1. WHO Regional Office for Europe Update on WHO GAVI European Regional Working Group and hepatitis B Immunization Viral Hepatitis Prevention Board Meeting 7-8 November 2002 Catania, Italy

2. WHO Regional Office for Europe Reported immunization coverage rate WHO/EURO, 1990-2001

3. WHO Regional Office for Europe 1991 Coverage for DTP3/OPV3 vaccine at 12 months of age 1991 Coverage for DTP3/OPV3 vaccine at 12 months of age >80 % Administrative data: 1991 Cisid >95% 90-95% <80% no data reported 80-90%

4. WHO Regional Office for Europe 2001 Coverage for DTP3/OPV-IPV3 vaccine at 12 months of age 2001 Coverage for DTP3/OPV-IPV3 vaccine at 12 months of age >95% 90-95% <80% no data reported 80-90% Administrative data: 2001 Joint Reporting Form

5. WHO Regional Office for Europe Introduction of new/under- utilized vaccines Substantial progress in introducing HepB 41 countries already included into routine immunization programme –37 infant & routine –4 adolescent Hib; widely used in W. Europe, limited in other areas –Need for burden assessment Improvement in implementation

6. WHO Regional Office for Europe Hep B immunization programmes, WHO European Region, 2002 Routine infant Routine newborn Adolescent only Selective HepB immun..

7. WHO Regional Office for Europe Reported DTP3 and HepB3 coverage WHO/EURO, 2001 Data from JRF

8. WHO Regional Office for Europe Objectives of GAVI Immunization is the right of every child to be protected against VPDs Improve access to sustainable immunization services Expand use of all existing vaccines Accelerate research and development of vaccines, with special focus to developing country needs Immunization an integral part of health systems and international development

9. WHO Regional Office for Europe GAVI Vaccine Fund support * new and under-used vaccines –Hep B –Hib –Yellow fever; bundled with safety equipment * immunization services support * injection safety support

10. WHO Regional Office for Europe New and under- used vaccines and injection safety Immunization services, new and under-used vaccines and injection safety Immunization services and injection safety DTP3 coverage >80% DTP3 coverage 50% - 80% DTP3 coverage <50% Basic Conditions GNP/capita < US$ 1000 ICC or equivalent Immunization assessment in last 3 years Multi-year plan for Immunization Injection safety strategy What will the FUND finance ?

11. WHO Regional Office for Europe Countries eligible for support from the GAVI Vaccine Fund Eleven out of 51 countries: Albania Armenia Azerbaijan Bosnia & Herzegovina Georgia Kyrgyzstan Moldova Tajikistan Turkmenistan Ukraine Uzbekistan

12. WHO Regional Office for Europe Status of country applications for GAVI / VF support, October 2002

13. WHO Regional Office for Europe Status of HepB introduction in GAVI / VF eligible countries (# 1) Country1 st GAVI supplyStatus of HepB introduction ALBOctober 2001Continued; started in 1994 ARMJune 2001Continued; started in 1999 AZEJune 2001Started in October 2001 BiHNot yetStarted in 1999 GEOAugust 2002Started in 2000 (USAID) KGZMarch 2001Started in 1999 ; since May 2001 in whole country

14. WHO Regional Office for Europe Status of HepB introduction in GAVI / VF eligible countries (# 2) Country1 st GAVI supplyStatus of HepB introduction MDAJune 2002Started in 1995 (JICA) TJKDecember 2001Started in February 2002 TKMNovember 2001Started in January 2002 UKRNot yetStarted in 1996 UZBAugust 2001Started in October 2001

15. WHO Regional Office for Europe GAVI related activities WHO/EURO Immunization and cold chain reviews Disease burden assessments Planning –Multi-year national immunization plans including new vaccine introduction –Safety of immunization –Financial sustainability Implementation –Training at national and subnational levels –Supervision Coordination –National ICCs

16. WHO Regional Office for Europe GAVI related activities WHO/EURO Monitor progress –Annual progress reports and joint reporting from –Data quality audits Subregional immunization programme managers meetings St Petersburg 2001 Vienna 2002 Kyiv 2003 (planned) Expansion to other countries –policies and strategies –training programmes and material –support for vaccine procurement

17. WHO Regional Office for Europe Technical support to GAVI countries, 2000-2002

18. WHO Regional Office for Europe European GAVI Regional Working Group Established and regularly met since 2001 Members:WHO, UNICEF, World Bank, CVP/PATH, Vaccine Fund, VHPB and CDC/Atlanta Coordinate GAVI partners’ support and activities Ensure timely and appropriate technical and financial support to countries Identify needs for strengthening immunization services and capacities for introduction of new vaccines Strengthen National ICCs Provide input to the Regional ICC

19. WHO Regional Office for Europe GAVI initiative and lessons learned WHO European Region Opportunity for accelerating new vaccine introduction Impact on strengthening immunization services –programme assessments –multi-year immunization plans –resource mobilization, coordination (national ICCs) –emphasis on injection safety Expand infrastructure, build capacity –Access (80/80 district goal) Apply lessons learned to other countries

20. WHO Regional Office for Europe Areas for future action Strengthen immunization service delivery Provide policy guidelines Use national multi-year plans as a managerial tool Monitor implementation/exchange information Support mid-term reviews and development of FSP Technical support for Hib burden assessments Support training, also for introduction of new vaccines Apply lessons learned/experience gained to “non-GAVI” countries