SUMMARY REPORT
First Workshop of the Partners Group on Ebola Vaccines Deployment 24-26 February 2015, Geneva, Switzerland
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WHO/EVD/Meet/HIS/15.2
Contents Executive Summary ........................................................................................................................ 3 Introduction ..................................................................................................................................... 4 Part I: Presentations ....................................................................................................................... 6 Part II: Working Group sessions and plenary discussion ................................................................. 8 Conclusion .................................................................................................................................... 10
Annexes Annex 1: Agenda .......................................................................................................................... 12 Annex 2: List of Participants .......................................................................................................... 15 Annex 3: Summary Action Points .................................................................................................. 17
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Executive Summary A first workshop of partners, convened by the World Health Organization, was held on 24-26 February 2015, to pursue planning and preparation goals for Ebola vaccines deployment, while convening country representatives and partners to ensure coordinated efforts in support to affected countries. The most advanced Ebola vaccine candidates are now entering Phase 3 safety and efficacy clinical trials. Depending on the evolution of the epidemic, results from clinical trials and availability of vaccines, vaccination strategies will be considered as part of the measures to control the outbreak, with a range of approaches. The workshop contributed to address requests formulated by the WHO Executive Board during their special session on Ebola, 26 January 2015 and offered the Ebola Vaccines Deployment Team of Partners (Steering Group and three Working Groups: a. Country Implementation; b. Monitoring, Surveillance and Impact Evaluation; and c. Vaccine Supply, Allocation and Procurement) the perfect forum to: 1) finalize the collaborative framework for the deployment of Ebola vaccines and reach agreement on the next steps; 2) review progress and evidence from Ebola vaccines development; 3) review options and strategies for deployment of Ebola vaccines, within the context of the epidemiological situation; 4) develop a draft outline of a collaborative plan for the deployment of Ebola vaccines; 5) develop draft checklists to guide the country assessments and to support country readiness for the roll-out of the vaccine; and 6) review critical actions for a successful vaccine deployment, within the context of the community engagement and risk communication needs. Emphasis was made on the importance to ensure a clear communication with experts involved in vaccine trials and on community engagement. Critical expectations from countries for vaccine deployment were presented, together with a summary of the current accelerated Ebola vaccine development, the Ebola virus disease epidemiology in West Africa and the implications for vaccine deployment strategies. Country representatives from Sierra Leone and Liberia, and a renowned anthropologist based in Guinea discussed community engagement, social mobilization in support of Ebola vaccine trials, successful introduction and risk communication within each specificity of in-country reality. Numerous challenges emerged from the discussions, such as the difficulty to identify one specific communication channel; the availability of experienced and skilled health care workers; and the mistrust from the communities. The country representatives identified several lessons learned as the importance to: train health care workers on how they should engage with communities; ensure the respect for the deceased; avoid conflicting messages; identify cultural approaches; engage with national councils, the elderly, religious leaders and community representatives. The unpredictable and hypothetical environment calls for flexibility from all partners. Although extremely challenging, this body of work presents an opportunity to have plans in place for use not only during this outbreak, but for future outbreaks. Country ownership and engagement from the onset is critical and will be prioritized, as well as communication among partners and countries, with rapid sharing and analysis of findings. It is important to learn from current experience with the vaccines during the clinical trials and to plan vaccine implementation without compromising the routine immunization programme, whilst always integrating community engagement plan into activities.
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Introduction Depending on the evolution of the current epidemic of Ebola virus disease (EVD), results from clinical trials and availability of vaccines, vaccination strategies will be considered as part of the measures to control the outbreak, with a range of approaches. This meeting was intended to pursue planning and preparation goals for Ebola vaccines deployment, convening country representatives and partners to ensure coordinated efforts in support to affected countries.
