The Effective Vaccine Management Initiative Past, Present and Future

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1 EVM setting a standard for the vaccine supply chain The Effective Vaccine Management Initiative Past, Present and Future Paul Colrain TechNet meeting Dakar, Senegal, February 2013 February 2013 TechNet meeting, Dakar, Senegal 1

2 EVM setting a standard for the vaccine supply chain The Effective Vaccine Management (EVM) Improvement Process Assessment & Recommendations Other Information Countries are encouraged to carry out an assessment every three years. The assessment is conducted by the MOH with the technical support of an expert independent consultant. Implementation & Monitoring Improvement Plan The key outcome of an assessment is a list of recommendations to address weaknesses and reinforce strengths. An improvement plan is prepared and implemented by the national EPI team, with the financial and technical support of partners. February 2013 TechNet meeting, Dakar, Senegal 2

3 EVM Assessment The 9 EVM Criteria At each level of the supply chain, each criterion is assessed against minimum standards. Information Systems & Supportive Management Data is collected from representative samples of vaccine and immunization facilities. Distribution storage Vaccine Management Stock Management Capacity Vaccine Arrivals The data is collected using questionnaires and through observation. Maintenance At each level of the supply chain, each of the 9 criteria is assigned a score out of 100%. The target score is set at 80% for each criterion. Temperature Monitoring Buildings & Equipment February 2013 TechNet meeting, Dakar, Senegal 3

4 # assessments (cumulative) EVM Assessment EVM assessment uptake 1. Pilot EVM Assessments in Vietnam and Senegal in At the end of 2010 GAVI requires all new vaccine support applicant countries to carry out an EVM assessment and prepare an improvement plan. 3. At the end of 2011 GAVI requires all countries in receipt of support to provide an up-to-date improvement plan implementation status each year By the end of 2013 all GAVI eligible countries should have carried out at least one EVM assessment, and many will have carried out two February 2013 TechNet meeting, Dakar, Senegal 4

5 EVM Assessment EVM Assessment Results Criteria Scores 100% 80% 60% 40% 20% 0% EVM Moldova 2011 PR SN LD SP E1 E2 E3 E4 E5 E6 E7 E8 E9 Some countries have largely effective vaccine management systems, in that all criteria at all levels score above or close to the target score of 80%. 100% 80% 60% 40% 20% 0% EVM Solomon Islands 2012 PR SN LD SP E1 E2 E3 E4 E5 E6 E7 E8 E9 Many have room for improvement. February 2013 TechNet meeting, Dakar, Senegal 5

6 EVM Assessment EVM Assessment Results Criteria Scores In general, vaccine management systems in GAVI eligible countries do not meet the minimum standards. 100% Primary Level 100% Sub-National level 80% 80% 60% 60% 40% 40% 20% 20% 0% E1 E2 E3 E4 E5 E6 E7 E8 E9 0% E1 E2 E3 E4 E5 E6 E7 E8 E9 100% Lowest Distribution level 100% Service Point level 80% 80% 60% 60% 40% 40% 20% 20% 0% 0% E1 E2 E3 E4 E5 E6 E7 E8 E9 E1 E2 E3 E4 E5 E6 E7 E8 E9 February 2013 TechNet meeting, Dakar, Senegal 6

7 Mean Level Score EVM Assessment EVM Assessment Results Criteria Scores Mean Level scores PRimary Sub-National Lowest Delivery Service Point 100% 80% 8 countries 34 countries 23 countries 60% 40% 20% 0% Why are the EVM scores increasing over time? Any ideas? February 2013 TechNet meeting, Dakar, Senegal 7

8 frequency EVM Assessment EVM data analyses The EVM database is currently being mined for nuggets of useful information. 80 E6:23a: Do vaccine stocks equal diluent stocks? All Countries - Service Point level number of vaccine doses - number of diluent doses February 2013 TechNet meeting, Dakar, Senegal 8

9 frequency EVM Improvement Plan Improvement Plan Content Improvement plans vary in the number and nature of improvement activities number of activities in improvement plan Some improvement plans contain a long list of very specific improvement activities, others contain a shorter list of more generic activities. Some improvement plans contain only programmatic improvement activities, others contain both programmatic and strategic activities. February 2013 TechNet meeting, Dakar, Senegal 9

