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National Immunization Strategy 2017-2022


Foreword
 
There have been many transformations to the NIP inthe recent years. New vaccines wereadded to the vaccination schedule, the cohorts served by the public sector kepton expandingsince the onset of the Syrian crisis, measures to consolidatethe vaccine purchasing arrangements were adopted,and there wasa leveraging up ofthe vaccinovigilanceand its effective management.In 2016, the Ministryof health in Lebanon decided that it was the time to take stock, constructon the current NIP strengthsand achievements andidentify areas for further improvement. A strategy for the NIP for 2016-2020 wasenvisagedin agreementwith the development partners. A detailed situation analysis assessment was initiatedin October 2015 in two stages: at the initial stage, the country and health system contexts were analyzed, and immunization system performance was measured. In the second stage, a framework was developed in consultations with key stakeholders to define gaps in the evidence. Immunization coverage evaluation survey was conducted in 2016 and fed into filling the lacunas in information.

The present document expresses the country vision, goals and priorities of the national immunization program. It relies on a careful examination of the situation analysis, an assessment of the enablers and challenges facing the immunization services and defines the national immunization strategies addressing these contests. The strategies were formulated as informed choices across more than one solution deemed most feasible and efficient considering the country context.

The document is structured in three sections:

Section 1“Situational analysis” presents briefly the organization and operation of the national immunization program as well as the recent achievements and remaining challenges,

Section 2 “Conceptual framework” describes the future vision of the country in regards to vaccine preventable diseases, the long term goals to be achieved and the more specific results –immunization system objectives and targets for 2020,

Section 3 defines the Strategies to address the bottlenecks and achieve immunization system objectives by 2020. Most of strategies (so called “immunization system specific” ones) are presented by relevant health system blocks.The focus of the NIP Strategy, is to assistthe MOPH to meet international goals set by the World Health Organization (WHO) under the Global Immunization Vision and Strategy (GIVS). The Strategy articulates action areas to conserve the successful achievements of the last years, built on the current favoring momentum and propose solutions for the drawbacks

The Strategy comprises nineStrategic Priority Areas to complement and strengthen the NIP.

