policy advising in uganda reports/acvi meeting report.pdfprosperity and welfare for the people of...
TRANSCRIPT
Policy Advising in Uganda:
First Meeting Report
Establishing the Advisory Committee on Vaccines and Immunization
UGANDA NATIONAL ACADEMY OF SCIENCES
Uganda National Academy of SciencesA4 Lincoln House
Makerere UniversityPO Box 23911
KampalaUganda
Tel: +256-414-53 30 44Fax: +256-414-53 30 44E-mail: [email protected]
Website: www.ugandanationalacademy.org
© Uganda National Academy of Sciences, October 2012.
ISBN: 978-9970-424-03-0
Support for this work was provided by the African Science Academy Development Initiative (ASADI) of the U.S. National Academies, Washington, DC. The Ministry of Health in Uganda also supports the mandate of the Advisory Committee on Vaccines and Immunization (ACVI).
All rights reserved. Except as otherwise permitted by written agreement, no part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means—electronic, mechanical, photocopying, recording, or otherwise—without the prior permission of the copyright owner, the Uganda National Academy of Sciences.
Establishing the advisory committee on vaccines and immunisation
iv Policy Advising in Uganda
UGANDA NATIONAL ACADEMY OF SCIENCES
The Uganda National Academy of Sciences (UNAS) works to achieve improved prosperity and welfare for the people of Uganda by generating, promoting, sharing, and using scientifi c knowledge and by giving evidence-based advice to government and civil society. UNAS was founded in 2000 and was granted a Charter by His Excellency the President of Uganda in 2009. It is an honorifi c and service-oriented organization founded on principles of objectivity, scientifi c rigor, transparency, mutual respect, linkages and partnerships, independence, and the celebration of excellence.
Council
Prof. Paul E. Mugambi PresidentProf. Elly N. Sabiiti Vice-PresidentProf. Edward K. Kirumira TreasurerProf. Justin Epelu-Opio Secretary GeneralDr. Ham-Mukasa Mulira MemberProf. William B. Banage MemberProf. Patrick R. Rubaihayo MemberProf. James P. M. Ntozi MemberProf. Nyeko Pen-Mogi MemberProf. Livingstone S. Luboobi MemberProf. Julius K. Zake Member
Staff
Franklin Nsubuga-Muyonjo Ag. Executive SecretaryHarriet Nanfuma Administrative AssistantPatrick Ochapet General Support Staff
Establishing the advisory committee on vaccines and immunisation
iv Policy Advising in Uganda
UGANDA NATIONAL ACADEMY OF SCIENCES
The Uganda National Academy of Sciences (UNAS) works to achieve improved prosperity and welfare for the people of Uganda by generating, promoting, sharing, and using scientifi c knowledge and by giving evidence-based advice to government and civil society. UNAS was founded in 2000 and was granted a Charter by His Excellency the President of Uganda in 2009. It is an honorifi c and service-oriented organization founded on principles of objectivity, scientifi c rigor, transparency, mutual respect, linkages and partnerships, independence, and the celebration of excellence.
Council
Prof. Paul E. Mugambi PresidentProf. Elly N. Sabiiti Vice-PresidentProf. Edward K. Kirumira TreasurerProf. Justin Epelu-Opio Secretary GeneralDr. Ham-Mukasa Mulira MemberProf. William B. Banage MemberProf. Patrick R. Rubaihayo MemberProf. James P. M. Ntozi MemberProf. Nyeko Pen-Mogi MemberProf. Livingstone S. Luboobi MemberProf. Julius K. Zake Member
Staff
Franklin Nsubuga-Muyonjo Ag. Executive SecretaryHarriet Nanfuma Administrative AssistantPatrick Ochapet General Support Staff
Establishing the advisory committee on vaccines and immunisation
vPolicy Advising in Uganda
ADVISORY COMMITTEE ON VACCINES AND IMMUNIZATION
Nelson Sewankambo (Chair), Professor and Principal, Makerere University College of Health Sciences, Kampala
George Barnabas Kirya, (Co-Chair), Chairman, African Medical and Research Foundation (AMREF) Uganda Advisory Council, Kampala
Jesca Nsungwa-Sabiiti, Assistant Commissioner, Child Health, Ministry of Health, Kampala
Patrick Y. Kadama, Director, Policy & Strategy, African Centre for Global Health and Social Transformation (ACHEST), Kampala
Peter Waiswa, Lecturer, Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala
Diana Kizza, Health Economist, Sabin Vaccine Institute, Kampala
Sabrina Bakeera-Kitaka, Senior Lecturer, Makerere University College of Health Sciences, Kampala
Sarah Kiguli, Associate Professor and Head of Department, Paediatrics, Makerere College of Health Sciences, Kampala
Jesca Lukanga Nakavuma, Senior Lecturer, Department of Biomolecular Resources and Biolab Sciences, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala
Roy William Mayega, Lecturer, Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala
Benson Obua-Ogwal, Hon Member of Parliament, Parliament of Uganda, Kampala
Lawrence Kaggwa, Technical Resource Person, AMREF, Kampala
Establishing the advisory committee on vaccines and immunisation
vi Policy Advising in Uganda
COMMITTEE ADVISORS
Francis Omaswa, Executive Director, African Centre for Global Health and Social Transformation (ACHEST), Kampala
Emmanuel Mugisha, Country Manager, Program for Appropriate Technology in Health (PATH), Uganda
Christian N. Acemah, ASADI Director for Strategy and Program Development, Board on African Science Academy Development, Institute of Medicine, U.S. National Academies, Washington, DC
Establishing the advisory committee on vaccines and immunisation
vi Policy Advising in Uganda
COMMITTEE ADVISORS
Francis Omaswa, Executive Director, African Centre for Global Health and Social Transformation (ACHEST), Kampala
Emmanuel Mugisha, Country Manager, Program for Appropriate Technology in Health (PATH), Uganda
Christian N. Acemah, ASADI Director for Strategy and Program Development, Board on African Science Academy Development, Institute of Medicine, U.S. National Academies, Washington, DC
Establishing the advisory committee on vaccines and immunisation
viiPolicy Advising in Uganda
REVIEWERS
This report was reviewed in draft form by independent reviewers chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the Uganda National Academy of Sciences (UNAS) Council. The purpose of this independent review is to provide candid and critical comments to assist UNAS in making the published report as sound as possible and to ensure that the report meets institutional standards, including those for objectivity and evidence. The review comments and draft manuscript remain confi dential to protect the integrity of the deliberative process.
