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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
C09BA04 PRETERAX ARGININE B Perindopril arginine - 2.5mg, Indapamide - 0.625mg Tablet, film coated 452,875 L.L
J07AL02 PNEUMOSIL (10-VALENT) G Pneumococcal polysaccharide conjugate vaccine (adsorbed) - Injectable suspension 3,386,483 L.L
N02BA51 ASPRIVIT G Acetylsalicylic acid - 500mg, Caffeine - 50mg, Vitamin B1 - 2mg Tablet 186,794 L.L
N04BA02 CARLEVO G Levodopa - 100mg, Carbidopa - 25mg Tablet 2,431,715 L.L
R03AK06 SERETIDE DISKUS 500 B Salmeterol (xinafoate) - 50mcg/inhalation, Fluticasone propionate - 500mcg/inhalation Inhalation powder 3,723,788 L.L
A10BD09 INCRESYNC B Pioglitazone - 30mg, Alogliptin - 25mg Tablet, film coated 3,897,143 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.3% G Sodium chloride - 0.3g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 204,554 L.L
C09BA04 BI-PRETERAX ARGININE B Perindopril arginine - 10mg, Indapamide - 2.5mg Tablet, film coated 765,990 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
N04BA03 COMBIPAR G Levodopa - 100mg, Carbidopa - 25mg, Entacapone - 200mg Tablet, film coated 1,202,314 L.L
R03AK06 FLUDALT DUO G Salmeterol (xinafoate) - 50mcg, Fluticasone propionate - 500mcg Capsule, inhalation 3,048,930 L.L
A10BD10 KOMBIGLYZE XR B Saxagliptin HCl - 2.5mg, Metformin HCl - 1000mg Tablet, extended release 4,059,748 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.3% G Sodium chloride - 0.3g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 220,643 L.L
C09BA05 TRILTEC PLUS G Ramipril - 10mg, Hydrochlorothiazide - 12.5mg Tablet 2,243,577 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
N04BA03 COMBIPAR G Levodopa - 150mg, Carbidopa - 37.5mg, Entacapone - 200mg Tablet, film coated 1,274,222 L.L
R03AK06 PROPIONATE DE FLUTICASONE/ SALMETEROL ARROW G Salmeterol - 50mcg/dose, Fluticasone propionate - 500mcg/dose Inhalation powder 2,605,711 L.L
A10BD10 KOMBIGLYZE XR B Saxagliptin HCl - 5mg, Metformin HCl - 1000mg Tablet, extended release 3,979,118 L.L
C09BA05 TRILTEC PLUS G Ramipril - 5mg, Hydrochlorothiazide - 12.5mg Tablet 2,189,823 L.L
N04BA03 COMBIPAR G Levodopa - 50mg, Carbidopa - 12.5mg, Entacapone - 200mg Tablet, film coated 1,061,373 L.L
R03AK06 SEROFLO 500 G Salmeterol (xinafoate) - 50mcg/inhalation, Fluticasone propionate - 500mcg/inhalation Inhalation suspension 2,031,890 L.L
A10BD11 JENTADUETO B Metformin - 1000mg, Linagliptin - 2.5mg Tablet, film coated 3,542,369 L.L
C09BB02 ZANIPRESS B Lercanidipine HCl - 10mg, Enalapril maleate - 20mg Tablet, film coated 2,548,821 L.L
J07AP03 TYPHIBEV TYPHOID CONJUGATED VACCINE (MONOVALENT) B Salmonella typhi polysaccharides Vi purified - 25mcg of Vi-PS2/0.5ml Injectable suspension 4,020,777 L.L
R03AK06 SEROFLO-S 125 G Salmeterol (xinafoate) - 25mcg/inhalation, Fluticasone propionate - 125mcg/inhalation Inhalation suspension 1,212,146 L.L
A10BD11 INAGLIMET G Metformin - 1000mg, Linagliptin - 2.5mg Tablet, film coated 1,670,844 L.L
C01EX CARDIOVITEX G Coenzyme Q10 - 300mg, Magnesium oxide - 100mg Tablet 2,822,069 L.L
C09BB02 ZANIPRESS B Lercanidipine HCl - 10mg, Enalapril maleate - 10mg Tablet, film coated 2,280,949 L.L
R03AK06 CYVAX G Salmeterol (xinafoate) - 25mcg/inhalation, Fluticasone propionate - 250mcg/inhalation Inhalation suspension 1,710,712 L.L
A10BD11 JENTADUETO B Metformin - 850mg, Linagliptin - 2.5mg Tablet, film coated 3,542,369 L.L
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