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Analytical summary - Immunization and vaccines development

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The reduction of morbidity and mortality due to vaccine-preventable diseases (particularly childhood diseases) through the effective and efficient delivery of the Expanded Programme on Immunization and related services has been a long-term priority for the Government of the Gambia's Ministry of Health and Social Welfare.[1] However, in order to attain this goal, the Ministry endeavoured to provide a vaccination schedule for children for all antigens (see table).

Expanded Programme on Immunization schedule[1]

The percentage of the target population vaccinated by antigen in 2010 in the Gambia is shown in the table.[2] The Expanded Programme on Immunization in the Gambia comprises components such as communication, logistics, data management and surveillance. These programme components work very closely in the delivery of the Expanded Programme on Immunization and related services in the country.

The percentage of the target population vaccinated by antigen in the Gambia, 2010[2]

The immunization system strengthening in the country includes:

  • training of immunization service providers[3]
  • data quality assessment
  • effective vaccine management assessment
  • monitoring and routine maintenance of the cold chain.

There is an active surveillance system for maternal and neonatal tetanus elimination in the country.

The measles pre-elimination programme in the Gambia comprises routine and supplementary measles immunizations and surveillance at all levels of service delivery.

Yellow fever control is the priority of the Ministry of Health and Social Welfare and it is almost at the state of elimination due to sustained high immunization coverage.

The polio eradication programme is characterized by high routine immunization, conduct of supplementary immunizations (national immunization days), implementation of acute flaccid paralysis surveillance and mopping up.

National immunization days are highly successful in the Gambia. With the support of WHO and other partners, they always register over 90% coverage.

The GAVI Alliance, the traditional partner for new vaccine support, has urged the Government to start contributing towards the purchase of these vaccines, which are relatively expensive. The Ministry of Finance has been very supportive in funding vaccines. In September 2009, pneumonia conjugate vaccine was added to the traditional vaccines, namely measles, diphtheria-tetanus-pertussis, polio and Bacille Calmette-Guérin, and new and underutilized vaccines such as Haemophilus influenza B vaccine. WHO and the Bill & Melinda Gates Foundation supported the use of new conjugate vaccines in the control of pneumococcal disease.

All regional health management teams obtain their vaccine supply quarterly from the central level. Most health facilities use ambulances to collect vaccines from the regional stores and the same ambulances are used for routine immunization during reproductive and child health services. Reproductive and child health trekking vehicles support immunization services in the absence of ambulances.

Antigens are kept in solar fridges that are monitored at least twice daily. An improved temperature-monitoring system is instituted using a device call fridge-tag that is capable of reading temperature for 1 month.

In 2011, the Expanded Programme on Immunization experienced a wastage rate for the following antigens: Bacille Calmette-Guérin 15%, oral polio vaccine 20%, tetanus toxoid 15%, Penta 15%, Pneumo 5%, measles 15% and yellow fever 15%.

The Historical analysis of the comprehensive multi-year plans in GAVI-eligible countries (2004-2015)[4] includes introduction of vaccines for rotavirus and other new vaccines.

Currently, all vaccine research and development is undertaken by the Medical Research Council in collaboration with the Government. The presence of the Medical Research Council in the Gambia holds a real potential for the development of research in the Gambia if skills are developed in young Gambian scientists.

References

  1. 1.0 1.1 The Gambia National Expanded Programme on Immunization. Desk review, final report. Banjul, Government of the Gambia, Expanded Programme on Immunization, 2006
  2. 2.0 2.1 National Expanded Programme on Immunization. Routine data. Banjul, Government of the Gambia, Expanded Programme on Immunization, 2010
  3. National Expanded Programme on Immunization training manual for health workers delivering immunization services. Banjul, Government of the Gambia, Expanded Programme on Immunization, revised 2011
  4. Historical analysis of the comprehensive multi-year plans in GAVI-eligible countries (2004–2015) (pdf 2.25Mb). Joint Collaboration between the Bill & Melinda Gates Foundation and the World Health Organization, 2012