UNAS thanks the following individuals for their participation in the review process:
Jesca Lukanga Nakavuma, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
Patrick Kelley, Institute of Medicine (IOM), U.S. National Academies, Washington, DC
Oyewale Tomori, Nigerian Academy of Science (NAS), Lagos, Nigeria
Anne Schuchat, U.S. Centers for Disease Control and Prevention (CDC)
Christian N. Acemah, Institute of Medicine, U.S. National Academies, Washington, DC
Establishing the advisory committee on vaccines and immunisation
viii Policy Advising in Uganda
Preface
The vision of the Uganda National Academy of Sciences (UNAS) is improved prosperity and welfare for the people of Uganda through science. The mission of UNAS is to generate, promote, share, and use scientifi c knowledge and to give evidence-based advice to government and civil society. Fulfi llment of this mission is intended to advance Uganda’s ability to address its national development challenges by:
• engaging in a series of scientifi c activities designed to elucidate potential evidence-based solutions to pressing national and regional development-related concerns;
• enhancing the capacity of UNAS to provide relevant and useful scientifi c policy advice; and
• building Uganda’s appreciation of and demand for advice from UNAS.
UNAS is an autonomous body that brings together a diverse group of experts from all scientifi c fi elds who work together in an inter- and transdisciplinary manner to achieve their main goal of promoting excellence in science and offering independent, evidence-based advice for the prosperity of Uganda. To fulfi ll its mission, UNAS has, since its founding in 2000, used a number of advisory models that have included both convening and consensus activities to (1) highlight and elucidate issues and (2) provide recommendations for addressing these issues. The former activities have involved mainly conducting workshops where experts speak authoritatively on issues of concern, while the latter have entailed primarily convening expert committees to undertake consensus studies. A more recent model at UNAS has involved forming advisory committees, starting with the Malaria Vaccine Committee (MVC) in 2011 and then the Advisory Committee on Vaccines and Immunization (ACVI) in 2012.
The idea of convening the ACVI was fi rst discussed with diverse stakeholders in Uganda (both individuals and organizations), including the Ministry of Health; all expressed unqualifi ed support for the project. Indeed, the Ministry of Health has already written formally to UNAS to, among other things, express its support and readiness to work with the Academy on the project. This report summarizes the proceedings of the fi rst meeting of the ACVI.
Establishing the advisory committee on vaccines and immunisation
viii Policy Advising in Uganda
Preface
The vision of the Uganda National Academy of Sciences (UNAS) is improved prosperity and welfare for the people of Uganda through science. The mission of UNAS is to generate, promote, share, and use scientifi c knowledge and to give evidence-based advice to government and civil society. Fulfi llment of this mission is intended to advance Uganda’s ability to address its national development challenges by:
• engaging in a series of scientifi c activities designed to elucidate potential evidence-based solutions to pressing national and regional development-related concerns;
• enhancing the capacity of UNAS to provide relevant and useful scientifi c policy advice; and
• building Uganda’s appreciation of and demand for advice from UNAS.
UNAS is an autonomous body that brings together a diverse group of experts from all scientifi c fi elds who work together in an inter- and transdisciplinary manner to achieve their main goal of promoting excellence in science and offering independent, evidence-based advice for the prosperity of Uganda. To fulfi ll its mission, UNAS has, since its founding in 2000, used a number of advisory models that have included both convening and consensus activities to (1) highlight and elucidate issues and (2) provide recommendations for addressing these issues. The former activities have involved mainly conducting workshops where experts speak authoritatively on issues of concern, while the latter have entailed primarily convening expert committees to undertake consensus studies. A more recent model at UNAS has involved forming advisory committees, starting with the Malaria Vaccine Committee (MVC) in 2011 and then the Advisory Committee on Vaccines and Immunization (ACVI) in 2012.
The idea of convening the ACVI was fi rst discussed with diverse stakeholders in Uganda (both individuals and organizations), including the Ministry of Health; all expressed unqualifi ed support for the project. Indeed, the Ministry of Health has already written formally to UNAS to, among other things, express its support and readiness to work with the Academy on the project. This report summarizes the proceedings of the fi rst meeting of the ACVI.
Establishing the advisory committee on vaccines and immunisation
ixPolicy Advising in Uganda
Acknowledgments
The Uganda National Academy of Sciences (UNAS) and the Advisory Committee on Vaccines and Immunization wish to express their warmest appreciation to the individuals and organizations that contributed in various ways to the realization of the committee’s fi rst meeting.
The committee is indebted to the African Science Academy Development Initiative (ASADI) of the U.S. National Academies for providing the funding for the initial 6 months of the committee’s work. The committee also thanks UNAS staff members for their support, especially in the planning and organization of the fi rst meeting. The team that produced the draft report (Anne Muwumba and Jonathan Reich, guided by Franklin Muyonjo) is also acknowledged. Finally, special thanks go to the reviewers who volunteered their time to provide candid and critical comments to ensure that this report would be accurate, effective, and credible.
