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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
R01AB06 OTRIVIN DUAL RELIEF B Xylometazoline HCl - 0.5mg/ml, Ipratropium bromide - 0.6mg/ml Solution 563,070 L.L
R06AX DESLAMED FORTE G Desloratadine - 1mg/ml, Betamethasone - 0.05mg/ml Syrup 1,009,802 L.L
A12CC MAVIT G Magnesium - 100mg, Pyridoxine HCl - 10mg Tablet 654,003 L.L
B05BA10 OLIMEL N9E B Glucose solution - 27.5%, Amino acids solution - 14.2%, Lipid emulsion - 20%, Sodium - 70mmol/2l, Potassium - 60mmol/2l, Magnesium - 8mmol/2l, Calcium - 7mmol/2l, Phosphate - 30mmol/2l, Acetate - 107mmol/2l, Chloride - 90mmol/2l, Azote - 18g/2l Injectable emulsion 5,496,316 L.L
C09DB04 TWINCARD 80/10 G Telmisartan - 80mg, Amlodipine - 10mg Tablet 1,460,309 L.L
J01DH51 CILANEM G Imipenem anhydrous - 500mg, Cilastatin (sodium) - 500mg Injectable solution 850,652 L.L
R01AB08 RINOFLUIMUCIL B Acetylcysteine - 1%, Tuaminoheptane sulfate - 0.5%, Benzalkonium chloride - 0.0125% Solution 419,279 L.L
R06AX DELINE CORT G Desloratadine - 5mg/5ml, Betamethasone - 0.25mg/5ml Syrup 693,679 L.L
B05BA10 PERIOLIMEL N4E B Olive oil + Soja oil - 45.00g, Alanine - 5.50g, Arginine - 3.72g, Aspartic Acid - 1.10g, Glutamic Acid - 1.90g, Glycine - 2.63g, Histidine - 2.26g, Isoleucine - 1.90g, Leucine - 2.63g, Lysine - 2.99g, Methionine - 1.90g, Phenylalanine - 2.63g, Proline - 2.26g, Serine - 1.50g, Threonine - 1.90g, Tryptophan - 0.64g, Tyrosine - 0.10g, Valine - 2.43g, Sodium acetate, 3H2O - 1.73g, Sodium glycerophosphate, H2O - 2.87g, Potassium chloride - 1.79g, Magnesium chloride, 6H2O - 0.67g, Calcium chloride 2H2O - 0.44g, Glucose monohydrate - 123.75g Injectable emulsion 5,288,020 L.L
C09DB04 TWYNSTA B Telmisartan - 80mg, Amlodipine - 5mg Tablet 2,261,687 L.L
D04AA32 DERMAMINE ITCH STOPPING G Diphenhydramine HCl - 1%, Zinc acetete - 0.1% Cream 560,382 L.L
J01DH51 IMIPENEM-CILASTATIN LABATEC G Imipenem (monohydrate) - 500mg, Cilastatin (sodium) - 500mg Injectable powder for solution 8,922,845 L.L
R06AX DESLAMED FORTE G Desloratadine - 1mg/ml, Betamethasone - 0.05mg/ml Syrup 673,201 L.L
B05BA10 SMOFKABIVEN G Glucose monohydrate - 462mg, Soya-bean oil, refined - 60mg, Triglycerides, Medium Chain - 60mg, Olive oil, refined - 50mg, Fish oil, rich in omega-3-acids - 30mg, Alanine - 14mg, Arginine - 12mg, Proline - 11.2mg, Glycine - 11mg, Lysine acetate - 9.3mg, Leucine - 7.4mg, Serine - 6.5mg, Valine - 6.2mg, Sodium acetate, 3H2O - 5.62mg, Phenylalanine - 5.1mg, Isoleucine - 5mg, Potassium chloride - 4.48mg, Threonine - 4.4mg, Methionine - 4.3mg, Sodium glycerophosphate, anhydrous - 4.18mg, Histidine - 3mg, Magnesium sulfate, 7H2O - 2.47mg, Tryptophan - 2mg, Taurine - 1mg, Calcium chloride 2H2O - 0.74mg, Tyrosine - 0.40mg, Zinc sulfate heptahydrate - 23mcg Injectable emulsion 3,835,326 L.L
