Strategy and documentation of the measles and rubella elimination in the WHO Regional Office for Europe

Transcription

1 Strategy and documentation of the measles and rubella elimination in the WHO Regional Office for Europe Progress Toward Rubella Elimination and CRS Prevention in Europe February 8-10, 2012; Rome, Italy Dragan Jankovic Vaccine Preventable Diseases & Immunization Division of Communicable Diseases, Health Security & Environment WHO Regional Office for Europe Copenhagen, Denmark

2 Developing the new European Policy for Health: Health 2020 Vision for Health 2020 A WHO European Region where all peoples are enabled and supported in achieving their full health potential and well-being, and in which countries, individually and jointly, work towards reducing inequalities in health within the Region and beyond. Health 2020 values Universality of the right to health and health care Equity Solidarity Sustainability Right to participate in decision making relating to personal health and the health of the society in which people live Dignity

3 WHO European Region: Immunization programmatic goals Immunization Systems Strengthening Accelerated Disease Control Enhanced Surveillance & Monitoring Stewardship/ sustainable financing Quality-assured vaccines, supply and safety Access to and utilization of immunization services Use of new and underutilized vaccines Communication & Advocacy Diseases with eradication & elimination goals Priority bacterial and viral diseases Communication & Advocacy Surveillance for disease control and prevention Strengthening laboratory networks Communication & Advocacy

4 Priorities in the current environment address the challenges Decreasing commitment (competing priorities for the health system, economic crisis) Health system reform (access to health services, weakened public health) Increasing momentum of vaccine refusals General complacency in absence of disease (low risk perception), variable public trust Anti-vaccination movement Refusal due to religious and philosophic reasons Unrecognized pockets of unimmunized and underimmunized in population - marginalized and vulnerable groups!!!

5 First import-related polio outbreak in the European Region since declared polio-free in 2002 Third region declared polio-free Last case of confirmed endemic wild poliovirus in the European Region was in 1998 in Turkey Last case of clinically confirmed polio in Tajikistan was in

6 Number of confirmed measles cases by month and year ( ) Data Source: Monthly measles and rubella data reporting to CISID Data as of Dec 2011

7 Member States adopted resolution at 60 th Regional Committee in September 2010

8 Resolution commitments Member States: Commit and give goal high priority Ensure required resources Establish National Verification Committees Engage in multisectoral partnerships Strengthen routine immunization Focus on pockets with low coverage and mobilize Supplementary immunization activities as needed European Immunization Week Strengthen health system components Strengthen surveillance, case-based WHO European Regional Office: Provide strategic direction- Strategic Plan Establish Regional Verification Commission to document progress Provide technical guidance to Member States Work with Member States on addressing : vulnerable groups anti-vaccine movements

9 Strategic plan and regional goal for measles and rubella elimination by 2015 To eliminate endemic measles, and To eliminate endemic rubella what will lead to prevention of CRS

10 Key areas for action for WHO The four key elimination strategies: routine immunization, additional opportunity for immunization, surveillance and availability and use of high-quality information a) Partnerships and resource mobilization b) National immunization policy c) Economics of elimination by Member States d) Monitoring and surveillance e) NITAGs f) Verification process g) Operational research

11 Partnerships and resource mobilization European Centre for Disease Control and Prevention UNICEF US Centres for Disease Control and Prevention WHO Collaborating Centres National health agencies and authorities Philanthropic foundations, academic institutions, and nongovernmental organizations Civil societies Media European Immunization Week EIW WIW Resource mobilization Measles initiative US CDC The Bill & Melinda Gates Foundation Member States of the European Region

12 Monitoring and surveillance Case-based MR surveillance Integrated work of all surveillance segments Critical role of laboratory and genotyping Regional database and network of main referent surveillance institutions (epidemiological and laboratory) Structured, systematic and ongoing monitoring Immunization coverage Diseases surveillance All other relevant information (AEFI, surveys, studies)

13 Document and verify when the elimination has been achieved in the WHO EUR The Regional Verification Commission for Measles and Rubella Elimination (RVC) Jan 2012 National Verification Committees for Measles and Rubella Elimination (NVCs) of the Member States Verification of measles and rubella elimination in the European Region

14 Components for verification Population immunity against measles and rubella Epidemiology of measles, rubella and CRS incidence during the previous 36 months Molecular epidemiology of measles and rubella viruses Performance of measles, rubella, and CRS surveillance Sustainability of the National Immunization Program Public acceptance of the measles/rubella immunization and elimination 14

15 Public acceptance of the measles/rubella immunization and elimination Need for effective advocacy and information, education and communication (IEC) strategies Methods - ad hoc surveys, periodic operational research activities Eventual indicators of performance or achievements under consideration

16 Vulnerable populations: unimmunized and under immunized

17 Information to population: sensation vs. facts

18 Reaching every child/susceptible person: WHO Europe s efforts All in partnership with key stakeholders (e.g., Member States, ECDC, UNICEF, non-governmental organizations, civil societies) WHO vaccine communications workgroup European Region immunization communications strategy Toolkit for Member States formative research tool, communications profiling, compendium of best practices, evaluation tool Build capacity with ECDC and UNICEF/CEE-CIS on use of social marketing in immunization Advocacy for political commitment

19 Summary Ongoing activities Confirm commitment by implementation - need to reframe activities within the adopted resolution to optimize coverage, strengthen surveillance, meet elimination goals and respond to outbreaks Sharing of best practices, and seeking shared solutions to common threats cooperation Build capacities and implement evidence based tailored advocacy and social mobilization 20