Welcome and opening remarks Marie-Paule Kieny, Assistant Director General, Health Systems and Innovation, WHO/HQ Geneva This workshop will complement and build into the work that has been accomplished to date, in terms of accelerating the development of Ebola vaccines, projecting scenarios for implementation of vaccinations and securing finances to support the effort. A series of high-level meetings have offered invaluable opportunities for experts and partners to discuss and coordinate these efforts. The most advanced Ebola vaccine candidates are now entering Phase 3 safety and efficacy clinical trials and could be available for deployment in a few months, after regulatory clearance and policy recommendation. During this workshop, available evidence will be reviewed as well as options and critical actions for a successful deployment of Ebola vaccines. The need for building a collaborative working relationships with all key partners was highlighted. Partners will finalize a framework and outline a plan for the deployment of Ebola vaccines, with a clear definition of roles, responsibilities and coordination mechanisms. These efforts are to support recommendations and country preparedness for the roll-out of the vaccine. Furthermore, the outcomes of the workshop will contribute towards addressing the needs that emerged from the WHO Executive Board special session on Ebola held on 26 January 2015. Particularly, in terms of ensuring the sustainability of the working groups on drugs and vaccines in order to support continued progress and commitment to the most affected countries in West Africa. It is important to emphasize the need to maintain a clear communication with the experts involved in vaccine trials, those involved in community engagement and with the individuals and communities. Timely sharing of accurate information in a manner that can be understood will be key to the success of all efforts in relation to the introduction of Ebola vaccines.
Context and objectives of the workshop Jean-Marie Okwo-Bele, Director, Immunization, Vaccines and Biologicals, Family, Women's, and Children's Health, WHO/HQ Geneva The present status of the current epidemic was briefly outlined as the largest outbreak ever recorded; with almost 23 000 reported confirmed, probable, and suspected cases of EVD; and almost 9 000 reported deaths, in the three most affected countries: Guinea, Liberia and Sierra Leone. Six other countries (Mali, Nigeria, Senegal, Spain, the United Kingdom and the United States of America) have also reported a case or cases imported from a country with intense and widespread transmission. This first workshop of the Partners Group on Ebola Vaccines Deployment is to pursue planning and preparation goals for vaccines deployment, convening country representatives and partners to ensure coordinated efforts to affected countries for the use of a safe and effective vaccine. The most advanced Ebola vaccine candidates are now entering Phase 3 safety and efficacy clinical trials. Depending on the evolution of the epidemic, results from clinical trials and availability of vaccines, different vaccination strategies will be considered as part of the measures to control the outbreak. Workshop objectives: To finalize the partners collaborative framework for the deployment of Ebola vaccines and to reach agreement on the next steps; To provide a synthesis on progress and evidence from Ebola vaccines development; To review options and strategies for deployment of Ebola vaccines, within the context of the epidemiological situation; To review critical actions for a successful vaccine deployment, focusing on community engagement and risk communication needs;
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To develop a draft outline of a collaborative plan for the vaccine deployment including outlines of operational plans with activities, deliverables and milestones for supply and procurement, deployment, monitoring and impact evaluation; To develop draft checklists to guide the country assessments, to support country readiness for the rollout of the vaccine.
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Part I: Presentations Critical expectations from countries for the Ebola vaccine deployment: Sierra Leone Dennis H. Marke, EPI Manager, Ministry of Health and Sanitation, Sierra Leone. The presentation is available upon request. The index case of Ebola Virus Disease (EVD) was confirmed in Sierra Leone in May 2014. As of 21 February, 2015 Sierra Leone had 8 260 cumulative confirmed cases and 3 079 cumulative confirmed deaths. The outbreak affected all the 13 districts in the country, significantly overwhelming the health care system and disrupting daily life. Four main expectations from Sierra Leone for the Ebola Vaccine Deployment Team were identified and presented: Successful vaccine trials; Rapid sharing and analysis of findings; Vaccine optimized to meet country needs; Financial and technical support for roll out.
Accelerated Ebola Vaccine Development Vaseeharan Sathiyamoorthy, Technical Officer, Initiative for Vaccine Research, Immunization, Vaccines and Biologicals, WHO/HQ Geneva. The presentation is available upon request. Once a Public Health Emergency was declared, WHO called for an international partnership to bring forward availability of high quality safety and immunogenicity data. This international partnership achieved unprecedented timelines for Phase 1 safety and immunogenicity generation for novel vaccine candidates. Two candidate vaccines started clinical evaluation in September-October 2014 (rVSV-ZEBOV [NewLink Pharmaceuticals / Merck / Public Health Agency of Canada] and ChAd3-ZEBOV [GSK/NIAID]) and one started clinical evaluation in January 2015 (Ad26.ZEBOV / MVA-BN-Filo, Johnson & Johnson / Janssen Pharmaceuticals / Bavarian Nordic). Multiple manufacturers will increase the chances of successful progress through development, testing and licensure for use, including opportunities for further improvements with the most advanced vaccines as well as with the pipeline vaccines (e.g. in presentation and stability of vaccines, and duration of protection).
