Haemophilus influenzae type b (Hib)

SAGE reviewed the morbidity and mortality of Hib pneumonia and meningitis in Africa and Asia and current national immunization recommendations against Hib disease. It also reviewed the GAVI Hib initiative whose purpose is to reduce the risk of childhood death and disability through sustained use of the vaccine. In countries that use Hib vaccine, the results of analyses indicate a significant reduction in pneumonia and meningitis, resulting in decreased use of health services for the treatment of these diseases. These potential gains need to be quantified in countries that are not using the vaccine.

SAGE recognized that studies on surveillance and disease burden were needed to support evidence-based decision-making in countries that have not introduced routine Hib vaccination, bearing in mind issues such as vaccine supply and cost, and carefully exploring financing options. Cost-benefit studies would also be needed. Whether all countries need to undertake all of these activities has not been resolved. Limitations in laboratory capacity were identified as major impediments that needed to be properly addressed. New financing opportunities for the poorest countries, particularly through the Global Alliance for Vaccines and Immunization and the IFFIm, will need to be encouraged.

SAGE strongly recommended that this new framework for Hib introduction should be expanded to the fullest extent possible to increase demand for the vaccine and accelerate the lowering of its price.

SAGE also recommended global implementation of Hib vaccination – unless robust epidemiological evidence exists of low disease burden, lack of benefit or overwhelming impediments to implementation. This recommendation will enhance fulfillment of the Millennium Development Goal of reduced childhood mortality (Goal 4)