Philippines: PCV Introduction and Experience. Dr. Enrique A. Tayag Assistant Secretary Department of Health Philippines

Transcription

1 Philippines: PCV Introduction and Experience Dr. Enrique A. Tayag Assistant Secretary Department of Health Philippines

2 Outline Evidence Communications and Advocacy Role of professional Organizations Role of Partners Barriers and how to overcome them Main challenges Key messages to other countries

3 Pneumococcal Conjugate Vaccines The World Health Organization recommended the inclusion of pneumococcal conjugate vaccines (PCV) in childhood immunization programs in countries with under 5 mortality of >50/1,000 births The World Health Organization recommended the use of two pneumococcal conjugate vaccines: PCV 10 or PCV 13 based on country s circulating serotypes

4 Health Statistics Number of children born every year (NSO 2010) 1,782,981* Number of poor children <5 years old (NHTS 2011) 3.6 million Top causes of death in children <5 years old (DOH, 2009) ** 1. Pneumonia 4, Diarrhea 2, Accidents 1,162 * Births based on civil registration and does not cover under registration. Thus, to cover unregistered births, NSO estimates the 0-11 months old infants nationwide by multiplying 2.7% to the total population. ** Excludes neonatal causes

5 Pneumonia and Sepsis Pneumonia was the leading cause of illness, hospitalization and deaths among Filipino children under 5 years old in 2010 & The average number of pneumonia cases in children under 5 years in 2010 & 2011 was over 340,000 per year. The estimated Case Fatality Rate for Sepsis in children up to 13 years was 44% The estimated Case Fatality Rate for Pneumonia in children under 5 years was 1.8%

6 Vaccine Costs It costs <$50 to protect a child from disseminated tuberculosis, hepatitis B infection, diphtheria, pertussis, tetanus, polio, and measles. In 2012, roughly $42 million was allocated to cover costs for childhood vaccines including syringes and needles.

7 Philippine Experience Communications and Advocacy Philippine Foundation for Vaccination, Inc. organized yearly campaigns on World Pneumonia Day and World Meningitis Day. Burden on Pneumonia and Pneumococcal Invasive Disease contextualized on achieving MDGs and Universal Health Coverage.

8 Philippine Experience Partnerships and Linkages Universal Health Care espoused Public-Private Partnership even for Public Health Recommendations on inclusion of PCV vaccines fostered by WHO recommendations, independent local researches, childhood immunization schedules from foreign and local vaccination advocates

9 Philippine Experience Overcoming Barriers and Challenges Enhancing disease surveillance for Invasive Pneumococcal Disease Designing Cost-free PCV impact study Balancing Benefits of Vaccination with Integrated Management of Childhood Illnesses Accessing Cheaper Vaccines from World Market Promoting Social Benefits of Vaccination Engaging Partners to achieve common Goals for Child Survival

10 Philippine Experience Program Implementation In 2013, PCV 10 2-dose, single syringe vaccine was introduced following prevailing WHO requirements Initially, only 300,000 eligible infants in 2 regions with high burden of illness were identified because vaccine was not cheap ($55 per child). In 2014, another 300,000 eligible infants from 4 regions with high burden of disease will be given PCV 13

11 PCV 10 or PCV 13? Actual Procurement 2012 PCV 10 was procured through UNICEF when it was a cheaper then than PCV PCV 13 was procured also through UNICEF when a WHO WPRO study demonstrated that PCV 13 was more costeffective than PCV10.

12 regarded as a better use of health care resources. Incremental outcomes of (i) using PCV10 (compared to no vaccination), (ii) using PCV13 (compared to no vaccination) and (iii) using PCV13 compared to PCV10. Table 2. Incremental outcomes of (i) using PCV10 (compared to no vaccination), (ii) using PCV13 (compared to no vaccination) and (iii) using PCV13 compared to PCV10. Abbreviations: Abbreviations: b, billion; m, million. b, billion; m, million. * PCV10 vs nothing PCV13 vs nothing PCV13 vs PCV10 Number vaccinated with 3 doses 55.6 m 55.6 m - Total vaccination cost $3.14 b $3.33 b $0.19 b Health care costs saved $0.27 b $0.473 b $0.203 b Productivity costs saved $70.1 m $51.2 m $-18.9 m IPD cases prevented Non-IPD pneumonia cases prevented Deaths prevented Acute otitis media cases prevented 28 m 18.3 m m DALYs prevented (undiscounted) 1.15 m 1.37 m m DALYs prevented (discounted) m m m Total net costs (undiscounted) $2.8 b $2.81 b $5.85 m Total net costs (discounted) $1.84 b $1.84 b $4.56 m * WHO WPRO study

13 Philippine Experience Key Lessons Before trying All Things New, Answer these questions: Can It Work? Will it Work? and finally, Is It Worth It? Vaccines will NOT save Lives. Vaccination saves Lives. Survival from any endeavor entails Variation, Selection and Adaptation.

14 Fun walk for World Meningitis Day April 24, 2010

15 The Finish Line