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Measles Elimination in the Western Pacific Region

Measles Elimination in the Western Pacific Region. 2007 Partners Meeting. Wayne A. Antkowiak, PMO-WHO/WPRO Ernest Smith, MO-EPI (Measles)-WHO/WPRO David H. Sniadack, CDC/Atlanta. Presentation Outline. Introduction Status of Measles Elimination in WPR Plan for 2007-2008

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Measles Elimination in the Western Pacific Region

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  1. Measles Elimination in the Western Pacific Region 2007 Partners Meeting Wayne A. Antkowiak, PMO-WHO/WPRO Ernest Smith, MO-EPI (Measles)-WHO/WPRO David H. Sniadack, CDC/Atlanta

  2. Presentation Outline • Introduction • Status of Measles Elimination in WPR • Plan for 2007-2008 • Partner Contributions • Unmet Needs

  3. WHO Region for the Western Pacific Population: 1.7 billion Countries/areas: 37 (including 20 PICs)

  4. WHO/WPRO Indicators for Measles Elimination • Low Incidence • Confirmed measles cases < 1/1,000,000 population • Excellent Surveillance • Suspected cases > 1 per 100,000 in 80% of districts • >80% of samples adequate serum for IgM • virus isolation in select outbreaks • Maintaining high population immunity to measles • >95% coverage with 2 doses of MMR • Outbreaks • <100 cases<3 month duration

  5. Measles Incidence Rate, 2005 (per 1 Million Population) LEGEND: < 1.0 (21) 1.0 – 9.9 (5) 10.0 – 99.9 (6) ≥ 100 (1) * 2005 data, from 2006 JRF No data (4)

  6. Case based (10) Aggregate data (2) Hospital-Based Active Surveillance (20) Not yet reporting regularly (5) Countries Reporting Surveillance Data to WPRO, 2006

  7. Indicators for Measles Elimination in WPR, 2005 & 2006 2006 case based or aggregate data 2005 case based or aggregate data

  8. LEGEND: ≥ 95% (14) 85 – 94% (4) 75 – 84% (7) 50 – 74% (5) < 50% (2) No data (5) MCV1 Coverage, WPR, 2005* * 2005 data, from 2006 JRF

  9. LEGEND: ≥ 95% (9) 85 – 94% (0) 75 – 84% (6) 50 – 74% (3) < 50% (1) No Data (9) No MCV2 (9) MCV2 Coverage, WPR, 2005* * 2005 data, from 2006 JRF

  10. Priority Countries, WPR • GAVI eligible • Papua New Guinea • Lao People’s Democratic Republic • Cambodia • Viet Nam • Mongolia • Not GAVI-eligible • The Philippines • China

  11. Reported Measles Cases and MCV1 CoveragePapua New Guinea, 1974 to 2005

  12. Reported Measles Cases and MCV1 CoverageLao PDR, 1974 to 2005

  13. Reported Measles Cases and MCV1 CoveragePhilippines, 1974 to 2005 SIA SIA

  14. Priorities for 2007-08: SIAs SIAs are needed in high risk countries/areas to interrupt measles virus circulation • Complete cMYPs for non-GAVI countries • VTN, CAM, LAO, MOG, PNG completed • Identify adequate financing for planned SIAs • IFFIm for GAVI-eligible countries • Other financing mechanisms for countries that are not GAVI-eligible • Ensure adequate technical assistance for high quality operational planning, preparation and implementation for campaigns

  15. Mongolia Oct/Nov 2007 Target age: 1-9 years Target number:431,521 Viet Nam 3rd Quarter 2007 Target age: high risk 7-20 yrs Target number: 3,537,194 2008 Target age: high risk 7-20 yrs Target number: 1,073,050 Lao PDR Oct/Nov 2007 Target age: 9m-15 years Target number: 2,262,000 Philippines 4th Quarter 2007 Target age: 9-48 months Target number: 8,600,000 Cambodia Feb/Mar 2007 Target age: 9-59 months Target number: 1,500,000 Papua New Guinea 4th Quarter 2008 Target age: 6m-10yrs Target number: 1,800,000 Planned SIAs, WPR,2007-2008