Ebola epidemiology in West Africa and the implications for vaccine deployment strategies Conall Watson, MRPharmS MFPH, Senior Registrar in Public Health Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London. The presentation is available upon request Incidence of Ebola virus disease has declined sharply in Liberia and Sierra Leone, but transmission is continuing in parts of Sierra Leone and notably in Guinea. Model projections suggest continued decline is likely in Liberia and Sierra Leone, but increased uncertainty over the future epidemic course in Guinea. This is consistent with field country situation reports, particularly in light of community resistance to the intervention of health workers. Ebola virus is largely transmitted along social networks, with adults at three times the risk of becoming infected than children. As transmission occurs during symptomatic illness or shortly after death, preventing cases through vaccination has the potential to enhance herd immunity and to interrupt transmission. Candidate vaccines as of yet, have not been tested for efficacy in humans and are to be tested in clinical trials in areas with ongoing transmission. There are substantial operational challenges facing the trials and any post-trial implementation. Should efficacy be demonstrated, vaccination of frontline workers is considered a high priority. In the communities, vaccine implementation strategies drawing on the surveillance-containment (including ring vaccination) approaches applied in smallpox eradication may be appropriate. Specific considerations include prevention of cases arising outside known contact networks, and planning around the specific properties of any effective vaccines, including any post-exposure prophylaxis potential, number of doses available and temperature-controlled storage and transportation.
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Community engagement and risk communication: Vaccine trials in Guinea Alain Epelboin, Medical Anthropologist and Film Maker, Centre National de la Recherche Scientifique (CNRS-MNHN), Musée de l’Homme, Paris The necessity for an Ebola vaccine is undeniable, but due to a variety of different factors (e.g. the unpredictability of the disease in time and space, rumours, misconception, mistrust, mass psychogenic illness, violence and stigma), it might only be possible to administer the vaccine to front line health workers and to high-risk contacts. Within the Guinea context, a ring vaccination seems challenging and not feasible at present. In West and Central Africa the immunization programmes are weakened by structural problems (e.g. qualifications and experience of HCWs, lack of standard care material, cold chain equipment, etc.), political environment, administrative and economic constraints. It is therefore extremely challenging to envisage building on a fragile system, with a lack of synergy and listening capacity from the institutions. A community engagement strategy, based on a deep understanding of the local culture, and adaptable to the micro specificity of the local level is absolutely necessary to regain the trust of the community.
Community Engagement & Social Mobilization in support of Ebola Vaccine trial and wide-scale deployment in Liberia Ukam Oyene, WHO/APOC Technical Adviser, WHO/Liberia. The presentation is available upon request. In Liberia, UNICEF, WHO, USAID, Red Cross and other Partners have made significant investment to support government efforts in social mobilization pillar comprising: advocacy, media communication and community engagement. A strong leadership on the EVD response also plays an important role as well as buy-in from the legislative branch of the government, community leaders, public and private sector at all levels. Community engagement and social mobilization activities are aimed at: 1) facilitating government ownership of the Ebola vaccine deployment program; 2) improving access to information about the Ebola Vaccine trial and wide-scale deployment; and 3) facilitating trust and acceptance of Ebola vaccine among community members, community and traditional leaders and other groups to engage their full participation. Periodic Intensification of Routine Immunization (PIRI), other vaccination programmes and Phase 3 vaccine trials could be potentially harmed, if community engagement is not scaled up to combat fear and rumours adequately. Alongside community engagement, efforts are highly needed in strengthening the coordination and training of health and social workers on interpersonal communication, documentation and monitoring of social mobilization interventions at county and sub-county levels. Four major strategic communication subsystems have been identified: Advocacy: provide human resources and material support to sustain high level advocacy for trial and wide-scale introduction of Ebola Vaccine; Risk Communication and Community Engagement: build capacity for sustained risk communication and community engagement for trial and wide-scale introduction of Ebola vaccine; Media and Interpersonal Communication: strengthen capacity of media to support Ebola vaccination campaign; Planning, Coordination, Monitoring and Evaluation: strengthening capacity for planning, coordination, monitoring and evaluation.
