4th Global Meeting on Implementing New and Under-utilized Vaccines, 23-25 June 2010
Workgroup 5. Impact of new vaccine introduction on immunization and health systems
Routine immunization and functioning health systems are preconditions for new vaccines introduction (NVI). NVI could be a stressor and expose existing immunization and health system weaknesses or act as catalyst to strengthen systems. Positive and negative system impacts have been described for other health initiatives (e.g., HIV/AIDS, malaria). The Strategic Advisory Committee of Experts (SAGE) on immunization has requested that a workgroup examine how introductions of new vaccines impact immunization and health systems.
Main Topics of Discussion
- Overall service delivery
- NVI was felt to add momentum, visibility, and public attention to service delivery
- Introduction can generate door-opener with MoF
- Messaging can be positive for immunization overall "don't wait, vaccinate'
- Early on system weaknesses can be turned into strengths
- The health workforce
- Positive impacts of training for new vaccines on health workforce use and deployment
- The health information system
- the need for integrated HIS is made more evident by NVI
- The support needed to make vaccines, medical products and technologies available
- NVI increase requirements for cold chain and logistics, but new tools are becoming available
- Financing and sustainability
- long-term sustainability and affordability in poor countries is more difficult to achieve
- Programme leadership and governance
- NVI helps to establish new governance structures, but also reinforces the need for active leadership
Overall impacts of NVI were seen as generally positive, if planning of essential processes was done appropriately. Evidence of the impact of NVI on immunization and health systems is available and is being collected and summarized in order to document and disseminate lessons learned.
Continue to address the questions raised by SAGE
- Work towards publication and dissemination of guidelines and tools to assist country decision makers and EPI managers in reviewing 'collateral effects' of NVI
- Revisit the 70% DTP3 GAVI threshold for new vaccine support, if NVI actually increases coverage (as evidenced in some countries).