1. 1 European Region Global Alliance for Vaccines & Immunization Overview on the Implementation Of the Introduction of New / Under-used Vaccines

2. 2 PRESENTATION OUTLINE STATUS OF GAVI COUNTRIES EUROPEAN GAVI WORKING GROUP TECHNICAL SUPPORT CHALLENGES FUTURE PLANS

3. 3 GAVI ELIGIBLE COUNTRIES (N = 11) GAVI ELIGIBLE COUNTRIES (N = 11) Kyrgyzstan; Tajikistan; Uzbekistan; Turkmenistan; Azerbaijan; Armenia; Georgia; Ukraine; Moldova; Albania; BiH

4. 4 COUNTRY STATUS BEFORE APPLICATION CountriesICC EPI. ASS. Cold Chain IMM. PLAN Hep B Intro Hib Burden Albania -----1999----- x May 95 99 - 00 Armenia -----1999 x Nov 99 ----- Azerbaijan -----1999----- x BiH ----- x 1999 (Fed.) ----- Georgia -----1999 x 2000 Limited ----- Kyrgyzstan X----- x 1999 Limited 99-00 Moldova -----1996----- x 1995 ----- Tajikistan ----- 1999 x ----- Turkmenista n -----1999 x 1992 Limited ----- Ukraine -----1996 x 1996 Limited ----- Uzbekistan -----199798+99 x 1998 limited -----

5. 5 GAVI Application Status EURO Region - June 2001 Immunization Services: 4 countries –3 countries approved –1 country to resubmit Hepatitis B: 10 / 11 countries –4 approved –3 approved with clarifications –2 approved with conditions –1 country to resubmit Hib - 5 countries : 1 approved

6. 6 Strengthening Immunization Sub-account CountriesStatus# additional children Amount granted US $ Armenia Approved 49415,000 x 2 Azerbaijan Approved 3,28016,500 x 2 Georgia Resubmission ----- Tajikistan Approved 24,998125,000 x 2 28,772313,000

7. 7 Hepatitis B introduction Thru 2002 Country statusAmountEDAValue Albania Approved351,000 d 10 d Vials Oct. 01166,000 Armenia Approved65,130 d 1 d Vial June 01124,000 Azerbaijan Approved203,225 d 10 d Vial June 0182,000 BiH Condition -------- Georgia Resubmit 5 th round --------

8. 8 Hepatitis B introduction Thru 2002 CountrystatusAmountEDAValue Kyrgyzstan Appr..400,000d 10dV 79,000d 1dV In country 322,400 Moldova 5 th round -------- Tajikistan Clarif.275,000d 10dV 47,550 1 d Vial --------313,000 Turkmen. Clarif399,000d 10V 99,750d 1dV --------294,000 Ukraine Cond.-------- Uzbekistan Appr.3,588,000d 10 dV Oct. 011,546,000

9. 9 PRESENT GAVI COMMITMENT Immunization services: 3 Countries –28,772 additional children –US $ 313,000 investment Hepatitis B introduction –7 Countries –1,100,000 children –5,508,155 doses of Hep B vaccine –2,850,000 US $ –2.6 US $ per child

10. 10 EURO GAVI Working Group Partners - WHO, UNICEF, PATH/CVP, VHPB, CDC, Govt Norway; USAID, DFID, WB, ADB, Gvts TOR - To optimize support provided by partners to NIPs, with focus on Global Fund eligible countries Secretariat - WHO EURO Meetings - quarterly - schedule with other regional meetings –Regional workplan review

11. 11 FOCUS of ACTIVITIES  EPI and cold chain assessments  Development and finalization of  multi-year National plan of action  preparing funding proposal  hepatitis B plan  Finalization of documentation for application  Strengthening National ICC  Monitoring and evaluation of implementation process

12. 12 Feedback from the Review Committee (as of 25 June 2001) More substantial information was requested on: Financial Sustainability – Commitments from Govts & Partners, Financing schemes Plans to improve the safety of injection Detailed introduction and integration plan for Hep B, including training, logistics, cold chain Vaccine handling and cold chain issues Hib burden of disease and introduction plan Evidence of progress in the implementation

13. 13 GAVI PROCESS A great opportunity Revitalize EPI and Review of EPI status of eligible countries Identify country needs Develop EPI plans in a more comprehensive way Establishment of national ICCs Emphasis on securing provision of vaccines as well as safety of immunization Tremendous boost for introduction of Hep B & Hib New way of working through partner collaboration

14. 14 Planned Vaccine Introductions

15. 15 EURO GAVI Workplan Objectives Support remaining countries to complete GAVI applications (eg. Georgia, Moldova, BiH, Ukr) Complete Hib assessments / plans in 5 countries Support countries to implement GAVI funding Support strengthening ICCs Support countries for all EPI activities Ensure and monitor implementation of Immunization plans

16. 16 Future areas of support Future areas of support  VPDs surveillance (focus on Hep B and Hib)  Monitoring of performances (DQA)  Quality of services  Coverage and wastage  Safety of immunization:  Injection safety: guidance to revise policies on injection procedures  Storage of vaccines, stock management and vaccines handling: Ensure financial support for cold chain maintenance and replacement  Waste disposal  AEFI surveillance and response