Evidence-based decision-making for vaccine introductions: Overview of the ProVac International Working Group's experience.
BACKGROUND
Pan American Health Organization's (PAHO) ProVac Initiative aims to strengthen countries' technical capacity to make evidence-based immunization policy. With financial support from the Bill and Melinda Gates Foundation, PAHO established the ProVac International Working Group (IWG), a platform created for two years to transfer the ProVac Initiative's tools and methods to support decisions in non-PAHO regions.


METHODS
In 2011, WHO Regional Offices and partner agencies established the IWG to transfer the ProVac framework for new vaccine decision support, including tools and trainings to other regions of the world. During the two year period, PAHO served as the coordinating secretariat and partner agencies played implementing or advisory roles.


RESULTS
Fifty nine national professionals from 17 countries received training on the use of economic evaluations to aid vaccine policy making through regional workshops. The IWG provided direct technical support to nine countries to develop cost-effectiveness analyses to inform decisions. All nine countries introduced the new vaccine evaluated or their NITAGs have made a recommendation to the Ministry of Health to introduce the new vaccine.


CONCLUSIONS
Developing countries around the world are increasingly interested in weighing the potential health impact due to new vaccine introduction against the investments required. During the two years, the ProVac approach proved valuable and timely to aid the national decision making processes, even despite the different challenges and idiosyncrasies encountered in each region. The results of this work suggest that: (1) there is great need and demand for technical support and for capacity building around economic evaluations; and (2) the ProVac method of supporting country-owned analyses is as effective in other regions as it has been in the PAHO region.


CONCLUSIONS
Decision support for new vaccine introduction in low- and middle-income countries is critical to guiding the efficient use of resources and prioritizing high impact vaccination programs.
Pan American Health Organization, Washington DC, USA. Electronic address: jauregub@paho.org.
Barbara
B
Jauregui
Pan American Health Organization, Washington DC, USA.
Ana Gabriela Felix
AG
Garcia
Pan American Health Organization, Washington DC, USA.
Cara
C
Bess Janusz
Agence de Médecine Préventive, Paris, France.
Julia
J
Blau
Agence de Médecine Préventive, Paris, France.
Aline
A
Munier
PATH, Seattle, WA, USA.
Deborah
D
Atherly
PATH, Seattle, WA, USA.
Mercy
M
Mvundura
Centers for Disease Control and Prevention, Atlanta, GA, USA.
Rana
R
Hajjeh
Centers for Disease Control and Prevention, Atlanta, GA, USA.
Benjamin
B
Lopman
London School of Hygiene and Tropical Medicine, London, UK.
Andrew David
AD
Clark
London School of Hygiene and Tropical Medicine, London, UK.
Louise
L
Baxter
Initiative for Vaccine Research, WHO, Geneva, Switzerland.
Raymond
R
Hutubessy
Sabin Vaccine Institute, Washington, DC, USA.
Ciro
C
de Quadros
Pan American Health Organization, Washington DC, USA.
Jon Kim
JK
Andrus
D002202:Capital Financing; D003141:Communicable Diseases / Q000191:economics* / Q000453:epidemiology; D003661:Decision Support Techniques; D003906:Developing Countries; D017048:Health Care Costs; D006291:Health Policy; D006801:Humans; D017589:Immunization Programs / Q000191:economics* / Q000458:organization & administration; D014611:Vaccination / Q000191:economics* / Q000379:methods; D014612:Vaccines / Q000008:administration & dosage / Q000191:economics* / Q000276:immunology*
D014612:Vaccines
Cost-effectiveness analysis; Economic evaluations; Evidence-based policy; Immunization policy; Immunization program