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  1. 1

    Harmonization of a vaccine procurement manual, October 7 -December 15, 1997, CIDEF, Paris, and World Bank, Washington, DC.

    Woodle D

    Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1997. [42] p. (Report; USAID Contract No. HRN-C-00-93-00031-00)

    Visits by Basic Support for Institutionalizing Child Survival (BASICS) consultants to US and European cities in 1997 sought to further harmonization of the BASICS/Program for Appropriate Technology in Health (PATH) and World Health Organization (WHO) vaccine procurement manuals and modify the Centre International de l'Enfance et de la Famille (CIDEF) training modules for compatibility with the WHO/US Agency for International Development (USAID)/BASICS/PATH Vaccine Procurement Manual. A second objective was to make a presentation on quality protection within the vaccine procurement process to a WHO Expanded Program on Immunization (EPI) program managers working group meeting in Berlin on vaccine quality control and sustainability of immunization programs in the Newly Independent States. This document details preparations for and the results of these events. Appended is a 1998 production plan for completion of the harmonized procurement manual and preparation for printing.
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  2. 2

    Diphtheria control in Armenia, Azerbaijan, and Georgia, 14 July - 6 August, 1995.

    Weeks M

    Arlington, Virginia, Partnership for Child Health Care, 1995. iii, 29 p. (BASICS Trip Report; BASICS Technical Directive: 000 NS 01 021; USAID Contract No. HRN-6006-C-00-3031-00)

    A diphtheria outbreak in the Caucuses necessitated a BASICS (Basic Support for Institutionalizing Child Survival) consultant to go to Armenia, Azerbaijan, and Georgia, during July 14-August 5, 1995, to determine the status of planning and preparations for mass immunization campaigns and disease control efforts. The campaigns are expected to take place during August-November 1995. There is enough funding to deliver supplies, oversee the planning and implementation of the campaigns at the district level, and to monitor the campaigns. UNICEF is securing sufficient antibiotics and diphtheria antitoxin. Political unrest plagues certain areas of all three countries. None of the countries have the resources to provide adequate health care. Health workers cannot be paid a living wage. None of the Ministries of Health (MOHs) are equipped to deliver and oversee immunization activities. UNICEF is providing new cold chain equipment. Yet, most health workers have not received training on vaccine storage requirements. They do not monitor refrigerator temperatures. UNICEF needs to provide technical assistance in monitoring and maintenance of the cold chain in all three countries. MOHs are in the process of improving management but trained managers and effective supervision will not be ready for a long time. Nongovernmental organizations (NGOs) can help with logistics, monitoring, social mobilization, local organization, and delivering immunizations. NGOs' assistance in coordinating resources will ease UNICEF's burden. Since December 1994, vaccines and supplies have been available in Ajara, Georgia, yet no mass immunization campaign has been implemented. In July, there were 27 cases of diphtheria in Ajara. UNICEF is trying to motivate the MOHs in Ajara and Tbilisi to immediately begin immunization and other control measures. BASICS could provide technical assistance with planning strategies for social mobilization and planning, implementation, and data analysis for post-campaign evaluations and coverage surveys.
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  3. 3

    Supplying the vaccine.

    Halliday D; Milstien J

    WORLD HEALTH. 1995 Jan-Feb; 48(1):18-9.

    UNICEF has procured and delivered more than 2500 million doses of oral poliomyelitis vaccine to over 100 developing countries since the Expanded Program on Immunization was launched in 1974. To ensure adequate supplies of vaccine for both routine and supplemental (e.g., national immunization days) use, significant planning and forecasting are required. UNICEF has lengthened its period for receiving price tenders to two years in order to assure producers of demand and enable them to plan for increases in volume. Although half of the vaccine used is manufactured within country, need often outpaces supply. To remedy this situation, imported bulk vaccine is mixed and filled into vials in the developing country. The vulnerability of vaccine to heat exposure has meant that as much as 50% of the vaccine delivered to immunization centers is discarded at the end of the day. Research efforts are focused on developing both a vaccine that retains its potency at high temperatures and a time-temperature indicator that will verify heat exposure. Encouraging has been a trend among recipient governments to fund their own vaccine needs and develop more sustainable systems for vaccine procurement and production.
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