New vaccine introduction in the East and Southern African sub-region of the WHO African region in the context of GIVS and MDGs
World Health Organization, Expanded Programme on Immunisation, Immunisation and Vaccine Development, South Africa.Vaccine (Impact Factor: 3.62). 09/2012; 30 Suppl 3:C3-8. DOI: 10.1016/j.vaccine.2012.05.086
Immunization programmes have over the years proven to be effective and useful in infectious disease control. However, based on current trends that show that many developing countries will not reach the Millennium Development Goals (MDG) targets, there is an urgent need to accelerate efforts to control the most common conditions still responsible for the largest morbidity and mortality in children under 5 years of age, like diarrhoea and pneumonia, for which safe and effective vaccines are now available.
- Vaccine 09/2012; 30 Suppl 3:C1-2. DOI:10.1016/j.vaccine.2012.06.094 · 3.62 Impact Factor
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ABSTRACT: We assessed the knowledge and awareness of cervical cancer, HPV and HPV vaccine, and willingness and acceptability to vaccinate in sub-Saharan African (SSA) countries. We further identified countries that fulfill the two GAVI Alliance eligibility criteria to support nationwide HPV vaccination. We conducted a systematic review of peer-reviewed studies on the knowledge and awareness of cervical cancer, HPV and HPV vaccine, and willingness and acceptability to vaccinate. Trends in Diphtheria-tetanus-pertussis (DTP3) vaccine coverage in SSA countries from 1990-2011 were extracted from the World Health Organization database. The review revealed high levels of willingness and acceptability of HPV vaccine but low levels of knowledge and awareness of cervical cancer, HPV or HPV vaccine. We identified only six countries to have met the two GAVI Alliance requirements for supporting introduction of HPV vaccine: 1) the ability to deliver multi-dose vaccines for no less than 50% of the target vaccination cohort in an average size district, and 2) achieving over 70% coverage of DTP3 vaccine nationally. From 2008 through 2011 all SSA countries, with the exception of Mauritania and Nigeria, have reached or maintained DTP3 coverage at 70% or above. There is an urgent need for more education to inform the public about HPV, HPV vaccine, and cervical cancer, particularly to key demographics, (adolescents, parents and healthcare professionals), to leverage high levels of willingness and acceptability of HPV vaccine towards successful implementation of HPV vaccination programs. There is unpreparedness in most SSA countries to roll out national HPV vaccination as per the GAVI Alliance eligibility criteria for supporting introduction of the vaccine. In countries that have met 70% DTP3 coverage, pilot programs need to be rolled out to identify the best practice and strategies for delivering HPV vaccines to adolescents and also to qualify for GAVI Alliance support.PLoS ONE 03/2014; 9(3):e90912. DOI:10.1371/journal.pone.0090912 · 3.23 Impact Factor
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ABSTRACT: Increasing coverage of routine immunisation and new vaccines is key to reaching Millennium Development Goal number four (MDG 4) on reducing child mortality. Malawi, despite a weak health system, is on track to achieve MDG 4, partly because of its high-performing immunisation programme. Among the early adopters of new vaccines, with major support from Global Alliance for Vaccines and Immunisation, Malawi introduced pneumococcal vaccine in 2011 during a time of severe political and economic crisis. This exploratory case study (part of a larger research project on explaining differential immunisation coverage, conducted in 2010 and 2011, using primarily qualitative methods including in-depth interviewing) looks at the decision-making and policy process for vaccine introduction within the broader political–economic context. Based on a framework of benchmarks on preparedness of immunisation systems and assessments of integration with health systems, the study findings suggest that pneumococcal vaccine introduction was more integrated with key health system functions the closer it got to the point of service delivery. Furthermore, although the vaccine introduction succeeded in relation to immunisation targets and prevention of disease, it may have had substantial indirect costs to other targeted health interventions and broader health systems functions at times when basic amenities are in short supply or unavailable. For a donor-dependent country such as Malawi, policy choices are limited to what is on offer – and new vaccines were on offer; other crucial necessities were not. Further research could establish with more certainty the conditions under which vaccine introduction strengthens health systems that are already weak, and when they push systems further into crisis.Forum for development studies 06/2014; 41(2):317-336. DOI:10.1080/08039410.2014.894936
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