  16. Priorities for 2007-08: Surveillance Surveillance is needed to identify high risk areas and monitor progress • Provide technical assistance to establish case-based reporting of measles throughout the region, integrated with AFP surveillance • Work with countries to strengthen national monthly reporting to WPRO • Publish monthly EPI bulletin based on data supplied from countries

  17. Priorities for 2007- 08: Routine Immunization Strengthened routine immunization is needed to sustain interrupted measles transmission • Assist GAVI-eligible countries to complete ISS, HSS plans and applications (e.g., LAO, CAM, MOG) • Encourage all countries on RED • Microplanning (including vaccine management and logistics) • Outreach • Supportive Supervision • Data collection and use • Community participation • Focus on urban poor as high risk group • Introduce routine MCV2 where feasible • School entry checks

  18. UNF Support to WPRO/UNICEF for SIAs in 2007-2008 • Viet Nam $4,458,000 • Papua New Guinea $1,788,000 • Lao PDR $1,208,000 • Cambodia $ 959,000 • Mongolia $ 302,000 • China $1,000,000 • Philippines $ - • Consultants $ 78,000 TOTAL $ 9,793,000

  19. Additional Partner Support for Measles Elimination in WPR • GAVI – MCV2 for • VTN: $2,500,000 for 5 years - conditionally approved • CAM: $600,000 - denied because MCV1=79% • CDC • $200,000/year to WPRO for measles support • $500,000/year for measles SIA and other activities in Sichuan Province, China • JICA • $15 million to WPR for EPI • $525,000 for Cambodia SIAs in 2007 • Feasibility study for project to strengthen measles and polio surveillance for provinces in Western China • CIDA - $200,000/year to WPRO for EPI and surveillance • AUSAID - $900,000/year to WPRO for EPI and surveillance

  20. Unmet SIA Needs in WPR, 2007- 08 • Lao PDR $ 986,000 • Philippines $ 7,334,000 • China $19,412,000 * TOTAL $27,732,000 * For 2007-2012

  21. Philippines SIA 4th Quarter 2007 Target Population – 8.6 million (9 - 48 months) • Operational Costs $3,420,000 • Vaccine/Syringe/SB $3,580,500 • Surveillance $ 870,000 • Advocacy $ 60,000 Total Requirement $7,930,500 Government Contribution $ 600,000 Shortfall $7,333,500

  22. China SIAs (2007 – 2012) Requirement supported by Govt. funds • Vaccine $ 9,907,000 • Vaccinators $ 2,810,000 • AEFI $ 133,000 Total Government Contribution $ 12,852,000 Unfunded requirement • Syringe/needle $ 3,820,000 • Cold Chain/Transport/Disposal $ 7,444,000 • Social Mobilization $ 8,147,000 Total Shortfall$19,412,000

  23. Thank You The moment one definitely commits oneself, then Providence moves too - Goethe

  24. Indicators forMeasles Elimination in PNG * 2005 data, from 2006 JRF

  25. Indicators forMeasles Elimination in Lao PDR * from 2005 aggregate data** 2005 data, from 2006 JRF

  26. Indicators forMeasles Elimination in Cambodia * from 2006 case-based data** 2005 data, from 2006 JRF

  27. Indicators forMeasles Elimination in Viet Nam * from 2005 case-based data** 2005 data, from 2006 JRF

  28. Indicators forMeasles Elimination in Mongolia * from 2006 case-based data** 2005 data, from 2006 JRF

  29. Indicators forMeasles Elimination in the Philippines * from 2006 case-based data** 2005 data, from 2006 JRF

  30. Indicators forMeasles Elimination in China * from 2006 aggregate data** 2005 data, from 2006 JRF

  31. SIA Budget Breakdown, Western China, 2007-2012

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