Country needs
To decide whether rotavirus vaccine introduction is appropriate, country leaders need information on disease burden, vaccine efficacy and safety, cost-effectiveness, health system requirements, and impact. RVP is on the ground sharing these data and stimulating discussions, particularly in countries that are eligible for support from the GAVI Alliance. PATH's longterm presence in the developing world has been an essential element to successful country collaborations.
Our discussions with health ministers have yielded important insight about public health priorities in different countries. For example, we learned that awareness of rotavirus is often low, while concern about diarrheal disease in general remains significant. Our activities are now moving beyond information-sharing to helping countries improve planning for diarrheal disease control and potential rotavirus vaccine introduction.
Nicaragua: In 2006, Nicaragua introduced rotavirus vaccine as part of a demonstration project with Merck & Co., Inc., marking the first time a vaccine became available in the public sector of a GAVI-eligible country during the same year it was introduced in the United States. Accelerated access to rotavirus vaccines provided an opportunity to scale up use of other tools for diarrheal disease control, and PATH convened a broad coalition to raise awareness about other interventions, including zinc and low-osmolarity ORS.
Kenya: We recently launched a pilot program in Kenya’s Western Province aimed at building awareness for new diarrheal disease control interventions, including rotavirus vaccines. Workshops with parents and providers are helping PATH and our partners to evaluate current practices and knowledge gaps around diarrheal disease control. Building on the needs identified through these workshops, PATH will train providers and educate community members on diarrheal disease control interventions.
Results from the project will inform development of Kenya’s National Plan for Diarrheal Disease Control, and activities were recently endorsed by Kenya’s Child Health Inter-agency Coordinating Committee (ICC).
Republic of Georgia: We are partnering with the Ministry of Labor, Health, and Social Affairs and the Curatio International Foundation to convene a cross-sectoral expert group to assess evidence on a package of interventions for diarrheal disease control. We also are supporting rotavirus surveillance strengthening and providing training on diarrheal disease management and guidelines.
Ukraine: We are in the early stages of helping Ukraine develop a multi-year plan on immunization. This plan will likely include rotavirus vaccine introduction, and we are collaborating with the Ukraine ICC to support their preparation of an application for GAVI support. In addition, we developed a series of educational materials for physicians on clinical management of diarrhea, as well as information about rotavirus.
Indonesia: We are helping to raise awareness about rotavirus in Indonesia in the context of broad diarrheal disease control planning. Together with the Ministry of Health in South Sulawesi province, we put a focus on educating health workers about diarrheal disease control interventions and distributed updated standards of practice. Future activities will look to expanding use of these standards to improve clinical case management nationwide.
Vietnam: In Vietnam, we are planning to build a coalition aimed at strengthening national policies for diarrheal disease control and updating guidelines on clinical management and home management of diarrhea. These efforts will inform a pilot project in Binh Dinh province aimed at scaling up use of zinc and low-osmolarity ORS. We also plan to work with the Ministry of Health and other in-country partners to evaluate the evidence for and feasibility of rotavirus vaccine uptake, along with the potential for future enteric vaccines. The experience in Binh Dinh will ultimately impact national planning, and in turn, Vietnam’s efforts may serve as an example to other countries in the Mekong region.
Top photo by Richard Lord.