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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
N02AA01 MST CONTINUS B Morphine sulfate - 10mg 10mg Tablet, film coated, prolonged release 972,942 L.L
N06AA21 MEFIDIOMIL B Maprotiline - 75mg 75mg Tablet, sugar coated 958,608 L.L
R01AB06 TRIOFAN B Xylometazoline HCl - 1mg/ml, Carbocysteine - 10mg/ml Spray, solution 646,388 L.L
R06AE09 XYZAL B Levocetirizine dihydrochloride - 5mg 5mg Tablet, film coated 572,477 L.L
A07FA02 ULTRA LEVURE B Saccharomyces boulardii - 200mg 200mg Capsule 513,348 L.L
A11AA PANTOGAR B P-aminobenzoic acid - 20mg, Keratine - 20mg, Medical yeast - 100mg, Thiamine mononitrate - 60mg, L-Cystine - 20mg, Calcium D-pantothenate - 60mg Capsule 2,005,013 L.L
C05A ANTROLIN B Nifedipine - 0.3%, Lidocaine - 1.5% Cream 1,333,092 L.L
C09CA04 APROVEL B Irbesartan - 300mg 300mg Tablet, film coated 651,764 L.L
J01CR05 TAZOCIN B Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable lyophilised powder for solution 1,306,215 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
L01ED05 LORBRENA B Lorlatinib - 25mg 25mg Tablet 134,559,469 L.L
N02AA01 MST CONTINUS B Morphine sulfate - 30mg 30mg Tablet, film coated, prolonged release 2,289,908 L.L
L01EX05 STIVARGA B Regorafenib - 40mg 40mg Tablet, film coated L.L
A07FA02 ULTRA LEVURE B Saccharomyces boulardii - 100mg 100mg Powder for suspension 536,193 L.L
B02BX01 DICYNONE B Etamsylate - 250mg/2ml 250mg Injectable solution 482,439 L.L
C09CA04 APROVEL B Irbesartan - 300mg 300mg Tablet, film coated 651,764 L.L
C10AA07 CRESTOR B Rosuvastatin (calcium) - 10mg 10mg Tablet, film coated 804,962 L.L
L01ED05 LORBRENA B Lorlatinib - 100mg 100mg Tablet 403,677,371 L.L
M01AE01 SPIDIFEN B Ibuprofen alginate - 400mg 400mg Tablet, film coated 330,585 L.L
N02AA01 MST CONTINUS B Morphine sulfate - 60mg 60mg Tablet, film coated, prolonged release 3,839,358 L.L
R01AB06 OTRIVIN DUAL RELIEF B Xylometazoline HCl - 0.5mg/ml, Ipratropium bromide - 0.6mg/ml Solution 563,070 L.L
A07FA51 INFLORAN B Bifidobacterium infantis - 1milliard, Lactobacillus acidophilus - 1milliard Capsule 647,732 L.L
B02BX01 DICYNONE B Etamsylate - 500mg 500mg Capsule 1,311,590 L.L
G04BE08 CIALIS B Tadalafil - 5mg 5mg Tablet, film coated 6,512,261 L.L
J07AL02 PREVENAR 20 B Pneumococcal polysaccharide for serotypes 1, 3, 4, 5 , 6A, 7F,8, 9V,10A, 11A, 12F, 14, 15B, 18C, 19A, 19F,22F, 23F, 33F (2.2mcg) Pneumococcal polysaccharide for serotypes 6B (4.4mcg)Conjugated to CRM197 carrier protein (approximately 51mcg) adsorbed on aluminium phosphate (0.125mg aluminium) - Injectable suspension 7,415,107 L.L
M01AE01 ADVIL B Ibuprofen - 200mg 200mg Tablet 321,178 L.L
R01AB08 RINOFLUIMUCIL B Acetylcysteine - 1%, Tuaminoheptane sulfate - 0.5%, Benzalkonium chloride - 0.0125% Solution 419,279 L.L
A07XA04 HIDRASEC INFANTS B Racecadotril - 10mg 10mg Granules for suspension 858,715 L.L
A11AB CYPRO-VITA B Vitamin C - 20mg, Vitamin B3 - 5mg, Vitamin B12 - 2.5mg, Vitamin B6 - 0.6mg, Vitamin B2 - 0.75mg, Vitamin B1 - 0.6mg, Vitamin D3 - 167IU, Vitamin A - 1670IU, Cyproheptadine HCl - 4mg Tablet, film coated 409,552 L.L
J07AL02 VAXNEUVANCE B Pneumococcal polysaccharide for serotypes 1, 3, 4, 5 , 6A, 7F, 9V,14, 18C, 19A, 19F, 22F, 23F,33F (2mcg) Pneumococcal polysaccharide for serotypes 6B (4.4mcg) Conjugated to CRM197 carrier protein and adsorbed on aluminium phosphate adjuvant - Injectable suspension 6,988,413 L.L
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