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Setting out national immunisation goals

The SIVAC (Supporting Independent Immunization and Vaccine Advisory Committees) Initiative aims at contributing to the development of national immunisation technical advisory groups in six resource poor countries in Africa and six in Asia. These committees will help national health authorities to set up vaccination policy and programmes adapted to their needs. Dr Kamel Senouci, was appointed as Programme Director for the SIVAC Initiative in December 2008 and speaks about this Initiative's strategy to Viveka Roychowdhury

Dr Kamel Senouci

Could you give us a brief overview of the SIVAC Initiative's goals in India and other Asian countries?

The SIVAC Initiative aims to support countries to strengthen their capacities in making evidence-based decision for establishing immunisation policies and programmes. The Initiative will mainly be conducted through the technical support to countries for the implementation or strengthening of National Independent Immunization Technical Advisory Groups (NITAG) as recommended by the World Health Organization (WHO).

These committees of national independent experts (clinicians, epidemiologists, infectious diseases specialists, health economists) will help national health authorities to set up vaccination policy and programmes adapted to their needs based on an evidence-based decision making process. That means that these national experts will make some recommendations to the authorities on various immunisation topics (modification of schedules, introduction of new vaccines) based on the rigorous methodological analysis of the information.

In Asia, many countries have already in place these NITAGs

(Eg: India or Sri Lanka) and some others did not yet create such committees (Eg: Cambodia or Laos). Depending on that background, the SIVAC initiative will either help the country to establish a NITAG or to strengthen its capacities.

Actually, we did not select the countries where SIVAC team will work in Asia. The selection process involves discussing with numerous partners (Ministry of Health, Universities, Research Institutes, Health Professionals Societies, NGOs, WHO) to identify the feasibility of the initiative in the country.

Another main criterion is the willingness of the National Authorities to support such activities. All these criteria will be evaluated during country visits in the next months.

What will be your role as Director of the SIVAC Initiative?

As a Director, my main role is to coordinate the Initiative. The geographical area of work of the SIVAC Initiative is worldwide. We will include countries from all the regions except the Americas. Some countries will be middle income countries and some poor countries. My main role is therefore to ensure that the activities are conducted in a similar approach taking into consideration local specificities of countries. I will be supported by regional coordinators to follow-up the activities in the regions like my colleague Dr Nyambat Batmunkh (International Vaccine Institute based in Seoul Korea) for Asia.

I also collaborate with other international partners (WHO, UNICEF, GAVI) to ensure that the SIVAC initiative is aligned with the main international health objectives as the Millennium Development Goals for Health (http://www.un.org/millenniumgoals/ ) or the Global Immunization Visions and Strategy (http://www.who.int/immunization/givs/en/index.html )

Who is the major funding agency for these activities?

The SIVAC Initiative is funded by a generous grant from the Bill & Melinda Gates Foundation.

India has one of the lowest immunisation rates in the world. How can SIVAC help bridge the gaps in the national vaccination programme?

SIVAC's main role is to assist local actors in identifying mechanisms that will improve evidence-based vaccine policy and programmes. One of the activities we will propose to the selected countries is to identify a major issue or a question they want to address and we will then support them technically until final recommendations are reached and disseminated to the National authorities.

So if local actors identify poor vaccine coverage as a major issue, then SIVAC will work on providing resources/information that local actors can use to address this issue.

There have been allegations from time to time that the introduction of new vaccines to the national vaccination program is sometimes not in tune with the epidemiological needs of the population. How do you respond to this perception?

The main objective of the SIVAC Initiative is to enhance the use of evidence-based information in the decision making process for establishing immunisation policies and programmes. It means that all the activities of the Initiative are oriented to ensure that countries are making the best decision based on the best information using the best available tools.

Of course these processes are not easy, will take time, will not always be perfect, but we, at AMP (the French agency Agence de Médecine Préventive), think that if this was possible in many developed countries, there is no reason it won't be successful elsewhere. Based on our 36 years of experience in immunisation (http://www.aamp.org), we know that the level of expertise in middle income or poor countries is good or even excellent!