Prof. Nelson SewankamboChair, Advisory Committee on Vaccines and Immunization
Prof. Paul Edward MugambiPresident, Uganda National Academy of Sciences
Establishing the advisory committee on vaccines and immunisation
x Policy Advising in Uganda
Contents
Summary…………………………………………………………………………... .............1
Committee Objectives ............................................................................................1
Key Issues in Immunization Policy .........................................................................1
Path Forward..........................................................................................................2
1 Introduction ............................................................................................................3
2 Formation of the Committee...................................................................................3
3 The Committee’s First Meeting ..............................................................................4
4 Committee Objectives ............................................................................................4
5 The Immunization Vision for Uganda .....................................................................5
6 Key Challenges in Immunization ............................................................................5
Coverage and Immunization Performance.............................................................5
Governance of Vaccines and Immunization Practice .............................................7
Budgeting and Financing .......................................................................................9
7 Path Forward........................................................................................................10
References ................................................................................................................11
Annex 1: List of Participants .....................................................................................12
Annex 2: Meeting Agenda ........................................................................................13
Annex 3: Uganda Immunization Schedule ..............................................................15
Establishing the advisory committee on vaccines and immunisation
x Policy Advising in Uganda
Contents
Summary…………………………………………………………………………... .............1
Committee Objectives ............................................................................................1
Key Issues in Immunization Policy .........................................................................1
Path Forward..........................................................................................................2
1 Introduction ............................................................................................................3
2 Formation of the Committee...................................................................................3
3 The Committee’s First Meeting ..............................................................................4
4 Committee Objectives ............................................................................................4
5 The Immunization Vision for Uganda .....................................................................5
6 Key Challenges in Immunization ............................................................................5
Coverage and Immunization Performance.............................................................5
Governance of Vaccines and Immunization Practice .............................................7
Budgeting and Financing .......................................................................................9
7 Path Forward........................................................................................................10
References ................................................................................................................11
Annex 1: List of Participants .....................................................................................12
Annex 2: Meeting Agenda ........................................................................................13
Annex 3: Uganda Immunization Schedule ..............................................................15
Establishing the advisory committee on vaccines and immunisation
xiPolicy Advising in Uganda
List of Boxes and Figures
BOX 1 Vaccine-Preventable Diseases ................................................................5
FIGURE 1 Immunization Coverage Trend in Uganda between 2000 and 2010 .......6
FIGURE 2 Government and Partnership Coordination of Health Service Delivery
for the Immunization Programme in Uganda ..........................................8
FIGURE 3 Concept of a Co-fi nancing Programmme ................................................9
Establishing the advisory committee on vaccines and immunisation
xii Policy Advising in Uganda
List of Acronyms
ACVI Advisory Committee on Vaccines and Immunization
ASADI African Science Academy Development Initiative
DTP3 Diphtheria-Tetanus-Pertussis (vaccine)
EPI Expanded Programme on Immunization
GAVI Global Alliance for Vaccines and Immunization
HPV Human Papilloma Virus
IOM Institute of Medicine
IPD Invasive Pneumococcal Disease
MCV Measles Childhood Vaccine
MVC Malaria Vaccines Committee
MDG Millennium Development Goal
NAS Nigerian Academy of Science
NITAG National Immunization Technical Advisory Group
OPV3 Oral Poliovirus Vaccine
PATH Program for Appropriate Technology in Health
PCV Pneumococcal Conjugate Vaccine PHC Primary Health Care
TT2 Tetanus Toxoid (vaccine)
UNAS Uganda National Academy of Sciences
UNEPI Uganda National Expanded Programme on Immunization
UNICEF United Nations Children’s Fund
WHO World Health Organisation
WHO-AFRO World Health Organisation Regional Offi ce for Africa
Establishing the advisory committee on vaccines and immunisation
xii Policy Advising in Uganda
List of Acronyms
ACVI Advisory Committee on Vaccines and Immunization
ASADI African Science Academy Development Initiative
DTP3 Diphtheria-Tetanus-Pertussis (vaccine)
EPI Expanded Programme on Immunization
GAVI Global Alliance for Vaccines and Immunization
HPV Human Papilloma Virus
IOM Institute of Medicine
IPD Invasive Pneumococcal Disease
MCV Measles Childhood Vaccine
MVC Malaria Vaccines Committee
MDG Millennium Development Goal
NAS Nigerian Academy of Science
NITAG National Immunization Technical Advisory Group
OPV3 Oral Poliovirus Vaccine
PATH Program for Appropriate Technology in Health
PCV Pneumococcal Conjugate Vaccine PHC Primary Health Care
TT2 Tetanus Toxoid (vaccine)
UNAS Uganda National Academy of Sciences
UNEPI Uganda National Expanded Programme on Immunization
UNICEF United Nations Children’s Fund
WHO World Health Organisation
WHO-AFRO World Health Organisation Regional Offi ce for Africa
Establishing the advisory committee on vaccines and immunisation
1Policy Advising in Uganda
Summary
In order to ensure evidence-based advice on routine immunization and in order to facilitate the effi cient introduction of new vaccines (such as those for malaria, pneumococcal disease, and rotavirus) in Uganda, the Ministry of Health and Uganda National Academy of Sciences (UNAS) agreed on the need to establish an independent advisory committee that would make evidence-based policy recommendations on these issues to the ministry. To this end, the Advisory Committee on Vaccines and Immunization (ACVI), comprising 12 nonpartisan experts, was formed. Its main goal is to advise on routine immunization and the introduction of new and underutilized vaccines. The committee held its fi rst meeting on 11 July 2012 to discuss its objectives and plan its future work.
COMMITTEE OBJECTIVES
The ACVI has three main objectives:
• Policy guidance: Provide the Ministry of Health with apolitical policy advice based on credible scientifi c evidence.
• Context-specifi c prioritization: Provide the Ministry of Health with recommendations on vaccine priorities, including new and underutilized vaccines.
• Forward thinking: Track the progress of vaccines and immunization practice throughout Uganda and internationally to better advise on planning for Uganda’s future needs.
KEY ISSUES IN IMMUNIZATION POLICY
The committee identifi ed several important issues that must be addressed in the development of a good vaccine and immunization policy for Uganda:
• Coverage: Are the vaccines routine, new, or underutilized? What training and/or infrastructure is required to administer the vaccines?
• Governance: Which authority or authorities will create and oversee immunization programs?
• Financing: How will the vaccine and immunization programs be fi nanced?
Establishing the advisory committee on vaccines and immunisation
2 Policy Advising in Uganda
PATH FORWARD
The committee recognized and agreed that a more comprehensive understanding of the vaccine and immunization status of Uganda was necessary before it could formulate policy advice. Accordingly, it was decided that the UNAS Secretariat would enlist the help of a consultant to provide in-depth reviews in the following areas:
• current governance arrangements, policies, and strategies for vaccines and immunizations in Uganda;
• coverage trends of routine immunization in Uganda;
• fi nancing options; and
• the country’s management capacity for immunization programs.
Establishing the advisory committee on vaccines and immunisation
2 Policy Advising in Uganda
PATH FORWARD
The committee recognized and agreed that a more comprehensive understanding of the vaccine and immunization status of Uganda was necessary before it could formulate policy advice. Accordingly, it was decided that the UNAS Secretariat would enlist the help of a consultant to provide in-depth reviews in the following areas:
• current governance arrangements, policies, and strategies for vaccines and immunizations in Uganda;
• coverage trends of routine immunization in Uganda;
• fi nancing options; and
• the country’s management capacity for immunization programs.
Establishing the advisory committee on vaccines and immunisation
3Policy Advising in Uganda
1. INTRODUCTION
With support from the Malaria Vaccine Initiative (MVI) of the Program for Appropriate Technology in Health (PATH), the Uganda National Academy of Sciences (UNAS) formed its multidisciplinary, independent Malaria Vaccines Committee in April 2011 to provide evidence-based policy advice to the government and the public on how best to plan for the possible introduction of a malaria vaccine in Uganda. The committee’s work is focused on decreasing the time between licensure and introduction of a vaccine and having effective (human) programs effi ciently delivered throughout the country.