Getting to zero transmission of EVD - Community engagement for successful EVD vaccine introduction in Sierra Leone Saffea Gborie, Information Assistant, WHO/Sierra Leone. The presentation is available upon request. In Sierra Leone, several partners are implementing social mobilisation activities at national and community levels under the leadership of the Ministry of Health and Sanitation’s Social Mobilization Pillar. A recent Knowledge, Attitude and Practice (KAP3) study shows that comprehensive knowledge on Ebola continues to improve across the board due to ongoing EVD sensitization and community engagements. Misconceptions continue to decline, together with stigma and discrimination against survivors. The community engagement strategy, to encourage community ownership includes building relationships between traditional and religious leaders and response teams; sensitization of key opinion leaders; and media engagement. Similar outreach activities are also underway as part of the vaccine study sensitisation and awareness activities. Three critical actions are identified for a successful vaccine deployment in Sierra Leone: coordination of partners; continued community engagement; and monitoring of vaccinated individuals for adverse effects of the vaccines.
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Part II: Working Group sessions and plenary discussion The Steering Group (SG) and the three Working Groups (WG) (Country Implementation; Monitoring, Surveillance and Impact Evaluation; and Vaccine, Supply and Procurement) reviewed and discussed in individual groups their respective terms of reference (ToRs), key activities, deliverables, milestones, group composition and group communication. Each group presented their final products, followed by a plenary discussion.
Discussion points The following activities are within the scope of the Ebola Vaccine Deployment Team: Vaccines procurement; Implementation and roll-out; Surveillance, monitoring and evaluation of impact; Recovery of health systems and immunization programmes, although crucial, is not within the scope of work for the Ebola Vaccine Deployment Team. One of the recurring topics remained the funding requirements for deployment of the vaccine. Potential vaccination scenarios were identified by WHO and partners in October 2014, among which the following three target groups are the most likely to be prioritized in the current context: a) health care workers (HCW); b) community Ebola respondents (CER); and c) contacts providing home care of cases and ring vaccination of subjects. The initial deployment plan will be generic and once accurate data emerge from country assessments, the plan will be further developed. The plans will only be finalized after SAGE guidance on targeting recommendations. For country involvement, after group discussion it was decided: The SG will communicate with MoH to rapidly identify appropriate points of contact; The WG leads will establish contact with identified country individuals; The WG will provide a questionnaire on information needed to plan for deployment; The SG will provide a consultant/team of consultants to assist in country planning activities in coordination with WG leads. The SG acknowledged during this first workshop that work is being accomplished in a dynamic and fast changing environment. Therefore, the SG will need to ensure the following at all times: Clearly defined mandates of the different partners; Partners’ willingness and flexibility to work adapting according to changes in information and assumptions; Partners’ preparedness to expedite internal review processes; Global commitment to work together in good trust.
Challenges and lessons learned Numerous challenges to be considered in the overall planning emerged from the discussions, such as the following: Communication channels remain a multi- approach effort and the channel depends on both the objectives and the target audience; Need for indicators for measuring the impact of community engagement and social mobilization; Need to (re-)sensitize families of affected communities with each new chain of transmissions; Experienced skilled staff and effective organizations; Institutions sometimes work in isolation leading to a lack of coordination, communication and duplication of efforts; Suspicion and wariness from the communities towards HCW; Confusion between clinical study and mass vaccination, between adverse events and potential rumours (mostly related due to the mistrust of the community);
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High demand for health workers; Due consideration of the background morbidity. The main lessons learned identified by the country representatives were: Training of HCWs and their engagement with communities; Ensure the respect for the deceased; Avoid conflicting messages; Lack and/or the loss of community trust and engagement requires time to be restored; In community engagement activities: it is vital to identify cultural approaches, such as inclusion of women, planning for salary incentives for both mobilizers and burial teams; Engage with national councils, elderly, religious leaders and secret society representatives; Build on ”what has worked well”, such as: - Nationals (Sierra Leoneans) talking to Nationals (Sierra Leoneans); - Information sessions at district facility level; - Proactive communication.
