Update on WHO GAVI European Regional Working Group

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

Reported immunization coverage rate WHO/EURO, 1990 -2001 WHO Regional Office for Europe

1991 Coverage for DTP 3/OPV 3 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 DTP 3/OPV-IPV 3 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 Hep. B • 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 Hep. B immun. . WHO Regional Office for Europe

Reported DTP 3 and Hep. B 3 coverage WHO/EURO, 2001 WHO Regional Office for Europe 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 ? DTP 3 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 DTP 3 coverage 50% - 80% Immunization services, new and under-used vaccines and injection safety DTP 3 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 WHO Regional Office for Europe

Status of Hep. B introduction in GAVI / VF eligible countries (# 1) Country 1 st GAVI supply Status of Hep. B introduction ALB October 2001 Continued; started in 1994 ARM June 2001 Continued; started in 1999 AZE June 2001 Started in October 2001 Bi. H 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 Hep. B introduction in GAVI / VF eligible countries (# 2) Country 1 st GAVI supply Status of Hep. B 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 WHO Regional Office for Europe

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