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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
N03AX22 FYCOMPA B Perampanel - 2mg 2mg Tablet, film coated 1,138,235 L.L
L04AX06 IMNOVID B Pomalidomide - 4mg 4mg Capsule, hard L.L
C07AB02 BETALOC ZOK B Metoprolol succinate - 50mg 50mg Tablet, controlled release 491,846 L.L
J07CA06 PENTAXIM B Poliomyelitis virus type 3 inactivated(Prefilled syringe) - 32D.U., Poliomyelitis virus type 2 inactivated(Prefilled syringe) - 8D.U., Poliomyelitis virus type 1 inactivated(Prefilled syringe) - 40D.U., Bordetella pertussis antigen (Prefilled syringe) - toxoid 25mcg+filamentous haemaglutinin 25mcg, Tetanus toxoid (Prefilled syringe) - ≥40IU, Diphtheria toxoid (Prefilled syringe) - ≥30IU, H. Influenza type b polysaccharide(Vial) - 10mcg Injectable dry powder+suspension 2,558,676 L.L
L01EL02 CALQUENCE B Acalabrutinib - 100mg 100mg Tablet, film coated 650,653,454 L.L
N02BA01 ASPIRINE B Acetylsalicylic acid - 300mg 0.3g Tablet 80,631 L.L
N03AX22 FYCOMPA B Perampanel - 4mg 4mg Tablet, film coated 8,751,127 L.L
R03AC18 ONBREZ BREEZHALER B Indacaterol maleate - 150mcg 150mcg Capsule, inhalation 2,284,532 L.L
B03BA51 DEPOVEX B Aluminium monostearate - 20mg/ml, Cyanocobalamine - 1mg/ml Injectable oily suspension 423,310 L.L
C09CA09 EDARBI B Azilsartan medoxomil - 40mg 40mg Tablet 1,846,440 L.L
C10AA08 LIVAZO B Pitavastatin - 2mg 2mg Tablet, film coated 1,558,857 L.L
J01DC04 CECLOR MR B Cefaclor (monohydrate) - 500mg 500mg Tablet, film coated, modified release 1,226,096 L.L
J07CA09 INFANRIX HEXA B Diphteria toxoid purified (Prefilled syringe) - ≥30IU/0.5ml, Tetanus toxoid purified (prefilled syringe) - ≥40IU/0.5ml, Bordetella pertussis antigen (Prefilled syringe) - toxoid 25mcg+filamentous haemaglutinin 25mcg+pertactin 8mcg/0.5ml, Poliomyelitis virus type 1 antigen (prefilled syringe) - 40D.U./0.5ml, Poliomyelitis virus type 2 antigen(prefilled syringe) - 8D.U./0.5ml, Poliomyelitis virus type 3 antigen (prefilled syringe) - 32D.U./0.5ml, HBs Antigen (prefilled syringe) - 10mcg/0.5ml, H. Influenza type b polysaccharide (Vial) - 10mcg/0.5ml Injectable suspension 4,230,416 L.L
L01EM03 PIQRAY B Alpelisib - 150mg 150mg Tablet, film coated 359,195,954 L.L
L04AA13 ARAVA B Leflunomide - 20mg 20mg Tablet, film coated 3,346,168 L.L
N02BA51 ASPIRINE C EFFERVESCENT B Acetylsalicylic acid - 400mg, Vitamin C - 240mg Tablet, effervescent 162,605 L.L
N03AX22 FYCOMPA B Perampanel - 6mg 6mg Tablet, film coated 8,751,127 L.L
R03AK06 SERETIDE DISKUS 100 B Salmeterol (xinafoate) - 50mcg/inhalation, Fluticasone propionate - 100mcg/inhalation Inhalation powder 2,276,469 L.L
C07AB02 BETALOC ZOK B Metoprolol succinate - 25mg 25mg Tablet, controlled release 219,046 L.L
C09CA09 EDARBI B Azilsartan medoxomil - 80mg 80mg Tablet 2,023,827 L.L
J01DC04 CECLOR MR B Cefaclor (monohydrate) - 750mg 750mg Tablet, film coated, modified release 1,555,018 L.L
L01EM03 PIQRAY B Alpelisib - 200mg, Alpelisib - 50mg 150mg Tablet, film coated 359,195,954 L.L
N03AX22 FYCOMPA B Perampanel - 8mg 8mg Tablet, film coated 10,180,812 L.L
N06AB10 CIPRALEX B Escitalopram (oxalate) - 15mg 15mg Tablet, film coated 2,378,601 L.L
C09DA01 HYZAAR B Losartan potassium - 50mg, Hydrochlorothiazide - 12.5mg Tablet 1,523,022 L.L
C10AA08 LIVAZO B Pitavastatin - 4mg 4mg Tablet, film coated 1,835,305 L.L
J01DC04 CECLOR B Cefaclor (monohydrate) - 125mg/5ml 125mg/5ml Granules for suspension 487,623 L.L
J07CA11 DIPHTHERIA, TETANUS,PERTUSSIS, HEPATITIS B AND HAEMOPHILUS INFLUENZAE TYPE B CONJUGATE VACCINE B Diphteria Toxoid1 - ≤25Lf (≥30IU)/0.5ml, Tetanus toxoid1 - ≥2.5Lf (≥40IU)/0.5ml, Bordetella pertussis (Whole cell) - ≤16OU (≥4.0IU)/0.5ml, HBs Antigen (r DNA)1 - ≥10mcg/0.5ml, H. Influenza type b, purified capsular polysaccharide2 - 10mcg/0.5ml, 1 adsorbed on aluminium phosphate, Al+++ - ≤1.25mg , 2 conjugated to tetanos toxoid carrier protein - Injectable suspension 1,515,854 L.L
L01EX01 SUTENT B Sunitinib maleate - 12.5mg 12.5mg Capsule 54,006,801 L.L
L04AA18 CERTICAN B Everolimus - 0.5mg 0.5mg Tablet 26,832,962 L.L
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