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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
J07AJ51 BOOSTRIX B Diphteria toxoid purified - ?2.5Lf/0.5ml, Tetanus toxoid purified - ?5Lf/0.5ml, Bordetella Pertussis Antigens: toxoid - 8mcg/0.5ml, Bordetella Pertussis Antigens: filamentous haemagglutinin - 8mcg/0.5ml, Pertactine - 2.5mcg Al3+/0.5ml, Aluminium hydroxide - 0.3mg Al3+/0.5ml, Aluminium Phosphate - 0.2mg/0.5ml Injectable suspension 1,394,909 L.L
L01EF01 IBRANCE B Palbociclib - 125mg 125mg Tablet, film coated 172,164,216 L.L
L04AA06 MYFORTIC B Mycophenolic acid (sodium) - 360mg 360mg Tablet, gastroresistant 17,836,325 L.L
N04BC05 SIFROL ER B Pramipexole (dihydrochloride monohydrate) - 0.375mg 0.375mg Tablet, extended release 665,202 L.L
R03AK10 RELVAR ELLIPTA B Vilanterol (trifenatate) - 25mcg/dose, Fluticasone furoate - 100mcg/dose Inhalation powder 3,928,052 L.L
G04BE03 VIAGRA B Sildenafil (citrate) - 50mg 50mg Tablet, film coated 2,089,675 L.L
J01MA02 CIPROBAY B Ciprofloxacine (HCl) - 500mg 500mg Tablet, film coated 654,451 L.L
J07AL01 PNEUMOVAX 23 B Polysaccharides from each of 23 capsular types of Streptococcus pneumoniae - 25mcgx23serotypes/0.5ml Injectable solution 2,378,601 L.L
L04AA06 CELLCEPT B Mycophenolate mofetil - 250mg 250mg Capsule 6,083,575 L.L
M01AE51 ADVIL COLD & SINUS B Ibuprofen - 200mg, Pseudoephedrine HCl - 30mg Caplet, coated 288,926 L.L
N04BC05 SIFROL ER B Pramipexole (dihydrochloride monohydrate) - 1.5mg 1.5mg Tablet, extended release 2,607,054 L.L
R03AK12 ZEPHIRUS B Salmeterol - 20mcg, Budesonide - 120mcg Capsule, inhalation 1,412,378 L.L
L01ED01 XALKORI B Crizotinib - 250mg 250mg Capsule L.L
A04AA01 ZOFRAN INJECTION B Ondansetron (HCl dihydrate) - 4mg/2ml 4mg/2ml Injectable solution 6,600,249 L.L
A10BD07 JANUMET B Metformin HCl - 500mg, Sitagliptin - 50mg Tablet 3,237,317 L.L
C09AA05 TRITACE B Ramipril - 10mg 10mg Tablet 689,391 L.L
J07AL02 PREVENAR 13 B Polysaccharide for serotypes 1, 3, 4, 5 , 6A, 7F, 9V,14, 18C, 19A, 19F, 23F (2.2mcg)Polysaccharide for serotypes 6B (4.4mcg)Conjugated to CRM197 carrier protein and adsorbed on aluminium phosphate (0.125mg aluminium) - Injectable suspension 6,352,343 L.L
L01EF02 KISQALI B Ribociclib - 200mg 200mg Tablet, film coated 200,752,977 L.L
L04AA06 CELLCEPT B Mycophenolate mofetil - 500mg 500mg Tablet 6,083,575 L.L
R03AK12 ZEPHIRUS B Salmeterol - 20mcg, Budesonide - 240mcg Capsule, inhalation 1,678,459 L.L
A16AB02 CEREZYME B Imiglucerase - 400IU 400IU Injectable lyophilised powder for solution L.L
A10BD07 JANUMET B Metformin HCl - 500mg, Sitagliptin - 50mg Tablet 3,237,317 L.L
J07AL02 SYNFLORIX B Polysaccharide from each of 10 capsular types of pneumococcus (conjugated to carrier proteins) adsorbed onto aluminium phosphate - 1mcg/0.5ml, Polysaccharide of serotypes 41,2, 18C1,3 and 19F1,4 - 3mcg/0.5ml, 1 adsorbed onto aluminium phosphate - 0.5mg Al3+, 2 conjugated to protein D (derived from NTHi) carrier protein - ~ 13mcg, 3 conjugated to tetanos toxoid carrier protein - ~ 8mcg, 4 conjugated to diphteria toxoid carrier protein - ~ 5mcg Injectable suspension 4,675,228 L.L
L01EF03 VERZENIO B Abemaciclib - 150mg 150mg Tablet 76,122,299 L.L
S01AE03 CILOXAN B Ciprofloxacine (HCl) - 3mg/ml 3mg/ml Drops solution 348,055 L.L
L01EF03 VERZENIO B Abemaciclib - 50mg 50mg Tablet 76,122,299 L.L
N04BC09 NEUPRO B Rotigotine - 2mg/24h 2mg/24h Patch 4,427,961 L.L
L04AD02 PROGRAF 0.5 MG B Tacrolimus - 0.5mg 0.5mg Capsule L.L
A10BD07 JANUMET XR B Metformin HCl - 500mg, Sitagliptin - 50mg Tablet 4,777,360 L.L
C01EA01 PROSTIN VR B Alprostadil - 500mcg/ml 500mcg/ml Injectable concentrated solution 19,894,577 L.L
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