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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
B01AD02 ACTILYSE BioTech Alteplase - 50mg 50mg Injectable dry powder for solution+diluent 91,949,371 L.L
L04AC07 ACTEMRA BioTech Tocilizumab - 80mg/4ml 80mg/4ml Injectable concentrated solution 11,127,864 L.L
L04AC07 ACTEMRA BioTech Tocilizumab - 200mg/10ml 200mg/10ml Injectable concentrated solution 25,485,937 L.L
L04AC07 ACTEMRA BioTech Tocilizumab - 400mg/20ml 400mg/20ml Injectable concentrated solution 47,925,322 L.L
L01FG01 AVASTIN BioTech Bevacizumab - 400mg/16ml 400mg/16ml Injectable concentrated solution 75,875,312 L.L
L01FG01 AVASTIN BioTech Bevacizumab - 400mg 400mg Injectable concentrated solution 75,875,312 L.L
L01FG01 AVASTIN BioTech Bevacizumab - 100mg/4ml 100mg/4ml Injectable concentrated solution 24,533,456 L.L
L01FG01 AVASTIN BioTech Bevacizumab - 100mg 100mg Injectable concentrated solution 24,533,456 L.L
B01AC17 AGGRASTAT B Tirofiban hydrochloride monohydrate - 0.25mg/ml 0.25mg/ml Injectable concentrated solution 18,280,324 L.L
L01BA04 ALIMTA B Pemetrexed (disodium) - 500mg 500mg Injectable concentrated powder for solution 71,767,770 L.L
L01BA04 ALIMTA B Pemetrexed (disodium) - 100mg 100mg Injectable concentrated powder for solution 16,854,009 L.L
B05XA31 ADDAVEN G Chromic chloride 6H2O - 53mcg/10ml, Copper chloride dihydrate - 1.02mg/10ml, Ferric Chloride hexahydrate - 5.40mg/10ml, Manganese chloride 4H2O - 198mcg/10ml, Potassium iodide - 166mcg/10ml, Sodium fluoride - 2.10mg/10ml, Sodium molybdate dihydrate - 48.5mcg/10ml, Sodium selenite anhydrous - 173mcg/10ml, Zinc chloride - 10.5mg/10ml Injectable concentrate for solution 4,065,124 L.L
A16AB05 ALDURAZYME B Laronidase - 100U/ml 100U/ml Injectable concentrate for solution 57,138,680 L.L
R03BB01 ATROVENT B Ipratropium bromide - 250mcg/2ml 250mcg/2ml Inhaltion solution with nebuliser 544,256 L.L
R03BB01 ATROVENT B Ipratropium bromide - 500mcg/2ml 500mcg/2ml Inhaltion solution with nebuliser 713,580 L.L
R03AC02 ASTHALIN G Salbutamol (sulfate) - 2.5mg/2.5ml 2.5mg/2.5ml Inhalation solution 325,210 L.L
R03AL03 ANORO ELLIPTA B Vilanterol - 25mcg, Umeclidinium bromide - 62.5mcg Inhalation powder 5,181,575 L.L
R03AL01 ATROVENT COMP. HFA B Fenoterol Hydrobromide - 20mcg/actuation, Ipratropium bromide - 50mcg/actuation Inhalation aerosol metered dose 847,965 L.L
R03BB01 ATROVENT N B Ipratropium bromide - 20mcg/actuation 20mcg/actuation Inhalation aerosol metered dose 428,686 L.L
R03DC03 AIRFAST PEDIATRICS G Montelukast (sodium) - 4mg 4mg Granules for solution 880,217 L.L
D11AX18 ALMIRAL G Diclofenac sodium - 1% w/w 1% w/w Gel 396,434 L.L
M02AA10 ACHONID GEL G Ketoprofen - 2.5% 2.5% Gel 179,179 L.L
G04BE08 AMOS G Tadalafil - 20mg 20mg Film, orodispersible 2,175,745 L.L
G04BE08 AMOS G Tadalafil - 10mg 10mg Film, orodispersible 1,662,781 L.L
G04BE08 AMOS G Tadalafil - 5mg 5mg Film, orodispersible 2,743,998 L.L
A07EC02 ASACOL B Mesalazine - 1g/100ml 1g/100ml Enema 2,748,158 L.L
S01CA01 API-TOBRASON G Dexamethasone - 1mg/ml, Tobramycin - 3mg/ml Drops suspension 294,302 L.L
S01EC04 AZOPT B Brinzolamide - 10mg/ml 10mg/ml Drops suspension 804,962 L.L
S01GA04 ALERJON G Oxymetazoline HCl - Drops solution 528,130 L.L
S01GX07 ALLERGODIL B Azelastine HCl - 0.5mg/ml 0.5mg/ml Drops solution 709,549 L.L
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