Expanded programme on immunization

More about the Expanded Programme on Immunization

Since the inception of the Expanded Programme on Immunization (EPI), vaccination has prevented millions of deaths and disabilities in the Western Pacific Region, achieved dramatic and visible declines of once highly endemic diseases, stopped the transmission of wild poliovirus across the Region, and dramatically reduced the transmission of measles virus and hepatitis B virus in many countries in the Region. Despite these achievements, inequitable access to vaccination remains a major problem in many countries, with coverage disparities across geographical areas and gaps of up to 30% between the highest and lowest socioeconomic quintiles.

Low reliability of reported administrative vaccination coverage data in many countries has not been resolved and deprives programmes of an essential monitoring tool. Moreover, while the health impact of vaccinations can be enhanced through the expanded use of new vaccines that are significantly more expensive, the vast majority of the Region’s population resides in middle-income countries that cannot afford their introduction and do not have access to external support mechanisms. Measles elimination requires very high levels of vaccination coverage and requires greater efforts to identify and close remaining immunity gaps by reaching all vulnerable populations and communities.

Aims of the Regional Framework for Implementation of the Global Vaccine Action Plan (GVAP) in the Western Pacific, 2011-2020

In May 2012, the World Health Assembly endorsed the Global Vaccine Action Plan 2011–2020 (GVAP), a global framework that builds on its predecessor, the Global Immunization Vision and Strategy 2006–2015 (GIVS). GVAP offers a broad range of strategies and activities and establishes new goals for achieving the Decade of Vaccines’ vision of a world in which all individuals and communities enjoy lives free from vaccine-preventable diseases.

The Regional Framework has been developed to incorporate all global immunization goals, define region specific goals, and translate the strategies and activities recommended by GVAP to the context of the Western Pacific Region. The immunization goals for the Western Pacific Region are:

  • Sustaining polio-free status
  • Maternal and neonatal tetanus elimination
  • Measles elimination
  • Accelerated control of hepatitis B
  • Rubella elimination
  • Introduction of new vaccines
  • Meeting regional vaccination coverage targets
  • Accelerated control of Japanese encephalitis

Overall the Regional Framework aims to accelerate progress towards achievement of global and regional immunization goals and to help stakeholders to better understand how to work together in implementing GVAP in the Region. It was endorsed in 2014 by the Regional Committee for the Western Pacific during its 65th session and by the Technical Advisory Group (TAG) on Immunization and Vaccine-preventable Diseases.

Advisory committees supporting the implementation of GVAP and Regional Framework

At global level the Strategic Advisory Group of Experts (SAGE) on Immunization was established in 1999 to provide guidance on the work of WHO for vaccines and immunization. It is charged with advising WHO on overall global policies and strategies, ranging from vaccines and technology, research and development, to delivery of immunization and its linkages with other health interventions.

At regional level, the Technical Advisory Group (TAG) on Immunization and Vaccine-preventable Diseases was established in 1991 and has since guided the implementation of EPI strategies in the Western Pacific Region, by:

  • reviewing the epidemiological situation in the region and recommending appropriate goals, targets, strategies and monitor progress towards the reduction of vaccine-preventable diseases;
  • recommending suitable strategies for sustaining high quality national immunization programmes;
  • issuing recommendations on technical matters regarding attaining and sustaining disease elimination, and processes to certify achievements; and
  • recommending suitable strategies and processes for the introduction and integration of new vaccines into the EPI

The GVAP and Regional Framework call for all countries to establish or have access to a National advisory committee on immunization (NITAG), to guide immunization policies at country level. NITAGs are multidisciplinary groups of national experts responsible for providing independent, evidence-informed advice to policy makers and programme managers on policy issues related to immunization and vaccines. As of 2017, 14 countries in Western Pacific region have established a NITAG and Pacific Islands are exploring possibility to establish a sub-regional advisory body.

Monitoring of progress towards regional immunization goals

Progress towards GVAP goals are monitored by an independent SAGE working group as well as by WHO Secretariat. Respective reports are published annually. Additionally, in 2016 a mid-term review of the Global Vaccine Action Plan was published and recommendations presented during WHA.

Progress towards Regional Framework is monitored by the TAG and annual reports have been published since 2016 (referenced as Regional reports - GVAP secretariat).

Regional framework