Action points Main specific action points include: 1. The working groups are to develop time bound plans, costing needs and funding requirements. The Steering group will consolidate plans, discuss collaboration, resources and funding needs with donors and partners as appropriate; 2. A close collaboration with the Strategic Advisory Group of Experts (SAGE) working group is to be maintained; 3. A dialogue with manufacturers is needed to inform cold chain and vaccine requirements for large scale deployment; 4. The planning needs to include provision of independent and active monitoring during the vaccination campaigns; 5. A mechanism for decision of vaccine allocation needs to be developed, such as an International Coordination Group (ICG)-like mechanism. Summary action points are presented in Annex 3.
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Conclusion The following points were identified as key to a successful vaccine deployment plan: Country ownership and engagement from the onset is critical and to be prioritized, countries expect rapid sharing and analysis of findings; There is need to integrate the community engagement plan into activities in the initial planning stage; The planning and implementation activities should not compromise the planned strengthening of the routine immunization programme; There is need to consider cross cutting issues identified between the groups with close and coordinated attention: community engagement, costing and risk communication; Learning from current experience with the vaccines is key (e.g. clinical trials protocols and implementation procedures, country experience during the trials); Communication is key among and between the working groups, this will be ensured through: Weekly SG teleconferences (with WG leads) with minutes to be shared with all team members; Flexible and ad hoc communication across the WG; Any issues may be brought to the attention of the SG.
The task is challenging, all the groups are working in unpredictable and hypothetical environments, particularly since: Work is being conducted in parallel to clinical trial, regulatory and policy work streams with undefined timelines; There is high local variability in the epidemiological situation and groups are versatile, dependent on emerging information.
The following immediate next steps will be taken: Posting of an executive summary of the workshop to WHO website; WG leads to share final draft of ToRs and workplans with the SG; Finalization of the project management structure and staffing; Official communication to countries to nominate focal points; Implementation of regular telephone conferences (TCs) and on-going work plan presentations; Sharing of an summary report of the West Africa EPI managers meeting in Lomé, Togo, 16-19th March; In-country deployment of technical support (consultants recommended by leads and countries); Planning of a future regional workshop. While up to seven scenarios for vaccine deployment have been identified , the SG provided the following three priority strategic scenarios and target groups for vaccination in order to guide the WGs in their initial work, with the understanding that these may change depending on the epidemiological situation: 1. Health Care Workers (doctors, nurses, cleaners); 2. Community Ebola Responders (burial team, contact tracers); 3. Contacts providing home care of cases & ring vaccination of subjects. The unpredictable and hypothetical environment calls for flexibility from all partners. This body of work presents an opportunity to have plans in place for use not only during this outbreak, but for future outbreaks of EVD or any other emerging disease. 1
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In Discussion Papers version 2.0, GAVI workshop on Ebola vaccine funding, Geneva 31 October 2014: 1) Health workers in clinical settings; 2) Community Ebola responders; 3) Contacts providing home care and ring vaccination of contacts; 4) Age-based vaccination strategy in affected areas: vaccinating adults; 5) Geographical strategy: affected districts and counties versus unaffected; 6) Pregnant women; and 7) People living with HIV.
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Closing remarks Dennis H. Marke, EPI Manager, Ministry of Health and Sanitation, Sierra Leone The global effort of the international community to engage the Ministries of Health and the affected countries was recognized and valued. The outcomes of the workshop represent the starting point of vaccine deployment. Emphasis was given on the country national plans, mapping out of technical support for countries as required, clear communication processes, social mobilization, need for KAP studies and development of tailored messages in each country.
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Annex 1: Agenda Background The current epidemic of Ebola virus disease (EVD) in West Africa is the largest outbreak ever recorded with almost 23 000 reported confirmed, probable, and suspected cases of EVD, and almost 9 000 reported deaths, in the three most affected countries: Guinea, Liberia and Sierra Leone. Six countries (Mali, Nigeria, Senegal, Spain, the United Kingdom and the United States of America) have also reported a case or cases imported from a country with widespread and intense transmission. The most advanced Ebola vaccine candidates are now entering Phase 3I safety and efficacy clinical trials and could be available for deployment in a few months. Depending on the evolution of the epidemic, results from clinical trials and availability of vaccines, vaccination strategies will be considered as part of the measures to control the outbreak, with a range of approaches: from protecting first responders, health care workers and high-risk contacts to inducing containment or protecting targeted age groups. This workshop is intended to pursue planning and preparation goals for Ebola vaccines deployment, while convening country representatives and partners to ensure coordinated efforts in support to affected countries.
