Immunization, Vaccines and Biologicals

IPV recommended for countries to mitigate risks and consequences associated with OPV2 withdrawal

WHO / C. Scudamore

In May 2012, the World Health Assembly declared the completion of polio eradication a programmatic emergency for global public health and requested the Director-General to rapidly finalize a comprehensive eradication and endgame strategy for the period 2013-2018. The draft strategic plan and current status of the global polio eradication programme were presented to SAGE. Noting the substantive progress made in implementing polio emergency action plans in the remaining polio infected countries, detailed attention to oral polio vaccine (OPV) campaign planning in the field, and new evidence in improving performance, SAGE was alarmed by the considerable funding shortfalls at a time when eradication is in sight, with OPV campaigns already cancelled or scaled back in over 25 high risk countries in 2012.

SAGE endorsed the four major objectives and milestones in the new strategic plan. SAGE also recommended that all countries should introduce at least one dose of inactivated polio vaccine (IPV) in their routine immunization programmes to mitigate the risks and consequences associated with the eventual withdrawal of the type 2 component of OPV (OPV2). SAGE will review progress on achieving the pre-requisites for OPV2 withdrawal, including the availability of affordable IPV products, every six months to ensure the earliest possible date for OPV2 withdrawal but with sufficient advance notification to ensure programmatic readiness and vaccine availability.

SAGE reviewed and endorsed the monitoring and evaluation/accountability framework for the Decade of Vaccines Global Vaccine Action Plan (GVAP). A SAGE working group is being established to review progress in rolling out the GVAP and will submit annual reports to SAGE. Following SAGE’s input, the report will then be submitted to the WHO Executive Board and the World Health Assembly for discussion.

SAGE commended countries for the progress made in globally reducing measles mortality. While the Region of the Americas has achieved measles and rubella elimination and the Western Pacific region is close to interrupting endemic measles transmission, current data indicate that global and regional elimination targets for 2015 and 2020 will not be achieved on time. SAGE urges the South-East Asia region to establish a measles elimination goal and for the regions of Africa, Eastern Mediterranean, South-East Asia and Western Pacific to work towards establishing regional rubella elimination goals. SAGE also endorsed the Global Measles and Rubella Strategic Plan for 2012-2020 and recommended the full implementation of key strategies in a manner that elicits country ownership, strengthens routine immunization system, promotes equity and reinforces linkages with polio eradication and other health programmes.

SAGE welcomed the framework on Vaccination in Humanitarian Emergencies, which provides an objective approach to decision making and closes an existing gap on the use of vaccination in humanitarian emergencies. SAGE endorsed the framework and proposed some suggestions to be incorporated in the final document including piloting the framework before finalization.

SAGE noted that Middle Income Countries (MIC) representing a population of 5 billion now have the greatest proportion of the world’s poor. In addition, many of these countries are not eligible for GAVI Alliance funding or support and are lagging behind in their ability to sustainably introduce new vaccines. Reasons for this are broader than just prices and procurement of vaccines, and include equity, sustainability, capacity building and partner support. As the approach from all organizations to assist MICs is currently fragmented and incomplete, SAGE requested WHO to establish a task force to coordinate an inclusive stakeholder engagement mechanism to create an enabling environment and assist MICs.

The report of the meeting will be published in the WHO Weekly Epidemiological Record on 4 January 2013.

The meeting documents, including presentations and background readings can be found below