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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
J07CA02 TETRAXIM (Vaccin Diphterique, tetanique, coquelucheux acellulaire et Poliomyelitique inactivé adsorbé) B Diphteria toxoid purified - ?30IU, Tetanus toxoid purified - ?40IU, Poliomyelitis virus type 1 inactivated - 40D.U., Poliomyelitis virus type 2 inactivated - 8D.U., Poliomyelitis virus type 3 inactivated - 32D.U., Bordetella Pertussis Antigens: toxoid - 25mcg, Bordetella Pertussis Antigens: filamentous haemagglutinin - 25mcg Injectable suspension 1,628,737 L.L
L04AX02 THALIDOMIDE BMS B Thalidomide - 50mg 50mg Capsule 27,387,764 L.L
L04AX02 THALIDOMIDE CELGENE B Thalidomide - 50mg 50mg Capsule 27,387,764 L.L
R03DA04 THEODEX G Theophylline - 80mg/15ml 80mg/15ml Elixir 156,142 L.L
R03DB05 THEODEX G Ipeca fluide extract - 20mg, Aminophylline - 150mg, Caffeine - 100mg, Ephedrine - 15mg Tablet 156,142 L.L
R03DA04 THEOSOL ELIXIR G Théophylline - 25mg/5ml 25mg/5ml Elixir 312,283 L.L
N01AF03 THIOPENTAL PANPHARMA G Thiopental - 500mg 500mg Injectable powder for solution 8,446,717 L.L
B01AC04 THROMBO G Clopidogrel - 75mg 75mg Tablet, film coated 764,646 L.L
L04AA04 THYMOGLOBULINE 5mg/ml BioTech Rabbit anti-human thymocyte immunoglobulin - 25mg/5ml 25mg/5ml Injectable powder for solution 21,092,764 L.L
H01AB01 THYROGEN BioHuman Thyrotropin alfa - 0.9mg 0.9mg Injectable lyophilised powder for solution+diluent 65,558,997 L.L
H03BB02 THYROZOL B Methimazole (Thiamazole) - 5mg 5mg Tablet, film coated 233,829 L.L
H03BB02 THYROZOL B Methimazole (Thiamazole) - 10mg 10mg Tablet, film coated 326,554 L.L
R01AD08 TICANASE G Fluticasone propionate - 50mcg/actuation 12g/Bottle Spray, suspension 405,840 L.L
B03AA07 TIMOFEROL G Iron bivalent (as dried ferrous sulfate) - 50mg (172.73mg), Ascorbic acid - 30mg Capsule 652,931 L.L
R03BB04 TIOVA-T G Tiotropium bromide monohydrate - 18mcg 18mcg Rotacaps 384,339 L.L
B01AC17 TIROPREST G Tirofiban - 12.5mg/50ml 12.5mg/50ml Injectable concentrate for solution 18,279,605 L.L
B02BC30-V03AK TISSEEL LYO B Fibrinogen, human (clottable protein) (I) - 91mg/ml, Aprotinin, synthetic (I) - 3000KIU/ml, Thrombin, Human (II) - 500IU/ml, Calcium chloride (II) - 40?mol/ml Injectable powder for solution + solution 53,437,592 L.L
B02BC30-V03AK TISSEEL LYO B Fibrinogen, human (clottable protein) (I) - 91mg/ml, Aprotinin, synthetic (I) - 3000KIU/ml, Thrombin, Human (II) - 500IU/ml, Calcium chloride (II) - 40?mol/ml Injectable powder for solution + solution 24,369,850 L.L
B02BC30-V03AK TISSEEL LYO B Fibrinogen, human (clottable protein) (I) - 91mg/ml, Aprotinin, synthetic (I) - 3000KIU/ml, Thrombin, Human (II) - 500IU/ml, Calcium chloride (II) - 40?mol/ml Injectable powder for solution + solution 13,394,024 L.L
J05AX12 TIVICAY B Dolutegravir - 50mg 50mg Tablet, film coated 54,508,037 L.L
S01AA12 TOBRACIN G Tobramycin - 0.3% 0.3% Drops 322,522 L.L
S01AA12 TOBRACIN G Tobramycin - 0.3% 0.3% Ointment 280,863 L.L
S01AA12 TOBRASTILL G Tobramycin - 0.3% 0.3% Drops solution 258,018 L.L
N06AA02 TOFRANIL 10 B Imipramine HCl - 10mg 10mg Tablet, sugar coated 579,772 L.L
N06AA02 TOFRANIL 25 B Imipramine HCl - 25mg 25mg Tablet, sugar coated 1,002,123 L.L
J01AA02 TOLEXINE G Doxycycline (monohydrate) - 100mg 100mg Tablet, microgranules 589,947 L.L
C09CA07 TOLURA G Telmisartan - 40mg 40mg Tablet 532,162 L.L
C09CA07 TOLURA G Telmisartan - 80mg 80mg Tablet 698,798 L.L
N03AX11 TOPAMAX B Topiramate - 50mg 50mg Tablet, film coated 1,914,976 L.L
N03AX11 TOPAMAX B Topiramate - 100mg 100mg Tablet, film coated 3,471,145 L.L
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