USAID Progress: The U.S. National Vaccine Plan of 1994 Ellyn Ogden Neal Brandes Angela Weaver Washington DC March 3, 2008
Objective 1.1/1.5 (New Vaccines) Support to GAVI for introduction of new vaccines in developing countries (e.g., rotavirus, PCV, Hib) Support to the Meningitis Vaccine Project (MVP) and its novel approach to the development of a conjugate meningitis group A vaccine for use in developing countries 30 years of investment to support a safe and effective malaria vaccine for children
Objective: 4.5 (Surveillance for VPDs) VPD surveillance Field Epidemiology training Integrated Disease Surveillance and Response Polio Lab Net 147 labs Many labs expanded to include measles, tetanus, rubella, yellow fever Polio Surveillance Facility-based: 24 countries; ~ 500 medical officers; polio, MNT, measles Community-based: 4 countries; ~ 30,000 case detection volunteers; polio, MNT, measles
Objective 4.6 (Tracking Systems) Newborn and Immunization tracking systems implemented in CORE NGO project areas: India, Nepal, Ethiopia, Angola Immunization Registries: Egypt, Indonesia Post-Campaign Monitoring: Polio
Objective 4.8 (International Travelers) Wide dissemination of Immunization requirements for Hadjj Cross Border Immunization e.g. Nigeria/Niger, Afghanistan/Pakistan
Objective 4.9 (Polio Eradication) 99% reduction in cases (from 1000 cases per day to 1300 per year) 4 endemic countries (India, Pakistan, Afghanistan, Nigeria) 10 of 13 post-nigerian cessation reinfected countries again polio-free 6 million cases of paralysis averted mopv1 and mopv3 USAID annual investment: $32 million, including: Surveillance and LabNet Human resources, training, cell lines and reagents, data quality and use Supplemental Immunization Delivering vaccine (e.g., planning, monitoring, cross border coordination) Communication / Social Mobilization (e.g., human resources (50,000 mobilizers), civil society, data collection and analysis, increasing awareness), social mapping epidemiology/social/cultural/campaign data Diplomacy and Advocacy (e.g. G8, World Health Assembly)
Progress Since 1988 - Today * as of 20 Feb 08 1988 125 endemic countries 1000 cases per DAY! 2007* 4 endemic countries (India, Nigeria, Pakistan, Afghanistan) 6 countries with active outbreaks b/t Aug 07 Feb 08 (Nepal, Angola, Niger, Chad, D.R.Congo, Sudan) 1300 cases per YEAR!
Objective 4.10 (maternal and neonatal tetanus (MNT) & measles control) Country specific support for measles campaigns: e.g. AFG, Nigeria, DR Congo Country specific support for MNT control: integrated MCH, school-based initiatives e.g. Indonesia Surveillance
Objective: 4.11 (Sustainability) GAVI: USAID $69 million annually Co-financing Health Systems Strengthening: to address the system barriers to improving immunization and other MCH outcomes Accelerated Development and Implementation Plans (ADIPS) Injection Safety IFFm: International Finance Facility for Immunization (not USAID funded) AMC Advance Market commitments (not USAID funded) Routine Immunization: Bilateral Project and Central Level Technical Assistance: Management, Data Quality, financing, policy development, communication and community mobilization National Regulatory Authorities advocacy and technical assistance
The Way Forward New global public health initiatives and new actors bring new opportunities and challenges Need to work within host-country policies and plans and be sensitive to community concerns Increased participation by domestic USG agencies is an opportunity for coordination into unified foreign aid policy role in international partnerships Research-to-use strategies support for research and innovation flexibility and collaboration of USG agencies Rotavirus, PCV, Hib Malaria Avian Influenza HIV/AIDS Polio Measles
Improving Health Outcomes: Role of USAID in the New Global Landscape for Research on Special Problems of Developing Countries Health Assessment/ Priority Setting Basic Research Applied Research/ Development/ Adaptation Field Implementation and Evaluation Task Disease surveillance Assessments of burden of disease Identification of critical knowledge gaps Product development Field trials Consumer research Modification of existing products Adaptation at scale Strengthening national health systems Monitor program effectiveness and modify approaches Performance Local agencies USAID (major)/cdc Bilateral donors NIH Pharmaceutical companies International foundations Local research organizations Pharmaceutical and medical supply companies Local research Organizations USAID Bilateral donors Local agencies USAID (major) Global Fund WHO Bilateral donors PEPFAR Improved Health Outcomes Source: National Research Council. 2006. The Fundamental Role of Science and Technology in International Development: An Imperative for the U.S. Agency for International Development. Washington: National Academies Press.
Accountability Performance monitoring focused on scaling up country and global tracking indicators (e.g., DHS, JRFs, MICs, etc.) Annual reporting on progress Office of Foreign Assistance and Congress