Objectives The six main objectives of the workshop are: 1. To finalize the partners collaborative framework for the deployment of Ebola vaccines and to reach agreement on the next steps; 2. To provide a synthesis on progress and evidence from Ebola vaccines development; 3. To review options and strategies for deployment of Ebola vaccines, in the context of the epidemiological situation; 4. To review critical actions for a successful vaccine deployment, in the context of the community engagement and risk communication needs; 5. To develop a draft outline of a collaborative plan for the deployment of Ebola vaccines, including outlines of operational plans with activities, deliverables and milestones a. for the supply & procurement; b. for the deployment; c. and for the related monitoring and impact evaluation; 6. To develop draft checklists to guide the country assessments to support country readiness for the rollout of the vaccine.
Background documents 1. Partners planning framework on Ebola vaccines deployment and preparation for large scale introduction, Draft version 5, 23 February 2015 2. WHO - Ebola Situation reports: http://apps.who.int/ebola/en/current-situation/ebola-situation-report 3. London School of Hygiene & Tropical Medicine, Centre for the Mathematical Modelling of Infectious Diseases - Visualisation and projections of the Ebola outbreak in West Africa: http://ntncmch.github.io/ebola/ 4. Second WHO high-level meeting on Ebola vaccines access and financing, 8 January 2015 - Summary report: http://who.int/mediacentre/events/2015/ebola-vaccine-access/en/
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Agenda Tuesday 24 February 2015 SESSION 1 – Chair: Jean-Marie Okwo Bele 09:00-09:15 09:15-09:45 09:45-10:15 Welcome address and introductions Context and objectives of the workshop, review of the agenda The three critical expectations from countries for the Ebola vaccines deployment Synthesis on progress and evidence from vaccine development Coffee Options and strategies for deployment of vaccines, epidemiological situation and implications for vaccine deployment Lunch Community engagement and risk communication Community engagement and social mobilization: perceptions from countries and the three critical actions for a successful vaccine deployment Alain Epelboin (Centre N de la Recherche Scientifique, Paris) Issiaga Konate (WHO Guinea) Ukam Oyene (WHO Liberia) Saffea Gborie (WHO Sierra Leone) al
Marie-Paule Kieny (WHO) Jean-Marie Okwo Bele (WHO) Camille Soumah (EPI Guinea) Adolphus Clarke (EPI Liberia) Dennis Marke (EPI Sierra Leone) Vaseeharan Sathiyamooorthy (WHO)
10:15-10:45 10:45-11:00 11:00-12:30
Conall Watson (London School of Hygiene and Tropical Medicine)
12:30-13:30 13:30-14:15 14:15-14:45
SESSION 2 – First group session 14.45-15:45 In group session to review: Final drafts of terms of reference Key activities, deliverables and milestones Steering group and the 3 working groups: 1. Country Implementation 2. Monitoring, Surveillance, Impact 3. Vaccine Supply, Allocation, Procurement
15:45-16:00
Coffee SESSION 3 – Chair: Marie-Pierre Preziosi
16:00-17:30
Plenary presentation and final discussion to harmonize terms of reference, key activities, deliverables, milestones, groups composition and between groups communication
Chair of the Steering group and Leads of each of the 3 working groups
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Wednesday 25 February 2015 SESSION 4 – Second group session 09:00-09:30 09:30-10:45 Expectations from the Working Groups (framework for group sessions and for plenary reporting) In-group session to review available information and develop: Draft synopsis of activities, deliverables and milestones Draft checklists to guide country assessments Coffee Continued in-group session Lunch SESSION 5 – Chair: Steering group 13:30-14:30 Report from Country Implementation working group and discussion on next steps Report from Monitoring, Surveillance and Impact working group and discussion on next steps Coffee Report from Vaccine Supply, Allocation and Procurement working group and discussion on next steps Report from Steering group and discussion on next steps Conclusion and next steps Working group leads Alejandro Costa (WHO) and Aurelia Nguyen (Gavi) Steering group chair Marie-Pierre Preziosi (WHO) Steering group Working group leads Adama Sawadogo (UNICEF) and Gavin Grant (CDC) Working group leads Jason Mwenda (WHO) and Adam Macneil (CDC) Continued in-group session Steering group Steering group and the 3 working groups: 1. Country Implementation 2. Monitoring, Surveillance, Impact 3. Vaccine Supply, Allocation, Procurement