Because the introduction of new vaccines (such as those for malaria, pneumococcal disease, and rotavirus) depends on having policies, strategies, and plans in place for vaccines and immunization practices, UNAS and the Ministry of Health agreed on the need to establish an independent Advisory Committee on Vaccines and Immunization (ACVI). This committee would provide evidence-based advice on vaccines and immunization practices in Uganda. The committee’s main goal is to advise on routine immunization and the introduction and delivery of new and underutilized vaccines. The initial focus will, however, be on routine immunization since the introduction of new and underutilized vaccines depends on the strength of the existing policies, governance, processes, procedures, and fi nancing issues related to routine immunization. The decision to form this committee should be viewed in the context of the fi rst strategic objective of the Global Vaccine Action Plan, which calls for the establishment of national immunization technical advisory groups (NITAGs) to reduce dependence on external bodies for policy guidance (WHO, 2012b).
The UNAS ACVI, chaired by Professor Nelson Sewankambo, Fellow of UNAS, has the mandate of advising the Government of Uganda and the general public on the following: (1) the effective use of vaccines to control vaccine-preventable diseases, (2) the introduction of vaccines, (3) means of strengthening Uganda’s health system to better deliver life-saving vaccines, and (4) any other issues related to immunization.
2. FORMATION OF THE COMMITTEE
Before convening the ACVI for its fi rst meeting, UNAS developed a proposed slate of committee members indicating areas of expertise that were critical to the committee’s viability and suitability and to the execution of its mandate. Individuals in these areas were then identifi ed as potential committee members. Before the committee’s formal establishment and launch, these potential members underwent a bias and confl ict-of-interest review by UNAS. This review was intended to ensure that no one on the committee would have intractable biases or stand to benefi t fi nancially or otherwise from the committee’s future recommendations. This process is crucial for the creation of a balanced, impartial academic committee, especially if the committee is meant to generate objective policy recommendations.
Before the committee could initiate its work, therefore, potential members were asked to disclose any biases or declare any potential confl icts of interest. They were then informed that they had been identifi ed and elected because of their individual expertise and merit and that they would serve as individuals, not as representatives of the institutions with which they were affi liated. They would also serve on a voluntary basis.
Establishing the advisory committee on vaccines and immunisation
4 Policy Advising in Uganda
3. THE COMMITTEE’S FIRST MEETING
At the committee’s fi rst meeting, it was deemed necessary for the members to be briefed on the current state of vaccines and immunization in Uganda before deciding on a path forward. To this end, the committee heard the following presentations and key points:
• Committee Considerations—Global/Regional (African Union [AU])/National) (Sabrina Bakeera Kitaka, Christian N. Acemah): This is the decade of vaccines, and Uganda needs to own the Global Vaccine Action Plan. The launch of the ACVI is therefore timely.
• Status of Vaccines and Immunization in Uganda (Jesca Nsungwa-Sabiiti): Vaccine and immunization coverage in Uganda has declined. Funding for immunization programmes needs to be increased and sustained, and immunization data management needs to improve.
• Role of International Organizations (Diana K. Mugenzi): International organizations are supporting developing countries by fi nancing vaccine and immunization programmes and providing recommendations on policy and regulations on the use of vaccines.
• Current Hot Topics in Immunization (Patrick Y. Kadama, Francis Omaswa): While Uganda has a clear governance and coordination structure for health service delivery, performance on routine immunization has declined. In this context, it is necessary to have a sustainable immunization fi nancing system, strengthen health systems, and restart dialogue on the country’s vaccine and immunization policy.
4. COMMITTEE OBJECTIVES
The following are the ACVI’s specifi c objectives:
• Policy guidance: The committee will provide independent, evidence-based advice to the Ministry of Health and the nation by conducting both convening and consensus activities. Examples of the former activities include policy makers’ dialogues, media roundtables, and workshops, while examples of the latter include closed committee meetings to analyze evidence as the basis for formulating policy recommendations. These activities will support Uganda in adopting apolitical, trustworthy, scientifi cally rigorous policies on vaccines and immunization based on credible evidence and on the consensus of a multidisciplinary expert committee.
• Context-specifi c prioritization: The committee will analyze the evidence with respect to routine vaccination as the basis for its recommendations on Uganda’s vaccine utilization priorities. While the focus will be on routine vaccination, the committee will also consider new and underutilized vaccines.
• Forward thinking: By tracking national, regional, and international innovations in vaccines and immunization practice, the committee will help ensure that the immunization program in Uganda is effective and effi cient for decades into the future. These innovations will be adapted to suit the Ugandan context.
Establishing the advisory committee on vaccines and immunisation
4 Policy Advising in Uganda
3. THE COMMITTEE’S FIRST MEETING
At the committee’s fi rst meeting, it was deemed necessary for the members to be briefed on the current state of vaccines and immunization in Uganda before deciding on a path forward. To this end, the committee heard the following presentations and key points:
• Committee Considerations—Global/Regional (African Union [AU])/National) (Sabrina Bakeera Kitaka, Christian N. Acemah): This is the decade of vaccines, and Uganda needs to own the Global Vaccine Action Plan. The launch of the ACVI is therefore timely.
• Status of Vaccines and Immunization in Uganda (Jesca Nsungwa-Sabiiti): Vaccine and immunization coverage in Uganda has declined. Funding for immunization programmes needs to be increased and sustained, and immunization data management needs to improve.
• Role of International Organizations (Diana K. Mugenzi): International organizations are supporting developing countries by fi nancing vaccine and immunization programmes and providing recommendations on policy and regulations on the use of vaccines.
• Current Hot Topics in Immunization (Patrick Y. Kadama, Francis Omaswa): While Uganda has a clear governance and coordination structure for health service delivery, performance on routine immunization has declined. In this context, it is necessary to have a sustainable immunization fi nancing system, strengthen health systems, and restart dialogue on the country’s vaccine and immunization policy.
4. COMMITTEE OBJECTIVES
The following are the ACVI’s specifi c objectives:
• Policy guidance: The committee will provide independent, evidence-based advice to the Ministry of Health and the nation by conducting both convening and consensus activities. Examples of the former activities include policy makers’ dialogues, media roundtables, and workshops, while examples of the latter include closed committee meetings to analyze evidence as the basis for formulating policy recommendations. These activities will support Uganda in adopting apolitical, trustworthy, scientifi cally rigorous policies on vaccines and immunization based on credible evidence and on the consensus of a multidisciplinary expert committee.
• Context-specifi c prioritization: The committee will analyze the evidence with respect to routine vaccination as the basis for its recommendations on Uganda’s vaccine utilization priorities. While the focus will be on routine vaccination, the committee will also consider new and underutilized vaccines.
• Forward thinking: By tracking national, regional, and international innovations in vaccines and immunization practice, the committee will help ensure that the immunization program in Uganda is effective and effi cient for decades into the future. These innovations will be adapted to suit the Ugandan context.