The matrix (Figure 2) in Annexesshows expected results of the immunization system development strategies by health system building blocks and links them to the root causes (weaknesses and treats) identified during the system analysis...
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ATC Name B/G Ingredients Dosage Form Price
J06BA02 HIZENTRA 2G BioHuman Immunoglobulin human - 2g/10ml 20% Injectable solution 16,183,030 L.L
B01AB12 HIBOR G Bemiparin Sodium - 7,500IU 7,500IU Injectable solution 2,198,526 L.L
J06BA02 HIZENTRA 4G BioHuman Immunoglobulin human - 4g/20ml 20% Injectable solution 32,371,333 L.L
M01AE03 HUMFINE G Ketoprofen - 100mg/2ml 100mg/2ml Injectable solution 3,514,148 L.L
L01XX41 HALAVEN B Eribulin mesylate - 0.88mg/2ml 0.88mg/2ml Injectable solution L.L
L04AB04 HUMIRA BioTech Adalimumab - 40mg/0.4ml 40mg/0.4ml Injectable solution L.L
B05BB02 HI-SODIUM WITHOUT POTASSIUM INJECTION G Sodium dihydrogenophosphate - 0.137g/100ml, Sodium lactate (anhydre) - 0.223g/100ml, Sodium chloride - 0.175g/100ml, Dextrose monohydrate - 5g/100ml Injectable solution 166,708 L.L
B05BB02 HI-SODIUM INJECTION G Sodium lactate - 0.223g%, Sodium dihydrogenophosphate - 0.137g%, Potassium chloride - 0.149g%, Sodium chloride - 0.175g%, Dextrose, H2O - 5.0g% Injectable solution 176,024 L.L
B05BB02 HI-SODIUM INJECTION WITH POTASSIUM G Potassium chloride - 0.149g/100ml, Sodium dihydrogenophosphate - 0.137g/100ml, Sodium lactate (anhydre) - 0.223g/100ml, Sodium chloride - 0.175g/100ml, Dextrose monohydrate - 5g/100ml Injectable solution 165,727 L.L
B02BX06 HEMLIBRA BioTech Emicizumab - 30mg/ml 30mg/ml Injectable solution L.L
N05AD01 HALDOL DECANOAS B Haloperidol (Decanoate) - 50mg/ml 50mg/ml Injectable solution 444,812 L.L
J01DB04 HIKMA CEFAZOLIN G Cefazolin (sodium) - 1g 1,000mg Injectable solution 215,015 L.L
L04AB04 HUMIRA BioTech Adalimumab - 40mg/0.4ml 40mg/0.4ml Injectable solution 33,860,031 L.L
L04AB04 HYRIMOZ BioTech Adalimumab - 40mg 40mg Injectable solution 26,053,947 L.L
L04AB04 HYRIMOZ BioTech Adalimumab - 40mg 40mg Injectable solution 26,053,947 L.L
A10AB04 HUMALOG BioTech Insulin lispro - 100IU/ml 100IU/ml Injectable suspension 1,988,887 L.L
A10AD01 HUMULIN 70/30 BioTech Insulin (human) - 100IU/ml 100IU/ml Injectable suspension 701,486 L.L
A10AD04 HUMALOG MIX 50 KWIKPEN BioTech Insulin lispro solution - 50%, Insulin lispro protamine suspension - 50% 100IU/ml Injectable suspension 3,950,897 L.L
A10AD04 HUMALOG MIX 25 KWIKPEN BioTech Insulin lispro solution - 25%, Insulin lispro protamine suspension - 75% 100IU/ml Injectable suspension 3,950,897 L.L
A10AE01 HUMULIN N U-100 BioTech Insulin (human) - 100IU/ml 100IU/ml Injectable suspension 701,486 L.L
J07BC01 HEPATITIS-B VACCINE (r DNA) PAEDIATRIC G Hepatitis B, purified surface antigen adsorbed on aluminium hydroxide (Al+++) (0.25mg to 0.40mg) - 10mcg/0.5ml 10mcg/0.5ml Injectable suspension 323,866 L.L
J07BC02 HAVRIX '1440' B Hepatitis A, inactivated, whole virus - 1,440 ELISA units/ml 1,440 ELISA units/ml Injectable suspension 2,215,996 L.L
J07BC02 HAVRIX JUNIOR 720 B Hepatitis A, inactivated, whole virus - 720 ELISA units/0.5ml 720 ELISA units/0.5ml Injectable suspension 1,491,665 L.L
J07BC02 HEALIVE-HEPATITIS A VACCINE (HUMAN DIPLOID CELL) INACTIVATED BioTech Hepatitis A, inactivated antigen (TZ84 Strain), human diploid cell - 0.5ml/dose 0.5ml/dose Injectable suspension 1,777,904 L.L
J07BC02 HEALIVE-HEPATITIS A VACCINE (HUMAN DIPLOID CELL) INACTIVATED BioTech Hepatitis A, inactivated antigen (TZ84 Strain), human diploid cell - 1ml/dose 0.5ml/dose Injectable suspension 2,257,655 L.L
J07CA09 HEXAXIM BioTech Diphteria Toxoid - ?20IU/0.5ml, Tetanus toxoid - ?40IU/0.5ml, Bordetella Pertussis Antigens: toxoid - 25mcg/0.5ml, Bordetella Pertussis Antigens: filamentous haemagglutinin - 25mcg/0.5ml, Polio virus inactivated type 1 (Mahoney strain) - 40D antigen units/0.5ml, Polio virus inactivated type 2 (MEF-I strain) - 8D antigen units/0.5ml, Polio virus inactivated type 3 (Saukett strain) - 32D antigen units/0.5ml, Hepatitis B, surface antigen - 10mcg/0.5ml, H. Influenza type b polysaccharide1 ,2 - 12mcg/0.5ml, 1 conjugated to tetanus protein - 22-36mcg, 2 adsorbed on aluminium hydroxide hydrated, Al+++ - 0.6mg Injectable suspension 4,462,901 L.L
A03AX HEPABYL G Sorbitol - 2.5g/5ml, Diisopromine - 0.02g/5ml Liquid 238,052 L.L
A06AA01 HUILE DE PARAFFINE G Liquid paraffin - Liquid 207,336 L.L
A06AB05 HUILE DE RICIN G Castor oil - Liquid 163,821 L.L
A07EA02 HEMORRANE G Hydrocortisone acetate - 10mg/g 10mg/g Ointment 710,893 L.L
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