C09DB04 TWINCARD 80/5 G Telmisartan - 80mg, Amlodipine - 5mg Tablet 1,372,511 L.L
J01DH51 IMIPENEME CILASTATINE PANPHARMA G Imipenem (monohydrate) - 500mg, Cilastatin (sodium) - 500mg Injectable powder for solution 10,840,366 L.L
M01AB55 DIFEN FLEX G Diclofenac sodium - 50mg, Pridinol mesylate - 4mg Tablet, film coated 575,165 L.L
R06AX DESLOCORT G Desloratadine - 1mg/ml, Betamethasone - 0.05mg/ml Syrup 673,201 L.L
A15 DESARROL G Cyproheptadine HCl - 0.2mg/ml, L-Arginine L-Aspartate - 25mg/ml, L-Carnitine - 50mg/ml Solution 1,007,882 L.L
B05BA10 SMOFKABIVEN PERIPHERAL G Glucose monohydrate - 143mg, Soya-bean oil, refined - 60mg, Triglycerides, Medium Chain - 60mg, Olive oil, refined - 50mg, Fish oil, rich in omega-3-acids - 30mg, Alanine - 14mg, Arginine - 12mg, Proline - 11.2mg, Glycine - 11mg, Lysine acetate - 9.3mg, Leucine - 7.4mg, Serine - 6.5mg, Valine - 6.2mg, Sodium acetate, 3H2O - 5.62mg, Phenylalanine - 5.1mg, Isoleucine - 5mg, Potassium chloride - 4.48mg, Threonine - 4.4mg, Methionine - 4.3mg, Sodium glycerophosphate, anhydrous - 4.18mg, Histidine - 3mg, Magnesium sulfate, 7H2O - 2.47mg, Tryptophan - 2mg, Taurine - 1mg, Calcium chloride 2H2O - 0.74mg, Tyrosine - 0.40mg, Zinc sulfate heptahydrate - 23mcg Injectable emulsion 4,571,752 L.L
B05XA31 NUTRYELT G Zinc (gluconate) - 10000mcg/10ml, Copper (gluconate) - 300mcg/10ml, Manganese (gluconate) - 55mcg/10ml, Sodium fluoride - 950mcg/10ml, Iodine potassium iodide - 130mcg/10ml, Selenium (sodium salt) - 70mcg/10ml, Molybdenum (Sodium molybdate) - 20mcg/10ml, Chrome (chlorure) - 10mcg/10ml, Ferrous (gluconate) - 1000mcg/10ml Injectable concentrate for solution 3,483,240 L.L
C09DB06 LOSANET AM G Losartan potassium - 100mg, Amlodipine - 10mg Tablet 1,044,358 L.L
J01DH51 SYNERGIC G Imipenem - 500mg, Cilastatin - 500mg Injectable powder 1,142,266 L.L
M01AB55 DIFEN FLEX G Diclofenac sodium - 75mg, Pridinol mesylate - 2.2mg Injectable solution 1,131,515 L.L
N01BB52 DILOCAIN 2% G Lidocaine HCl - 20mg/1.7ml, Epinephrine (bitartrate) - 0.0125mg/1.7ml Injectable solution 2,768,316 L.L
R06AX FRENALER CORT G Desloratadine - 5mg, Betamethasone - 0.6mg Tablet, film coated 632,950 L.L
A15A DYNAMOGEN G Arginine Aspartate - 1g/10ml, Glutodine (Cyproheptadine ?-ketoglutarate) - 3mg/10ml Solution 1,019,976 L.L
B05BB01 LACTATED RINGER'S G Sodium lactate - 0.31g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.03g/100ml, Sodium chloride - 0.598g/100ml Injectable solution 147,095 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
C09DB06 LOSANET AM G Losartan potassium - 100mg, Amlodipine - 5mg Tablet 1,044,358 L.L
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