10:45-11:00 11.00-12:30 12:30-13:30
14.30-15:30
15:30-15:45 15:45-16:45
17:45-18:15 18:15-18:30
Thursday 26 February 2015 SUPPLEMENTARY SESSION FOR WORKING GROUPS 09:00-10:45 During this session, each working group / sub-group will have the opportunity for finalizing reporting or for collaborative work on the development of tools and guidelines or for more detailed planning, as relevant Coffee During this session, each working group / sub-group will have the opportunity for finalizing reporting or for collaborative work on the development of tools and guidelines or for more detailed planning, as relevant Steering group and the 3 working groups as needed Steering group and the 3 working groups as needed
10:45-11:00 11.00-12:30
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Annex 2: List of Participants BILL & MELINDA GATES FOUNDATION Andrew Jones* Senior Program Officer, Vaccine Delivery & Integrated Delivery, Seattle Helen Matzger Senior Program Officer, Vaccine Delivery Team, Seattle CENTERS FOR DISEASE CONTROL AND PREVENTION, ATLANTA Laura Conklin Medical Officer, Immunization Systems Branch/Global Immunization Division, Atlanta Gavin Grant Medical Officer, Accelerated Disease Control and VPD Surveillance Branch/Global Immunization Division, Atlanta Katrina Kretsinger Medical Officer, Accelerated Disease Control and VPD Surveillance Branch/Global Immunization Division, Atlanta Adam Macneil Epidemiologist, Strategic Information & Workforce Development Branch/Global Immunization Division, Atlanta Manish Patel Medical Officer, Immunization Systems Branch/Global Immunization Division, Atlanta John Stevenson Statistician, Program Operations Branch/Immunization Services Division, Atlanta CENTRE NATIONAL DE LA RECHERCHE SCIENTIFIQUE, PARIS Alain Epelboin Medical Anthropologist, film maker, CNRS-MNHN, Musée de l’Homme, Paris GAVI, THE VACCINE ALLIANCE Hope Johnson* Head Outcomes and Impact, Geneva Melissa Malhame Head Market Shaping Policy & Performance, Geneva Stefano Malvolti Director, Vaccine Implementation, Geneva Patience Musanhu Senior Manager, Pandemic and Epidemic Diseases, Vaccine Implementation, Geneva Aurelia Nguyen Director, Policy & Market Shaping, Geneva UNICEF SUPPLY DIVISION Jesus Barral-Guerin Senior Manager, Vaccine Centre, Supply Division, Copenhagen Gregory Kiluva Technical Specialist (Cold Chain), Supply Division, Copenhagen UNICEF PROGRAM DIVISION / WCARO Ernest Dabire Emergency Health Specialist, WCARO, Dakar Imran Mirza Health Specialist, Program Division, New York Savita Naqvi Regional Advisor, Communication for Development (C4D), WCARO, Dakar Adama Sawadogo Cold Chain & Logistics Specialist, Programme Division, New York UNICEF SOCIAL MOBILIZATION Jonathan Shadid Communications for Development (C4D), WCARO, Dakar Rafael Obregon* Chief, Communications for Development (C4D), New York USAID Angela Shen Senior Advisor for Vaccines and Immunization, Washington WHO SECRETARIAT Blanche Anya Routine Immunization Officer, Routine Immunization and New Vaccines, Immunization, Vaccines and Emergencies, Brazzaville Madhava Balakrishnan Medical Officer, Safety and Vigilance, Regulation of Medicines and other Health Technologies, Geneva Virginia Benassi Consultant, Initiative for Vaccine Research, Immunization, Vaccines and Biologicals, Geneva Alison Brunier Communication Officer, Communication Capacity Building, Department of Communications, Geneva Thomas Cherian Coordinator, Immunization, Vaccines and Biologicals, Family, Women's, and Children's Health, Geneva