Establishing the advisory committee on vaccines and immunisation
5Policy Advising in Uganda
5. THE IMMUNIZATION VISION FOR UGANDA
Immunization is crucial for the strengthening of any country’s health system, as well as for attaining the Millennium Development Goals (MDGs), particularly those related to health (MDGs 4, 5, and 6) (WHO, 2005). In line with the global Decade of Vaccines vision, the committee believes Uganda’s goal should be for every child, adolescent, and adult to have equal and equitable access to vaccines and immunization services (Decade of Vaccines Collaboration, 2012). Equal and equitable access will ensure that more people are protected against more vaccine-preventable diseases (see Box 1) and that vaccines are put to their best use in improving health (GAVI, 2011).
BOX 1Vaccine-Preventable Diseases
• Anthrax• Cholera• Diphtheria• Hepatitis A• Hepatitis B• Hepatitis E• Haemophilus infl uenza type b• Human papillomavirus• Japanese encephalitis
• Measles• Meningococcal disease• Mumps• Pertussis• Pneumococcal disease• Poliomyelitis• Rabies• Rotavirus gastroenteritis
• Rubella• Infl uenza• Tetanus• Tuberculosis• Typhoid fever• Tick-born encephalitis• Varicella and herpes
zoster (shingles)• Yellow fever
SOURCE: Decade of Vaccines Collaboration, 2012.
To achieve this goal, the immunization program in Uganda needs to have three major areas of focus: (1) strengthening routine immunization, (2) conducting supplemental immunization activities, and (3) sustaining a sensitive disease surveillance system (WHO-UNICEF, 2011a).
6. KEY CHALLENGES IN IMMUNIZATION
Key challenges in immunization in Uganda include inadequate coverage and immunization performance, governance of vaccines and immunization practice, and budgeting and fi nancing.
Coverage and Immunization Performance
Population coverage for immunization against vaccine-preventable diseases falls into three categories: (1) traditional or routine vaccines, (2) new and underutilized vaccines, and (3) future vaccines. Between 2009 and 2010, Uganda’s immunization performance showed a decline (see Figure 1), which led to an increasing number of under- and unimmunized children. Immunization performance in Uganda varies among districts, and the proportion of districts achieving the set targets for routine immunization and surveillance has not reached required certifi cation levels (WHO-UNICEF, 2011b).
Establishing the advisory committee on vaccines and immunisation
6 Policy Advising in Uganda
FIGURE 1 Immunization coverage trend in Uganda between 2000 and 2010. NOTE: The bright red line represents the target coverage percentage (80 percent) for the diphtheria-tetanus-pertussis (DPT3), polio 3, measles, and tetanus toxoid (TT2)+pregnant immunizations. Note the decline in coverage of all four vaccines between 2009 and 2010. SOURCE: WHO-UNICEF, 2011b.
Routine Immunization
Routine immunization is the basis of the immunization program in Uganda. The aim is to attain 80 percent diphtheria-tetanus-pertussis (DTP3) coverage, eliminate measles by maintaining measles childhood vaccine (MCV) coverage at 95 percent, and eliminate polio through four oral poliovirus vaccine types (OPV0, OPV1, OPV2, and OPV3). According to the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO), however, in 2010 Uganda was among the lowest-ranked African countries in coverage of these three vaccines, at 60 percent for DTP3 and 55 percent for both MCV and the third dose of poliovirus vaccine (WHO-UNICEF, 2012).
• Measles: Uganda has a high burden of disease due to measles. The recent outbreak of measles highlights the urgency of securing the crucial political support and dedicated funding needed to improve routine immunization coverage with two doses of measles vaccine, carry out supplementary immunization activities, and maintain high-quality laboratory-supported surveillance (WHO, 2010).
Establishing the advisory committee on vaccines and immunisation
6 Policy Advising in Uganda
FIGURE 1 Immunization coverage trend in Uganda between 2000 and 2010. NOTE: The bright red line represents the target coverage percentage (80 percent) for the diphtheria-tetanus-pertussis (DPT3), polio 3, measles, and tetanus toxoid (TT2)+pregnant immunizations. Note the decline in coverage of all four vaccines between 2009 and 2010. SOURCE: WHO-UNICEF, 2011b.
Routine Immunization
Routine immunization is the basis of the immunization program in Uganda. The aim is to attain 80 percent diphtheria-tetanus-pertussis (DTP3) coverage, eliminate measles by maintaining measles childhood vaccine (MCV) coverage at 95 percent, and eliminate polio through four oral poliovirus vaccine types (OPV0, OPV1, OPV2, and OPV3). According to the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO), however, in 2010 Uganda was among the lowest-ranked African countries in coverage of these three vaccines, at 60 percent for DTP3 and 55 percent for both MCV and the third dose of poliovirus vaccine (WHO-UNICEF, 2012).
• Measles: Uganda has a high burden of disease due to measles. The recent outbreak of measles highlights the urgency of securing the crucial political support and dedicated funding needed to improve routine immunization coverage with two doses of measles vaccine, carry out supplementary immunization activities, and maintain high-quality laboratory-supported surveillance (WHO, 2010).
Establishing the advisory committee on vaccines and immunisation
7Policy Advising in Uganda
• Polio: The wild poliovirus outbreaks of 2009 and 2010 were a clear indication of a gap in population immunity due to under- and unimmunized children (WHO-UNICEF, 2011b). Among African countries, Uganda has the highest number of children that have not received their fi rst dose of oral poliovirus vaccine, and 43 percent of districts have an OPV3 coverage of less than 80 percent (WHO, 2012c).
As a result, immunization is high on the agenda of the Parliament of Uganda, which is in the process of forming a Uganda Parliamentary Forum on Immunization (McQuestion, 2012).
Introduction of New Vaccines
Currently, Uganda is facing a high disease burden as a result of invasive pneumococcal disease and severe diarrheal disease due to rotavirus, as well as high associated medical costs (WHO-UNICEF, 2011b). The Global Alliance for Vaccines and Immunization (GAVI) is supporting the introduction of three new vaccines in Uganda: the pneumococcal vaccine (PCV), the rotavirus vaccine, and the human papillomavirus (HPV) vaccine. With approval from GAVI, Uganda will be introducing the pneumococcal vaccine to the public in 2013 (GAVI Alliance, 2012b).
Governance of Vaccines and Immunization Practice
At the global level, the decisions made on what vaccines Uganda administers are based on advice from the WHO Executive Board and the World Health Assembly. At the regional level, the WHO Regional Offi ce for Africa (WHO-AFRO) advises on these decisions. At the country level, there is a clear government and partnership coordinating body on the governance of vaccines and immunization practice in Uganda (see Figure 2).
