization - EPI

  4. PreventiveCampaigns: Definingriskcriteria to support planing, implementation and impact evaluation • Principle: • Countries with the highest epidemic risk should be prioritized • No all the population within a country is at the same level of risk • Assessing the epidemiological risk • Review epi data: historical surveillance data, gray/published literature • Collect complementary data: field studies, serological surveys, etc… • Categorization of risk: statistical / mathematical models • Assessing non epi factors (environmental, operational, etc…) • National/international Expert's opinion • Obtain stakeholder's consensus • Forecast vaccine needs • Provide background surveillance data for impact assessment

  5. Result of Meningitis Risk Assessment: Immunization Phases in Nigeria REPUBLIC OF NIGER Phase One: 17,515,568 doses needed 1 2 3 4 5

  6. Result of Yellow fever Risk Assessment: Immunisation Phases in Nigeria 2013 (Phase I) 2014 (Phase II) 2015 (Phase III) 2016 (Phase IV) 2017 (Phase V, after completion of this application)

  7. Roll Out Plan for Men A Vaccine: PreventiveCampaigns in 26 countries, 2010-2016

  8. YF Preventive Campaigns: Implementation Planning Investment case countries Countries requiring GAVI application

  9. Preventive Campaigns Men A conjugate vaccine:Progress to date. 2012 - 2012 57 million people vaccinated 2012: 54 M

  10. YellowfeverPreventiveCampaigns:Progres to date, 2007 - 2012 YF Preventive campaign achieved YF Preventive campaign partially achieved Risk assessment done - campaign planned Risk assessment 2012 63 million people vaccinated

  11. Special conditions for GAVI Men A & YF vaccine applications • MenA & YF preventive campaigns • Co-financing not required • GAVI finances full cost of vaccine for campaign • GAVI provides $0.65 per dose to cover operational costs • Countries are required to accommodate the balance of operational costs • MenA & YF routine immunization • GAVI provides funding for support to routine YF • Support for introduction of MenA in routine (2015) under discussion • Co-financing policy applies from onset of support

  12. Expected Applications for Men A & YF vaccines in 2012 Men A • Ethiopia : 68 m in three phases • The Gambia : 1.2 m Yellow Fever • Nigeria : 75 m in five phases • Cameroun : 7 m in two phases

  13. YF Vaccine Supply: an Important Constraint YF Vaccine • 4 manufacturers: Bio-Manguinhos, Sanofi-P, IP-Dakar, Chumakov • Production capacity: 125m doses/y • Actual production ~60-80 m doses/y • IC boosted vaccine production from 30 to 75 m/y • End of GAVI support risks to drasticallyreducesupply In 2013 YF vaccine production will decrease to 60 m

  14. YF outbreaks since 1980 Assembled from WHO outbreak list and publications (Weekly Epidemiological Record)

  15. StrategicDemandForecast for Men A vaccine Men A conjugate • Only one prequalified manufacturer : SIIL • Production capacity: 55-75 m doses/y • Definition of routine strategydeterminant for vaccine production/ forecasting Source: Path

  16. Thank-you!

  17. Three outcomes are obtained through a mixed methods approach Classification and categorization leading to risk ranking and categories Based on risk level Decreasing risk levels might used to phase immunization over time Expert Opinion will confirm or refute the vaccination order Performance Flags computed independently of the level of risk

  18. Implementation Note: DPT will be implemented in some countries after the campaigns. Main aim of the exercise will be impact assessment and surveillance reinforcement.

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