Delegates from across the Region stand together to immunize Europe
Immunization programme managers from 46 Member States gathered in Antalya, Turkey on 18–20 March 2014 to assess the current status of vaccine-preventable diseases and set the future course for immunization in the European Region. The WHO/Europe meeting created the opportunity for all those who lead immunization programmes in the Region to share their concerns, experiences and plans with each other as well as with representatives of partner and donor agencies and international associations of health care professionals.
Organized at a pivotal time for reaching regional immunization targets, this multi-stakeholder forum allowed for fruitful discussions on pressing topics, including:
- elimination of measles and rubella;
- development of a Regional Vaccines Action Plan (RVAP);
- programme implications of the global Polio Endgame Strategy, including introduction of inactivated polio vaccine (IPV);
- ongoing threats to the Region’s polio-free status and preparation for potential reintroduction of the disease;
- tackling vaccine hesitancy, and driving acceptance and demand for vaccines;
- introduction of new and under-utilized vaccines;
- tailoring immunization programmes to reach the underserved;
- impact and future plans for European Immunization Week.
Reversing negative spiral in the battle against measles and rubella
After dramatic successes in reducing the burden of measles and rubella over recent decades, the European Region has seen a rebound in the number of measles cases reported since 2010 and the number of rubella cases reported in 2012 and 2013. Persistent outbreaks point to weaknesses in immunization services and disease surveillance systems that threaten the Region’s goal of eliminating these diseases by 2015.
Reminding participants that “business as usual” is not enough, WHO/Europe presented its plan for accelerated action to rid the Region of these highly contagious and serious diseases. Professor Günter Pfaff, chair of a panel on multi-stakeholder involvement in this effort, advocated along with others for greater political commitment at the national level: “Accountability for interrupting endemic transmission of these diseases and responsibility for reaching elimination for the Region lies with each Member State. Stakeholders and partners can assist in this process but each Member State needs to lead the effort – through implementation of their own accelerated package of activities.”
Establishing a joint vision for immunization in the European Region
Plotting the future course for all immunization-related activities was the topic of a full-day session on development of the Regional Vaccine Action Plan (RVAP) for 2014–2020. Member States were asked to comment on a draft version of the document presented by WHO/Europe, which highlights components of the Global Vaccine Action Plan most appropriate and valuable to the WHO European Region. The Regional Plan focuses on achieving five strategic objectives:
- All countries commit to immunization as a priority.
- Individuals understand the value of immunization services and vaccines, and demand immunization as both their right and responsibility.
- The benefits of immunization are equitably extended to all people through tailored and innovative strategies.
- Strong immunization systems are an integral part of a well-functioning health system.
- Immunization programmes have sustainable access to long-term funding and quality supply.
Much of the discussion focused on selecting indicators to monitor and evaluate progress towards these objectives. They must be general enough to stimulate better performance across 53 highly diverse Member States, but also specific enough to allow for meaningful measurement. RVAP must furthermore reflect country needs and priorities while also fulfilling obligations previously agreed upon in related regional strategies and action plans, including:
- Health 2020;
- European Action Plan for Strengthening Public Health Services and Capacity (2012);
- Tallinn Charter: Health Systems for Health and Wealth (2008); and
- European strategy for adolescent health and development (2005) and its action plan (2008).
- After incorporating the rich feedback from immunization programme managers throughout the Region, the finalized document will be formally presented at the Regional Committee in September 2014.
Introduction of IPV
As part of the global Polio Eradication and Endgame Strategic Plan, all countries in the European Region that currently use only oral poliovirus vaccine (OPV) will soon introduce one or more additional doses of IPV and cease using trivalent OPV in favour of a bivalent form. Many countries had questions and concerns regarding the practicalities of this transition, including the availability, pricing and funding of the new vaccines. Planning and support for these activities was discussed in dedicated sessions with representatives of WHO, the United Nations Children’s Fund and the GAVI Alliance.
Until polio is eradicated globally, all countries must furthermore be prepared for possible reimportation of the virus into the European Region. Dr Dina Pfeiffer, Programme Manager of the Vaccine-preventable Diseases and Immunization Programme urged all Member States to “update or create preparedness plans, revise them periodically and test them through outbreak simulation exercises”. She also pledged technical support from WHO to help Member States carry out these requirements.