Guidance on coordination and governance is provided through three structures: the management structure, which guides the internal coordination for the Ministry of Health; the governance structure, which works to defi ne the guiding strategic direction and follows up on the operation of interventions; and the partnership structure, which guides external coordination of service delivery by all stakeholders at the respective levels of care (Uganda Ministry of Health, 2010).
Establishing the advisory committee on vaccines and immunisation
8 Policy Advising in Uganda
FIGURE 2 Government and partnership coordination of health service delivery for the immunization programme in Uganda. NOTES: Note the presence of the Health Policy Advisory Committee (HPAC), the main body involved in coordinating the health sector. Specifi cally, HPAC is a donor/stakeholder coordination mechanism that works through established technical working groups; provides a forum for sharing information and experience; and approves the work plans, budget, and other project expenditures for the health sector.CSO = civil society organisation; DGHS = Director General of Health Services; DHMT = District Health Management Team; HDP = health development partner; HSD = Health Subdistrict; LG = local government; MoH = Ministry of Health; OPM = Offi ce of the Prime Minister; PS = Permanent Secretary; S/C = subcounty; VHT = village health team.SOURCE: Uganda Ministry of Health, 2010.
Ê
7Ê
ÊÊÊÊ
Ê
Ê
FIGURE 2 Government and partnership coordination of health service delivery for the immunization programme in Uganda. NOTES: Note the presence of the Health Policy Advisory Committee (HPAC), the main body involved in coordinating the health sector. Specifically, HPAC is a donor/stakeholder coordination mechanism that works through established technical working groups; provides a forum for sharing information and experience; and approves the work plans, budget, and other project expenditures for the health sector. CSO = civil society organisation; DGHS = Director General of Health Services; DHMT = District Health Management Team; HDP = health development partner; HSD = Health Subdistrict; LG = local government; MoH = Ministry of Health; OPM = Office of the Prime Minister; PS = Permanent Secretary; S/C = subcounty; VHT = village health team. SOURCE: Uganda Ministry of Health, 2010.
1. Strategic policy direction
2. Operational policy direction
3. Technical direction
4. Regional coordination
5. District coordination
6. HSD coordination
7. Facility coordination
8. Community coordination
Roles Structure Members (Government and Partners)
Cabinet/Parliament
Top Management Committee
Health Policy Advisory Committee
Senior Management Committee
Regional Stakeholders Fora
District Stakeholders Fora
Health Subdistrict Stakeholders Fora
Subcounty Stakeholders Fora
Technical Working Groups (TWGs)
Village Health Teams
OPM, Minister of Health, Ministers of State and PS of Health,
Parliamentary Committees
PS’s and DGHS Office (Chair), Directorates and Departments
PS’s (Chair), Directorate and Department Heads,
HDP Representatives, Private-Sector and CSO Representatives
DGHS (Chair) Heads of Departments and Divisions
MoH Departments, HDP Representatives, Private-Sector and
CSO Representatives
LG Public and Non-Public-Sector Representatives
DHMT, HSD, S/C Representatives
S/C and Parish RepresentativesÊ
VHTs
HSD and S/C RepresentativesÊ
Establishing the advisory committee on vaccines and immunisation
8 Policy Advising in Uganda
FIGURE 2 Government and partnership coordination of health service delivery for the immunization programme in Uganda. NOTES: Note the presence of the Health Policy Advisory Committee (HPAC), the main body involved in coordinating the health sector. Specifi cally, HPAC is a donor/stakeholder coordination mechanism that works through established technical working groups; provides a forum for sharing information and experience; and approves the work plans, budget, and other project expenditures for the health sector.CSO = civil society organisation; DGHS = Director General of Health Services; DHMT = District Health Management Team; HDP = health development partner; HSD = Health Subdistrict; LG = local government; MoH = Ministry of Health; OPM = Offi ce of the Prime Minister; PS = Permanent Secretary; S/C = subcounty; VHT = village health team.SOURCE: Uganda Ministry of Health, 2010.
Ê
7Ê
ÊÊÊÊ
Ê
Ê
FIGURE 2 Government and partnership coordination of health service delivery for the immunization programme in Uganda. NOTES: Note the presence of the Health Policy Advisory Committee (HPAC), the main body involved in coordinating the health sector. Specifically, HPAC is a donor/stakeholder coordination mechanism that works through established technical working groups; provides a forum for sharing information and experience; and approves the work plans, budget, and other project expenditures for the health sector. CSO = civil society organisation; DGHS = Director General of Health Services; DHMT = District Health Management Team; HDP = health development partner; HSD = Health Subdistrict; LG = local government; MoH = Ministry of Health; OPM = Office of the Prime Minister; PS = Permanent Secretary; S/C = subcounty; VHT = village health team. SOURCE: Uganda Ministry of Health, 2010.
1. Strategic policy direction
2. Operational policy direction
3. Technical direction
4. Regional coordination
5. District coordination
6. HSD coordination
7. Facility coordination
8. Community coordination
Roles Structure Members (Government and Partners)
Cabinet/Parliament
Top Management Committee
Health Policy Advisory Committee
Senior Management Committee
Regional Stakeholders Fora
District Stakeholders Fora
Health Subdistrict Stakeholders Fora
Subcounty Stakeholders Fora
Technical Working Groups (TWGs)
Village Health Teams
OPM, Minister of Health, Ministers of State and PS of Health,
Parliamentary Committees
PS’s and DGHS Office (Chair), Directorates and Departments
PS’s (Chair), Directorate and Department Heads,
HDP Representatives, Private-Sector and CSO Representatives
DGHS (Chair) Heads of Departments and Divisions
MoH Departments, HDP Representatives, Private-Sector and
CSO Representatives
LG Public and Non-Public-Sector Representatives
DHMT, HSD, S/C Representatives
S/C and Parish RepresentativesÊ
VHTs
HSD and S/C RepresentativesÊ
Establishing the advisory committee on vaccines and immunisation
9Policy Advising in Uganda
Budgeting and Financing
Immunization fi nancing in Uganda depends on external donations (WHO-UNICEF, 2011b). In the past, Uganda had a national fund for vaccines and immunization, but that fund is now defunct. According to fi nancial projections, Uganda may need at least US$100 million by 2014 to sustain its immunization program (GAVI Alliance, 2012a).
Financing for vaccines and immunization in Uganda could be provided by public-private partnerships through such organisations as GAVI. GAVI offers co-fi nancing programs whereby the governments of developing countries are required to contribute a certain fraction of the cost of vaccines or immunizations, and GAVI covers the rest of the cost (see Figure 3).
FIGURE 3 Concept of a co-fi nancing program. NOTE: An organization such as the Global Alliance for Vaccines and Immunization (GAVI) could pilot an International Finance Facility Fund, which would raise funds from government and private donors. These funds would then be distributed to help developing countries pay for vaccines and immunizations. SOURCE: Center for Global Development, 2005.