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Alejandro Costa Scientist, Control of Epidemic Diseases, Department of Pandemic and Epidemic Diseases, Geneva Pierre Gsell Technical Officer, Health Systems and Innovation, Geneva Ana Maria Henao Restrepo* Medical Officer, Immunization, Vaccines and Biologicals, Family, Women's, and Children's Health, Geneva Marie-Paule Kieny Assistant Director General, Health Systems and Innovation, Geneva Lidija Kamara* Programme Manager, Immunization, Vaccines and Biologicals, Family, Women's, and Children's Health, Geneva Souleymane Kone* Technical Officer, Expanded Programme on Immunization Plus, Immunization, Vaccines and Biologicals, Geneva Jacqueline Lee Endt Assistant, Initiative for Vaccine Research, Immunization, Vaccines and Biologicals, Geneva Christine Maure Technical Officer, Safety and Vigilance, Regulation of Medicines and other Health Technologies, Geneva Vaseeharan Sathiyamoorthy Technical Officer, Initiative for Vaccine Research, Immunization, Vaccines and Biologicals, Geneva Harou Moussa* Technical Officer (Cold-Chain), Polio Eradication, Libreville Jason Mwenda Mathiu Coordinator, Routine Immunization and New Vaccines, Immunization, Vaccines and Emergencies, Brazzaville Jean-Marie Okwo-Bele Director, Immunization, Vaccines and Biologicals, Family, Women's, and Children's Health, Geneva Isis Pluut Technical Officer, Health Systems and Innovation, Geneva Marie-Pierre Preziosi Medical Officer, Initiative for Vaccine Research, Immunization, Vaccines and Biologicals, Geneva
WHO SOCIAL MOBILIZATION Issiaga Konate* National Professional Officer, Conakry Ukam Oyene Technical Adviser, Sustainable Drug Distribution, Monrovia Saffea Gborie Information Assistant, Freetown WHO COUNTRY REPRESENTATIVES Camille Soumah* EPI Manager, Ministry of Health and Public Hygiene, Guinea Adolphus Clarke* Deputy EPI Programme Manager, Ministry of Health and Social Welfare, Liberia Dennis Marke EPI Manager, Ministry of Health and Sanitation, Sierra Leone WHO CONSULTANTS Bernardus Ganter Independent Consultant, Amsterdam Lisa Stockdale Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London Conall Watson Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London *unable to attend
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Annex 3: Summary Action Points All Ensure smooth communication across working groups, with steering group (SG) and between working groups (WG). Leads of WG report to SG; Leads of subgroups report to lead WG. Organize regular teleconferences for all the groups and sharing of minutes WGs to develop costing needs and funding requirements. SG to consolidate plans and discuss with donors and partners for collaboration, support and funding needs as appropriate
Steering Group (SG) Ensure availability of updated information on clinical trials, interact with clinical trial and research groups Request the protocols and procedures from phase 2 and 3 trials for WGs as relevant Collaborate with SAGE working group and share minutes as appropriate Ensure coordination with SAGE and vaccine manufacturers
Country Implementation WG Define roles and responsibilities for social mobilization, in collaboration with countries, using existing social mobilization systems (engagement of countries is important in all aspects and especially for crisis communication) Ensure planning for adequate waste management control at country level Plan the cold chain assessment, based on experience from the clinical trials Develop cold chain scenarios, including implications and feasibility Ensure safety and security of vaccine campaigns for both the vaccines and the vaccination teams Ensure the transfer of funds to countries, with timely reporting for control and auditing
Supply and Allocation WG Ensure communication with manufacturers to develop cold chain monitoring Develop a mechanism for vaccine allocation, for example a mechanism similar to the ICG Ensure communication with manufacturers regarding stability data, temperature requirements and use of vaccines
Surveillance, Monitoring and Impact evaluation WG Adverse events following immunization (AEFI): strengthen existing strategies and plan for active safety surveillance Evaluation of campaigns: plan for independent and active monitoring during the campaign Measuring effectiveness: ensure dose distribution is registered, develop monitoring systems for each vaccine based on mono-dose or booster-dose schedules Develop training documentation and conduct training for health care workers (HCW), including for campaign monitoring
Summary Report: First Workshop of the Partners Group on Ebola Vaccines Deployment
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