ETAGE: terms of reference

Aims and objectives

ETAGE's aims and objectives are to:

  • serve as a forum for technical discussion and provision of advice to the Regional Director in the field of immunization;
  • review the status of immunization services in the Member States of the Region;
  • direct special attention to the progress being made towards the Region's vaccine-preventable disease control targets and objectives, especially identifying any constraints, obstacles and threats;
  • make recommendations on operational aspects of immunization policies and strategies, as well as the incorporation of new scientific developments;
  • make technical recommendations that will help to strengthen national and regional efforts to implement policies and strategies, and help to monitor progress towards set targets;
  • serve as a forum for discussion on comprehensive introduction of additional, newly developed vaccines or other interventions promoting both child and adult health, using evidence to make recommendations;
  • promote support for adequate and comprehensive surveillance for vaccine-preventable diseases and for adverse events following immunization;promote understanding of and support for EVAP targets among national immunization technical advisory groups (NITAGs), national governments, technical institutions, professional associations and bilateral/multilateral and private agencies, including, where appropriate, by responding to anti-vaccination messages;
  • advise on matters of special importance for submission to the WHO Regional Committee;
  • serve as a forum for discussion on implementation of SAGE recommendations within the regional context where appropriate;
  • function as an independent technical advisory body for the Regional Office and its subsidiary parts.

Composition of ETAGE and appointment of members

ETAGE members will be appointed by the Regional Director.

ETAGE will comprise six to eight experts (including a Chairperson) who have substantial technical expertise and experience in areas related to immunization and vaccine-preventable diseases (e.g. epidemiology, public health, vaccinology, immunology, paediatrics, internal medicine, infectious diseases, programme management, immunization service delivery, health economics, social behavioural science and vaccine quality and safety).

Membership will normally be for a period of three years in the first instance, with an option to extend by a further two years at the discretion of the Regional Director. Suitable applications will be solicited both by public advertisement and in person. Applications will be submitted in writing detailing relevant expertise and experience and motivation for joining and will include a WHO Declaration of Interests (see below). There will be no interview process.

Applications are assessed by the Regional Office (the 'Secretariat') in consultation with the ETAGE Chairperson. The Secretariat will recommend selected candidates to the Regional Director, who will approve appointments at his or her discretion, taking further internal or external advice into account if/as necessary.

Consideration will be given to ensuring appropriate geographical representation and gender balance.

The Chairperson of ETAGE will normally be appointed from among existing ETAGE members in order to ensure familiarity with the working procedures of the group. Members will normally propose a candidate for Chairperson to the Secretariat, which will forward it to the Regional Director for approval, taking further internal or external advice into account if/as necessary.

If no suitable, willing candidate is available, the appointment may be made from outside the group by external advertisement or personal solicitation of interest following the same procedure as for new members.

The Chairperson will normally be appointed for a period of three years in the first instance, with an option to extend by a further two years at the discretion of the Regional Director – these terms being over and above any terms of ordinary membership already served.
At the time of any application for membership, a WHO Declaration of Interest form ( must be completed and will be taken into consideration in decisions regarding appointments. All ETAGE members must regularly update these declarations (at least annually) bringing any potentially important new interests to the attention of the Secretariat.

All ETAGE members must complete a confidentiality agreement, which must cover the full period of their membership or renewed membership. All papers presented to ETAGE, which may include pre-publication copies of research reports or documents of commercial significance, shall be treated as confidential. ETAGE deliberations are confidential and may not be publicly disclosed by ETAGE members. A register of members' interests and signed confidentiality agreements shall be maintained by the Secretariat.

Possible grounds for early termination of ETAGE membership include but are not limited to: 

  • failure to attend ETAGE meetings regularly
  • new interests creating significant conflicts
  • breach of confidentiality or other form of professional misconduct.

ETAGE meetings and operational procedures

Meetings of the ETAGE will be held annually, with additional meetings convened as required. Private session/s (attended by only ETAGE members and the Executive Secretary) may also be conducted, if needed. Decisions or recommendations will, as a rule, be taken by consensus. If a vote is required and is equally split, the Chairperson will have the casting vote.

In addition to attending meetings, ETAGE members are expected to actively participate in working groups, video and telephone conferences as well as e-mail exchanges with other members and the Secretariat. Review of documents may also be solicited. ETAGE members may be invited to participate in other VPI meetings.

Representatives of the Regional Office committees/bodies in the field of immunization (e.g. the Regional Verification Commission for Measles and Rubella Elimination (RVC), the Regional Certification Commission for Poliomyelitis Eradication (RCC), the Regional GAVI working group) and other key partners, including the United States Centers for Disease Control and Prevention (CDC), the European Centre for Disease Prevention and Control (ECDC), and the United Nations Children's Fund (UNICEF) may participate as observers at ETAGE meetings. The Secretariat may also invite other observers, including representatives of SAGE, NITAGs, national immunization programme managers, non-governmental organizations, international professional organizations, technical agencies and donor organizations. Additional experts may also be invited to meetings, as appropriate, to further contribute to specific agenda items.

ETAGE will work with VPI to develop its priorities of work and meeting agendas.

ETAGE will be kept informed by VPI (and partner agencies) on progress towards attainment of regional objectives at country and regional levels. ETAGE will also be informed of policies and recommendations set by SAGE. The Regional Office, with advice from ETAGE, will determine which policy recommendation issues and information from other advisory groups should be brought to the attention of ETAGE.

ETAGE working groups are established as resources intended to increase the effectiveness of ETAGE deliberations by reviewing and providing evidence-based information and options for recommendations together with implications of the various options to be discussed by ETAGE. These working groups are established on a time-limited basis in exceptional situations to help address specific questions identified by ETAGE when the issue is particularly pressing and/or complex and could not otherwise be addressed by existing WHO advisory committees. The need and charge for a working group is discussed and agreed during ETAGE meetings.

ETAGE members will not be remunerated for their participation in ETAGE; however, reasonable expenses such as travel expenses incurred by attendance at ETAGE or related meetings will be compensated by the Regional Office.

ETAGE reports to the Regional Director (or designee(s)). The ETAGE Chairperson will debrief the Regional Director (or designee) and the Divisional Director responsible for VPI following each ETAGE meeting.

The VPI Progamme Manager will function as Executive Secretary for ETAGE. Other staff may be invited to ETAGE meetings, as appropriate. A  rapporteur for each meeting will be arranged by VPI in consultation with the ETAGE Chairperson.

After each ETAGE meeting, a meeting report will be drafted and circulated among ETAGE members for their comments and endorsement. The finalized report will be presented to the Regional Director (or designee) for approval and distributed appropriately to interested parties by VPI, in addition to being posted on the Regional Office website.

ToR version: December 2015