Poliovirus vaccine stockpile
Health systems strengthening
Advance contracts for new vaccines available soon (for example, rotavirus and
pneumococcal disease)
Advance contracts to buy new vaccines (for example, HIV, malaria, tuberculosis)
International Finance Facility
Fund
Capital markets
Donor Donor
Establishing the advisory committee on vaccines and immunisation
10 Policy Advising in Uganda
Funding from the Government of Uganda for the Uganda National Expanded Programme on Immunization has remained static for the past 5 years, and primary health care (PHC) funding is inadequate and irregular (WHO-UNICEF, 2011b). Routine funding for immunization is available through PHC conditional grants to the districts, but this funding is often delayed, which affects the implementation of activities (WHO-UNICEF, 2011b).
7. PATH FORWARDAfter listening to the expert testimony summarized above, the committee was
concerned about the current state of Uganda’s immunization system. Members agreed that they needed more information before developing policy suggestions, and therefore decided to hire a consultant to undertake a quick but systematic review of the current status of vaccines and immunization practice in Uganda. The consultant’s main role will be to gather data that the committee will then analyze and synthesize to arrive at an evidence-based position. The UNAS Secretariat will develop the terms of reference for the consultant, and was also asked to formulate a work plan for the committee in close collaboration with the committee chair.
Finally, the committee decided that for its work to have impact, the following will be necessary:
• The Ministry of Health should be given regular updates on the committee’s work.• The committee should work with greater determination and focus on ensuring that
rigorous academy processes are followed.• Committee reports should be disseminated widely (to ministries, Parliament,
development partners, district medical offi cers, and professional associations).• The committee should encourage renewal of the process of public discussion and
decision making on vaccines and immunization in Uganda by hosting focused media roundtables and policy dialogues.
Establishing the advisory committee on vaccines and immunisation
10 Policy Advising in Uganda
Funding from the Government of Uganda for the Uganda National Expanded Programme on Immunization has remained static for the past 5 years, and primary health care (PHC) funding is inadequate and irregular (WHO-UNICEF, 2011b). Routine funding for immunization is available through PHC conditional grants to the districts, but this funding is often delayed, which affects the implementation of activities (WHO-UNICEF, 2011b).
7. PATH FORWARDAfter listening to the expert testimony summarized above, the committee was
concerned about the current state of Uganda’s immunization system. Members agreed that they needed more information before developing policy suggestions, and therefore decided to hire a consultant to undertake a quick but systematic review of the current status of vaccines and immunization practice in Uganda. The consultant’s main role will be to gather data that the committee will then analyze and synthesize to arrive at an evidence-based position. The UNAS Secretariat will develop the terms of reference for the consultant, and was also asked to formulate a work plan for the committee in close collaboration with the committee chair.
Finally, the committee decided that for its work to have impact, the following will be necessary:
• The Ministry of Health should be given regular updates on the committee’s work.• The committee should work with greater determination and focus on ensuring that
rigorous academy processes are followed.• Committee reports should be disseminated widely (to ministries, Parliament,
development partners, district medical offi cers, and professional associations).• The committee should encourage renewal of the process of public discussion and
decision making on vaccines and immunization in Uganda by hosting focused media roundtables and policy dialogues.
Establishing the advisory committee on vaccines and immunisation
11Policy Advising in Uganda
REFERENCES
Center for Global Development. 2005. Making markets for vaccines: Ideas to action. http://www.cgdev.org/doc/books/vaccine/MakingMarkets-complete.pdf (accessed September 14, 2012).
Decade of Vaccines Collaboration. 2012. Draft 4 of the Global Vaccination Action Plan. http://www.who.int/immunization/sage/meetings/2012/february/GVAP_Draft_March_2012.pdf (accessed September 14, 2012).
GAVI (Global Alliance for Vaccines and Immunization. 2011. Gender and immunization factsheet. http://www.gavialliance.org/about/mission/gender/ (accessed September 14, 2012).
GAVI Alliance. 2012a. Guidelines for applications: New and underused vaccines support. http://www.gavialliance.org/support/nvs/ (accessed September 14, 2012).
GAVI Alliance. 2012b. Report to the GAVI Alliance Board (June 12-13). http://www.gavialliance.org/about/governance/gavi-board/minutes/2012/12-june/ (accessed September 14, 2012).
McQuestion, M. 2012. Uganda Parliament Forms Core Immunization Group. http://www.sabin.org/blog/uganda-parliament-forms-core-immunization-group (accessed September 14, 2012).Uganda Ministry of Health. 2010. Health sector strategic & investment plan (2010/11–2014/15). http://www.kampala.cooperazione.esteri.it/utlkampala/Download/HSSIP%20Final.pdf (accessed September 14, 2012).
WHO (World Health Organization). (2005). Health and the millennium development goals. www.who.int/hdp/publications/mdg_en.pdf (accessed September 14, 2012).
WHO. 2010. Global immunization vision and strategy. http://apps.who.int/gb/ebwha/pdf_fi les/EB128/B128_9-en.pdf (accessed September 14, 2012).
WHO. 2012a. Strengthening routine immunization in Uganda. Global Immunization News.
WHO. 2012b. Global vaccine action plan. http://apps.who.int/gb/ebwha/pdf_fi les/WHA65/A65_22-en.pdf (accessed September 14, 2012).
WHO. 2012c. Immunization profi le—Uganda. http://apps.who.int/immunization_monitoring/en/globalsummary/countryprofi leresult.cfm?C=uga (accessed September 14, 2012).
WHO-UNICEF (United Nations Children’s Fund). 2011a. Uganda national expanded programme on immunization multi year plan 2010-2014. ftp://iff-immunisation.org/Monitoring%20IRC%20July%202012/IRC%20review%20docs/UGA/APR%20&%20background%20documents/new%20cMYP%20APR%202011%20-%201%20-%20EN.pdf (accessed September 14, 2012).
WHO-UNICEF. 2011b. Uganda national expanded programme on immunization multi year plan 2012-2016. ftp://iff-immunisation.org/Monitoring%20IRC%20July%202012/IRC%20review%20docs/UGA/APR%20&%20background%20documents/Other%20-%20UGANDA%20EPI%20cMYP%202012-2016%20-%201%20-%20EN.pdf (accessed September 14, 2012).
WHO-UNICEF. 2012. Immunization summary: A statistical reference containing data through 2010. http://www.childinfo.org/fi les/immunization_summary_en.pdf (accessed September 14, 2012).
