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  1. Strengthening National Immunization Technical Advisory Groups in the Americas Jon K. Andrus Barbara Jauregui Cara Janusz Immunizations-PAHO Pan American Health Organization

  2. Background: PAHO ProVac Initiative PAHO project financed by the Bill & Melinda Gates Foundation ProVac aims to strengthen technical capacity at the country-level for evidence-based decisions on new vaccine introduction To date, ProVac has focused on the following new vaccines: Rotavirus Pneumococcal conjugate HPV Influenza (pandemic and seasonal) (near future: dengue, malaria and others) Pan American Health Organization

  3. Opportunities to improve decision-making processes 1 Burns JE, Mitrovich RC, Jauregui B, Ruiz Matus C, Andrus JK. Descriptive analysis of immunization policy decision making in the Americas. Rev Panam Salud Publica. 2009;26(5):398–404. Pan American Health Organization

  4. EPI Financing and Vaccine Legislation in the Americas EPI Expenditures (millions) Number of Laws 99% 94% 90% 92% 79% *Includes financing data from all countries in the region; same data will be disaggregated and analyzed for only the countries included in the study.

  5. Situation Analysis: NITAGs in the Americas Many existing NITAGs Chartered by ministerial decree or law Members represent different fields of expertise Few NITAGs independent from Ministry of Health Not all NITAGs declare conflict of interest Pan American Health Organization

  6. 1. Strengthen infrastructure and processes for decision-making related to new vaccines in the LAC Region 2. Develop tools and training workshops to assist multidisciplinary country teams in conducting economic and epidemiological impact studies 3. Support country-led cost-effectiveness analyses and other economic evaluations to support the new vaccine decision making process in LAC 4. Advocate for evidence-based decision-making 5. Assist countries in the LAC Region in planning for vaccine introduction when evidence supports a decision to introduce ProVac Initiative: Objectives Pan American Health Organization

  7. Provide support for NITAG members in the PAHO region to assist and observe ACIP and NACI meeting Invite Members of National Committees to Regional and Sub-regional Immunization meetings (i.e. TAG) Develop Operational Guidelines for NITAGs Provide platform for virtual exchanges between NITAGs in the Region to discuss relevant and timely vaccine-related policy issues Activities with National Committees on Immunization Pan American Health Organization

  8. Countries have requested technical support from PAHO; to help integrate economic studies into the national decision-making process- 2006 Directing Council resolution (CD47.R10) StrengtheningNITAGs EPI Manager Surv. Officers PAHO Country Focal Point Health Economist ProVac Country Team Ministry of Health Nat’l Consultant Clinician ProVac Central Team (PAHO HQ) National Committee ProVac Centers of Excellence National level Regional level

  9. Functions Formal structure Procedures Standardizing criteria for decision making regarding immunization PAHO Operational Guidelines for NITAGs 2004 Pan American Health Organization

  10. Frameworks of Evidence for Decision-makers • Technical Criteria: • Burden of disease • Vaccine characteristics (efficacy, safety, etc) • Adverse events and post-marketing surveillance • Economic considerations (CEA) • Programmatic and Operational Criteria: • Supply chain • Other logistical and operational issues • Financing strategies and budget impact studies • Stakeholder support • Social Criteria: • Risk perception • Political will • Equity Pan American Health Organization

  11. Harmonize ProVac tools – Build upon newly acquired skill sets Generate models to compare multiple health interventions (against vaccination strategies) Improve macro-evidence frameworks Catalyze transition from regional priority-based decision-making to national evidence-based decision-making in the Region Long-term Goals of ProVac Pan American Health Organization

  12. (ProVac e-Support Center) Contact Jon K. Andrus, Barbara Jauregui or Cara Janusz at: Further Information Pan American Health Organization

  13. Thank You