Regional : Systems Strengthening for Effective Coverage of New Vaccines in the Pacific Project

Health / Disease control of communicable disease - Health system development

The Systems Strengthening for Effective Coverage of New Vaccines in the Pacific Project (the project) adopts a regional approach to improving immunization outcomes by introducing three vaccines in Samoa, Tonga, Tuvalu, and Vanuatu. It supports the countries in (i) pooling the procurement of the human papillomavirus (HPV) vaccine, the pneumococcal conjugate vaccine (PCV), and the rotavirus vaccine through the United Nations Children's Fund (UNICEF); (ii) strengthening primary health care and the capacity to deliver vaccination programs; and (iii) increasing community awareness and the population's knowledge of and attitude toward vaccines. The project will reduce the burden and minimize outbreaks related to vaccine-preventable diseases, integrate immunization programs into broader health systems, and improve access to primary health services.

As a response to the coronavirus disease (COVID-19) pandemic, the governments of Samoa, Tonga, Tuvalu, and Vanuatu have been preparing for the imminent arrival of COVID-19 vaccines, and have requested additional financing from the Asian Development Bank (ADB) to further strengthen immunization programs and prepare for the vaccine rollout. The additional financing will build on the original project to support the four governments in meeting their urgent needs.

Human papillomavirus (HPV) causes almost all cervical cancers through communicable disease transmission. Cervical cancer is a major cause of premature death in the Pacific causing nearly 500 deaths in 2010 and is therefore a leading cause of death among women in 2010 across the Pacific region. It is largely preventable through cost effective interventions of early detection and HPV vaccination. Immunization is pro-poor, providing relatively larger benefits to low-income households.

The governments of Samoa, Tonga, Tuvalu, and Vanuatu have incurred considerable costs to prevent the entry of COVID-19 through travel restrictions, while mitigating the pandemic's effects on their economies. The additional financing expands the scope of the original project, i.e., to include the introduction of COVID-19 vaccines, which will enable the gradual reopening of borders and economies, and reestablish the free movement of people both nationally and internationally.

Incidence and prevalence of cervical cancer in the Pacific region reduced; healthy lives ensured and well-being for all at all ages promoted; and SARS-Cov2 virus spread, morbidity and mortality reduced, and confidence of citizens restored.

Immunization coverage of vaccines increased

Inception Mission was held in February 2020 to facilitate start up activities, and signing of agreements with UNICEF and consulting firm for implementation and monitoring.

Review Mission was held in September 2020.

Review Mission was held in March 2021.

Midterm Review Mission was held in September to October 2021.

Review mission was held in April 2022.

Review mission was held in SAM, TON, VAN in July-Oct 2022. TUV continues to have C19 travel restrictions.

Regional vaccine procurement strengthened

Health systems strengthened

Community awareness improved

No stock out issues noted in 2022 Q3 review missions.

All 4 countries have started to collect the sex-disaggregated immunization data and to be reflected in the national reports. Sex-disaggregated immunization data is observed at the national level in both SAM, TON, and TUV, but progress remains to be made for VAN.

Completed in all 4 countries, and revised in 2022.

Facility-level microplanning training have been completed in all four DMCs, but only TON has compiled micro-plans at health facility level.

All 4 national immunization polices have been updated in 2021.

On track to meet cold chain inventory targets in all 4 countries.

Training on collecting and reporting of adverse events following immunization has commenced, but no evidence of collation of data from facility level to national level.

At least two health promotion activities has been conducted for the three new vaccines as well as for COVID-19 vaccine introduction.

COVID-19 information materials have been rolled-out in ongoing campaigns, and has reached at least 50% population in SAM and TON. To be confirmed in VAN and TUV.

Amended UNICEF VII Agreement signed

Samoa/Tonga/Tuvalu/Vanuatu: Achieved

UNICEF Agreement signed.

Samoa/Tonga/Tuvalu/Vanuatu: All 3 vaccines, buffer stock included, arrived. Supplies for catch-up plans need to be considered and re-evaluated.

The following consulting services will be advertised soon:

1. Health Demographer and Statistician (Tonga)

2. Health Demographer and Statistician (Tuvalu)

3. Health Demographer and Statistician (Vanuatu)

The following goods are to be procured:

Samoa

1. PPEs (Direct Contracting)

2. Health Care Waste Equipment (Direct Contracting)

3. Medical Equipment (Direct Contracting)

4. EPI Vehicles (Shopping)

5. Walk-in Cooler (Shopping)

6. IT Equipment (Shopping)

Vanuatu

1. Cold Chain Equipment (Direct Contracting)

2. Purchase of Boats (Shopping)