Hib Initiative ActivitiesThe Hib Initiative conducts activities that are designed according to the situation and needs of each region and country, as described below. In addition, support and coordination is provided to various activities that are relevant to Hib vaccine and that are conducted by partners and other organizations.
Regions with Well Documented Burden of Hib Disease:
MeetingsRegional forums on bacterial meningitis and pneumonia sponsored by Hib Initiative:
Country Consultations Conducted
Research and Surveillance in the RegionAfrica Hib Initiative activities in the AFRO region are focused on supporting surveillance activities and evaluating the impact of Hib vaccine on disease. Support to the Pediatric Bacterial Meningitis (PBM) Network will allow the network to expand within countries and to new countries providing local data on Hib disease. Surveillance in Mozambique is currently supported by the Hib Initiative, and PBM surveillance in Ethiopia has been expanded from 1 to 4 sites in preparation for a vaccine impact study. Vaccine impact research studies are planned for Ethiopia and Mozambique and have started in the Gambia. Specific research questions on Hib vaccine effectiveness in HIV positive children will be answered in the Mozambique study and specific research questions around waning immunity and the need for a booster dose will be answered in the Gambia. Ethiopia is one of the first countries and the largest GAVI-eligible country to date to introduce the all-liquid pentavalent vaccine so demonstrating vaccine effectiveness here is important. Middle East Surveillance in the Middle East region has been progressing steadily. Since 2004, WHO Eastern Mediterranean Regional Office (EMRO), which includes countries in the Eastern Mediterranean and Middle East regions, has supported Bacterial Meningitis Surveillance in 12 countries (Pakistan, Sudan, Syria, Yemen, Morocco, Iran, Libya, Lebanon, Oman, Egypt, Tunisia and Jordan). In 2007, in collaboration with PneumoADIP, the Hib Initiative expanded surveillance in 6 of these countries (Pakistan, Sudan, Syria, Yemen, Morocco and Iran) to form a comprehensive invasive disease surveillance network. In addition, Tunisia and Libya will be using their own financial resources to add enhanced surveillance. As more and more countries adopt Hib vaccine, the Hib Initiative will continue to support the establishment of surveillance systems to document impact and sustain use. In both of the WHO African (AFRO) and European (EURO) regions, additional efforts such as post introduction evaluation (PIE) activities will provide an assessment of the impact of the vaccine on the overall immunization program as well as important lessons learned for neighboring countries. By mid 2008, PIE’s were conducted in Ethiopia, Sierra Leone, and Ukraine. Country Specific ActivitiesBurkina Faso
Ethiopia
Gambia
Mozambique
Papua New Guinea
Senegal
Sierra Leone
Tanzania
Yemen, Sudan
Countries with Undetermined Burden of Hib Disease:
MeetingsRegional forums on bacterial meningitis and pneumonia sponsored by the Hib Initiative:
Country Consultations Conducted
Research and Surveillance in the RegionEfforts in this region have focused on supporting studies to document vaccine impact on pneumonia and meningitis, and to provide technical assistance and coordination to neighboring countries through cost –effective analyses and surveillance support. Ukraine’s introduction of Hib vaccine in 2006 serves as a starting point for increasing momentum of vaccine introduction amongst GAVI-eligible countries. In both of the WHO African (AFRO) and European (EURO) regions, additional efforts such as post introduction evaluation (PIE) activities will provide an assessment of the impact of the vaccine on the overall immunization program as well as important lessons learned for neighboring countries. By mid 2008, PIE’s were conducted in Ethiopia, Sierra Leone, and Ukraine. Country Specific ActivitiesUzbekistan, Azerbaijan and Georgia
Ukraine
Countries with Emerging Data on Hib Disease:
MeetingsRegional forums on bacterial meningitis and pneumonia sponsored by Hib Initiative:
Country Consultations Conducted
Research and Surveillance in the RegionData from the South and East Asian regions continues to emerge. As some of the world’s largest birth cohorts are based in this region of the world, it represents a strategic and important focus for the Hib Initiative. India, which alone represents roughly 1/3 of the birth cohort of all GAVI eligible countries, is a primary focus, with research efforts targeted to help guide state level introduction and sustained use of the vaccine. Other key activities in the region are to support surveillance in India, Sri Lanka and Nepal and to fund studies to assess the impact of Hib vaccine introduction (Bangladesh and Pakistan), as well as examining the long term sequelae of Hib disease (India). For countries in the East Asia region, where data continues to emerge, key activities will be to support surveillance in Vietnam. Cost effectiveness analyses will provide further data to sustain the use of Hib vaccine to countries that plan to, or have already introduced Hib vaccine. Since 2004, WHO Eastern Mediterranean Regional Office (EMRO), which includes countries in the Eastern Mediterranean and Middle East regions, has supported Bacterial Meningitis Surveillance in 12 countries (Pakistan, Sudan, Syria, Yemen, Morocco, Iran, Libya, Lebanon, Oman, Egypt, Tunisia and Jordan). In 2007, in collaboration with PneumoADIP, the Hib Initiative expanded surveillance in 6 of these countries (Pakistan, Sudan, Syria, Yemen, Morocco and Iran) to form a comprehensive invasive disease surveillance network. As more and more countries adopt Hib vaccine, the Hib Initiative will continue to support the establishment of surveillance systems to document impact and sustain use. Additional efforts such as post introduction evaluation activities will provide important lessons learned for neighboring countries. Country Specific ActivitiesCambodia, Lao, Vietnam and Mongolia
India, Sri Lanka and Nepal
Bangladesh
Cambodia
India
Indonesia
Mongolia
Pakistan
Papua New Guinea
Vietnam
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