10 EVM Improvement Plan Implementation Evidence of implementation* In April 2012 (red line), GAVI required approximately 40 countries to report on the implementation status of their improvement plans. Assuming a three year implementation window, about 15 countries reported being on or ahead of schedule. Approximately 20 countries either did not report or reported no progress. * Implementation numbers are indicative only (±5 activities). February 2013 TechNet meeting, Dakar, Senegal 10 Senegal 2009 Viet Nam 2009 Mauritania 2010 Congo 2010 Ghana 2010 Sierra Leone 2010 Lao PDR 2010 Cameroon 2010 Chad 2010 Nigeria 2010 Moldova 2011 Haiti 2011 Armenia 2011 Togo 2011 Liberia 2011 Guinea 2011 Guinea-Bissau 2011 Djibouti 2011 Burundi 2011 Bangladesh 2011 Angola 2011 Papua New Guinea 2011 Niger 2011 Gambia 2011 Azerbaijan 2011 Sudan 2011 South Sudan 2011 Zambia 2011 Uganda 2011 Timor-Leste 2011 São Tomé and Príncipe 2011 Rwanda 2011 Myanmar 2011 Mali 2011 Korea, DPR 2011 Indonesia 2011 Georgia 2011 Afghanistan 2011 Madagascar 2011 Lesotho 2011 DR Congo 2011 Central African Republic 2011 Kyrgyzstan 2011 Nepal 2011 Cambodia 2012 Viet Nam 2012 Uzbekistan 2012 Sri Lanka 2012 Tanzania 2012 Senegal 2012 Mozambique 2012 Côte d'ivoire 2012 Bhutan 2012 Benin 2012 Zimbabwe 2012 Solomon Islands 2012 Mongolia 2012 Burkina Faso 2012 Tajikistan 2012 Ukraine 2012 Pakistan 2012 Malawi 2012 Kenya 2012 Comoros 2012 Eritrea 2012 Are Improvement Plans being implemented?

11 EVM Improvement Plan Implementation Evidence of implementation* In April 2012 (red line), GAVI required approximately 40 countries to report on the implementation status of their improvement plans. Assuming a three year implementation window, about 15 countries reported being on or ahead of schedule. Approximately 20 countries either did not report or reported no progress. * Implementation numbers are indicative only (±5 activities). Senegal 2009 Viet Nam 2009 Mauritania 2010 Congo 2010 Ghana 2010 Sierra Leone 2010 Lao PDR 2010 Cameroon 2010 Chad 2010 Nigeria 2010 Moldova 2011 Haiti 2011 Armenia 2011 Togo 2011 Liberia 2011 Guinea 2011 Guinea-Bissau 2011 Djibouti 2011 Burundi 2011 Bangladesh 2011 Angola 2011 Papua New Guinea 2011 Niger 2011 Gambia 2011 Azerbaijan 2011 Sudan 2011 South Sudan 2011 Zambia 2011 Uganda 2011 Timor-Leste 2011 São Tomé and Príncipe 2011 Rwanda 2011 Myanmar 2011 Mali 2011 Korea, DPR 2011 Indonesia 2011 Georgia 2011 Afghanistan 2011 Madagascar 2011 Lesotho 2011 DR Congo 2011 Central African Republic 2011 Kyrgyzstan 2011 Nepal 2011 Cambodia 2012 Viet Nam 2012 Uzbekistan 2012 Sri Lanka 2012 Tanzania 2012 Senegal 2012 Mozambique 2012 Côte d'ivoire 2012 Bhutan 2012 Benin 2012 Zimbabwe 2012 Solomon Islands 2012 Mongolia 2012 Burkina Faso 2012 Tajikistan 2012 Ukraine 2012 Pakistan 2012 Malawi 2012 Kenya 2012 Comoros 2012 Eritrea 2012 Are Improvement Plans being implemented? February 2013 TechNet meeting, Dakar, Senegal

12 February 2013 TechNet meeting, Dakar, Senegal 12 EVM News EVM Assessment Tool New versions of the EVM assessment tool and questionnaire will be released shortly. Changes have been made to the questionnaire, bugs in the tool have been fixed, and new features have been added. Final tests are in progress. EVM Assessors Training A global training course for new EVM consultants will be held in June Location to be announced. Are you or someone you know interested in participating? Contact me

13 February 2013 TechNet meeting, Dakar, Senegal 13 EVM Summary More than 70 countries have carried out EVM assessments Countries are recognizing the strengths and weaknesses in their systems Improvement plans are being prepared Some countries are making good progress in implementing their improvement plans Assessment & Recommendations! Improvement plan implementation is slow in many countries! The EVM improvement process is continuously under review, with particular focus now among partners on: improvement planning, support for implementation, and, monitoring of implementation Implementation & Monitoring Improvement Plan

14 EVM setting a standard for the vaccine supply chain Thank you February 2013 TechNet meeting, Dakar, Senegal 14

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