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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
J07AH MENFIVE G Meningococcal (serogroups A, C, Y, W, X) Polysaccharide conjugate vaccine - Injectable freeze dried powder + diluent 3,527,587 L.L
N02AJ13 TRAMADOL/PARACETAMOL ARROW LAB G Tramadol - 37.5mg, Paracetamol - 325mg Tablet, coated 205,608 L.L
R02A CHLORASEPTIC TOTAL SORE THROAT + COUGH LOZENGES WILD CHERRY G Benzocaine - 6mg, Dextromethorphan - 5mg, Menthol - 10mg Lozenge 537,537 L.L
A10BD19 GLYXAMBI B Linagliptin - 5mg, Empagliflozin - 25mg Tablet, film coated 4,162,216 L.L
C09BB02 ZANIPRESS B Lercanidipine HCl - 10mg, Enalapril maleate - 10mg Tablet, film coated 2,280,949 L.L
J07AH08 MENACTRA MENINGOCOCCAL POLYSACCHARIDE DIPHTERIA TOXOID CONJUGATE VACCINE B Meningococcal Polysaccharides (serogroups A, C, Y and W-135) - 4mcg/0.5ml each, Diphteria Toxoid Protein - 48mcg/0.5ml Injectable solution 6,144,048 L.L
N02AJ14 LENIZAK B Tramadol HCl - 75mg, Dexketoprofen - 25mg Tablet, film coated 494,534 L.L
R02AA05 GOLASEPTINE-LIDOCAINE G Chlorhexidine HCl - 5mg, Lidocaine HCl - 1mg Tablet, chewable 736,426 L.L
A06AB05 HUILE DE RICIN G Castor oil - Liquid 163,821 L.L
A10BD19 EMPAGLINE G Empagliflozin - 25mg, Linagliptin - 5mg Tablet, film coated 2,237,050 L.L
C09BB04 COVERAM B Perindopril arginine - 5mg, Amlodipine - 5mg Tablet 821,088 L.L
J07AH08 NIMENRIX B Polysaccharide of Neisseria meningitidis (serogroups A, C, Y and W-135) conjugated - 5mcg/0.5ml, Tetanus toxoid carrier protein - 44mcg/0.5ml Injectable lyophilised powder for solution+diluent 4,483,059 L.L
R02AA20 ANGINOVA G Lidocaine HCl - 1mg, Dequalinium HCl - 0.25mg Lozenge 349,399 L.L
A06AB07 COLON-X G Frangula Purshiana - 62.5mg, Plantago Afra - 100mg, Foeniculum Vulgare - 50mg, Zingiber Officinale - 50mg, Aniseed powder - 20mg, Glycyrrhiza Glabra - 12.5mg, Senna Alexandrina - 25mg Tablet, film coated 833,182 L.L
C09BB04 PRESORYL PLUS G Perindopril arginine - 5mg, Amlodipine (besylate) - 5mg Tablet 557,695 L.L
J07AH08 MENQUADFI G Meningococcal (serogroups A, C, W and Y) conjugate vaccine - Injectable solution 4,859,334 L.L
A06AB58 PICOPREP B Magnesium oxide - 3.5g, Citric acid - 12g, Sodium picosulfate - 10mg Powder 694,767 L.L
C09BB04 COVERAM B Perindopril arginine - 10mg, Amlodipine - 5mg Tablet 1,116,733 L.L
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
A06AB58 CITRAFLEET G Sodium picosulfate - 10mg/sachet, Magnesium oxide (light) - 3.5g/sachet, Citric acid (anhydrous) - 10.97g/sachet, Potassium - 195mg/sachet Powder for solution 1,191,988 L.L
A10BD20 EMPAZIMET G Metformin HCl - 1000mg, Empagliflozin - 12.5mg Tablet, film coated 1,840,168 L.L
C09BB04 PRESORYL PLUS G Perindopril arginine - 10mg, Amlodipine (besylate) - 5mg Tablet 770,022 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
A10BD20 FLORIMET 5/1000 G Metformin - 1000mg, Empagliflozin - 12.5mg Tablet, film coated 1,836,585 L.L
C09BB04 COVERAM B Perindopril arginine - 10mg, Amlodipine - 10mg Tablet 1,116,733 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
C09BB04 PRESORYL PLUS G Perindopril arginine - 10mg, Amlodipine (besylate) - 10mg Tablet 770,022 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
C09BB06 ENEAS G Enalapril maleate - 10mg, Nitrendipine - 20mg Tablet 2,009,045 L.L
J07AL02 PNEUMOSIL (10-VALENT) G Pneumococcal polysaccharide conjugate vaccine (adsorbed) - Injectable suspension 3,386,483 L.L
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