Establishing the advisory committee on vaccines and immunisation
12 Policy Advising in Uganda
Annex 1List of Participants
MEETING OF THE ADVISORY COMMITTEE ON VACCINES AND IMMUNIZATION(11 JULY 2012)
Nelson K. SewankamboCollege of Health SciencesMakerere UniversityPaul E. MugambiUganda National Academy of SciencesJ. Epelu-OpioUganda National Academy of SciencesSabrina B. KitakaCollege of Health SciencesMakerere UniversityGeorge B. KiryaAdvocates for Professionalism and Quality in Health (APROQUAH)Jesca Nsungwa-SabiitiMinistry of Health, Kampala Peter WaiswaSchool of Public HealthMakerere UniversityRoy William MayegaSchool of Public HealthMakerere UniversityDiana K. MugenziSabin Vaccine InstituteSarah KiguliCollege of Health SciencesMakerere UniversityLawrence KaggwaAfrican Medical and Research Foundation, KampalaJesca L. NakavumaCollege of Veterinary MedicineMakerere University, Kampala Benson Obua-OgwalParliament of UgandaPatrick KadamaAfrican Centre for Global Health and Social Transformation, KampalaFrancis OmaswaAfrican Centre for Global Health and Social Transformation, Kampala Christian N. AcemahInstitute of Medicine, U.S. National AcademiesFranklin Nsubuga-MuyonjoUganda National Academy of SciencesPatrick OchapetUganda National Academy of Sciences
Establishing the advisory committee on vaccines and immunisation
12 Policy Advising in Uganda
Annex 1List of Participants
MEETING OF THE ADVISORY COMMITTEE ON VACCINES AND IMMUNIZATION(11 JULY 2012)
Nelson K. SewankamboCollege of Health SciencesMakerere UniversityPaul E. MugambiUganda National Academy of SciencesJ. Epelu-OpioUganda National Academy of SciencesSabrina B. KitakaCollege of Health SciencesMakerere UniversityGeorge B. KiryaAdvocates for Professionalism and Quality in Health (APROQUAH)Jesca Nsungwa-SabiitiMinistry of Health, Kampala Peter WaiswaSchool of Public HealthMakerere UniversityRoy William MayegaSchool of Public HealthMakerere UniversityDiana K. MugenziSabin Vaccine InstituteSarah KiguliCollege of Health SciencesMakerere UniversityLawrence KaggwaAfrican Medical and Research Foundation, KampalaJesca L. NakavumaCollege of Veterinary MedicineMakerere University, Kampala Benson Obua-OgwalParliament of UgandaPatrick KadamaAfrican Centre for Global Health and Social Transformation, KampalaFrancis OmaswaAfrican Centre for Global Health and Social Transformation, Kampala Christian N. AcemahInstitute of Medicine, U.S. National AcademiesFranklin Nsubuga-MuyonjoUganda National Academy of SciencesPatrick OchapetUganda National Academy of Sciences
Establishing the advisory committee on vaccines and immunisation
13Policy Advising in Uganda
Annex 2Meeting Agenda
UGANDA NATIONAL ACADEMY OF SCIENCES
Meeting Agenda 11 July 2012
ADVISORY COMMITTEE ON VACCINES AND IMMUNIZATION
First Meeting
Kabira Country Club, Kampala
AGENDA
Opening: J. Epelu-Opio (Uganda National Academy of Sciences [UNAS]) and Nelson Sewankambo (UNAS)
SESSION 1: OPEN
08H30–09H00: Registration
09H00–09H05: Self-Introductions
09H05–09H10: Opening Remarks PE Mugambi, PresidentUNAS
09H10–09H30: The Role of Science Academies: An Overview Franklin Muyonjo
UNAS
09H30 -09H50: The Nature of Advisory CommitteesChristian N. AcemahInstitute of Medicine, U.S. National Academies
09H50–10H00: DISCUSSION
10H00–10H30: TEA/COFFEE BREAK
Establishing the advisory committee on vaccines and immunisation
14 Policy Advising in Uganda
SESSION 2: CLOSED
10H30–11H0O: Rationale for the Committee
Nelson Sewankambo, Chair
Advisory Committee on Vaccines and Immunization (ACVI)
Fellow of UNAS
11H00–11H30: Bias and Confl ict of Interest Discussion
Franklin Muyonjo
UNAS
11H30-12H00: Committee Considerations (Global/Regional [African Union]/National)
Sabrina Bakeera-Kitaka
College of Health Sciences
Christian N. Acemah
Institute of Medicine, U.S. National Academies
12H00–12H30: The Status of Vaccines and Immunization in UgandaJesca Nsungwa-Sabiiti
Ministry of Health
12H30–13H00: The Role of International OrganizationsDiana KizzaSabin Vaccine Institute
13H00–14H00: LUNCH BREAK
14h00–14H30: Current Hot Topics in ImmunizationFrancis OmaswaPatrick Kadama African Centre for Global Health and Social
Transformation (ACHEST)
14H30–15H00: Proposed Work Plan for the CommitteeNelson SewankamboUNAS
15H00–15H30: Path Forward Nelson SewankamboUNAS
15H30–16H00: TEA/COFFEE BREAKDeparture at Leisure
Establishing the advisory committee on vaccines and immunisation
14 Policy Advising in Uganda
SESSION 2: CLOSED
10H30–11H0O: Rationale for the Committee
Nelson Sewankambo, Chair
Advisory Committee on Vaccines and Immunization (ACVI)
Fellow of UNAS
11H00–11H30: Bias and Confl ict of Interest Discussion
Franklin Muyonjo
UNAS
11H30-12H00: Committee Considerations (Global/Regional [African Union]/National)
Sabrina Bakeera-Kitaka
College of Health Sciences
Christian N. Acemah
Institute of Medicine, U.S. National Academies
12H00–12H30: The Status of Vaccines and Immunization in UgandaJesca Nsungwa-Sabiiti
Ministry of Health
12H30–13H00: The Role of International OrganizationsDiana KizzaSabin Vaccine Institute
13H00–14H00: LUNCH BREAK
14h00–14H30: Current Hot Topics in ImmunizationFrancis OmaswaPatrick Kadama African Centre for Global Health and Social
Transformation (ACHEST)
14H30–15H00: Proposed Work Plan for the CommitteeNelson SewankamboUNAS
15H00–15H30: Path Forward Nelson SewankamboUNAS
15H30–16H00: TEA/COFFEE BREAKDeparture at Leisure
Establishing the advisory committee on vaccines and immunisation
15Policy Advising in Uganda
Annex 3Uganda Immunization Schedule
NOTE: This schedule will be updated with the introduction of new vaccines.
9 7 8 9 9 7 0 4 2 4 0 3 0