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WHO/Europe’s country work achievements in 2009 included the following.

• In 2009, supplementary immunization activities (SIA) for polio or measles and rubella (MR) were conducted in Armenia, Georgia, Kazakhstan and Kyrgyzstan to reach remaining susceptible populations. All SIA reached more than 95% of their intended target population.  

• In October 2009, WHO/Europe, in collaboration with the Centers for Disease Control and Prevention (CDC), conducted post introduction evaluation of Haemophilus influenzae type b (Hib) and DTPa-IPV vaccines in Bosnia and Herzegovina. Six investigation teams, composed of local specialists and WHO/Europe and CDC consultants, visited 24 sites, including two central public health institutes, four regional/cantonal public health institutes and eighteen health facilities. The investigators interviewed immunization programme personnel, health care professionals and mothers using standardized questionnaires and observed immunization sessions. The team of experts summarized evaluation findings and recommendations, which were presented to the Ministry of Health and immunization programme personnel. These recommendations focused on strengthening service delivery in areas with poor access and less than optimal implementation of programme staff were occurring. The experts also developed a lessons learned tool for use by the Ministry to avoid common planning and implementation pitfalls when introducing new vaccines.

• In September 2009, WHO/Europe conducted a workshop in Tbilisi, Georgia on bacterial meningitis surveillance with specific emphasis on the establishment and implementation of surveillance for diseases caused by Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis. The trainees were epidemiologists and clinicians responsible for implementation of bacterial meningitis surveillance in five countries: Azerbaijan, Georgia, Kazakhstan, Ukraine and Uzbekistan. The main outcomes of the training were improvements in: understanding of the epidemiology and prevention of bacterial meningitis and the preventive role of new vaccines; understanding of the key principles of bacterial meningitis surveillance; and practical skills in completing case report forms, interpreting clinical and laboratory results, reflecting these results appropriately with the bacterial meningitis surveillance system, and managing a database.

• Surveillance systems to monitor the burden of invasive bacterial diseases, including S. pneumoniae, N. menigitidis and H. influenzae were established in Azerbaijan, Georgia and Uzbekistan to provide evidence for decision-making on the introduction of pneumococcal vaccine in reducing transmission of bacterial meningitis

• National-level laboratory surveillance for rotavirus was implemented in Armenia and the Republic of Moldova in 2009.

• A regional reference laboratory for invasive bacterial diseases surveillance was established in Moscow, Russian Federation in April 2009. It is in the final stages of official WHO quality assurance accreditation.