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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
J01CR05 PIPERACILLINE/ TAZOBACTAM ARROW Piperacillin (sodium) - 4g, Tazobactam (sodium) - 500mg 7,378,682 L.L
N02BE51 PARACETAMOL/CAFEINE/CODEINE BIOGARAN Paracetamol - 400mg, Caffeine - 50mg, Codeine - 20mg 548,288 L.L
C09BA04 PRETERAX ARGININE B Perindopril arginine - 2.5mg, Indapamide - 0.625mg Tablet, film coated 452,875 L.L
N06AB03 PROZAC B Fluoxetine (HCl) - 20mg 20mg Pulvule 907,094 L.L
A01AD11 PYRALVEX B Salicylic acid - 0.01g/ml, Rhubarb (Anthraquinone Glycosides) - 0.05g/ml Solution 327,898 L.L
D07AC18 PEITEL B Prednicarbate - 0.25% 0.25% Cream 507,972 L.L
R06AX02 PERIACTIN B Cyproheptadine HCl - 4mg 4mg Tablet 255,970 L.L
N02AB03 PECFENT B Fentanyl (citrate) - 400mcg/spray 400mcg/spray Spray 5,718,050 L.L
N02AB03 PECFENT B Fentanyl (citrate) - 100mcg/spray 100mcg/spray Spray 4,343,299 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
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
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
M01AE02 PROXEN 500 B Naproxen - 500mg 500mg Tablet, film coated 841,245 L.L
M01AE02 PROXEN 250 B Naproxen - 250mg 250mg Tablet, film coated 542,912 L.L
M01AE03 PROFEMIGR B Ketoprofen - 150mg 150mg Tablet, scored 302,365 L.L
M01AE03 PROFENID B Ketoprofen - 100mg 100mg Tablet, film coated 469,001 L.L
A07EC02 PENTASA B Mesalazine - 1g 1g Tablet, controlled release 4,945,340 L.L
M01AE03 PROFENID B Ketoprofen - 100mg 100mg Suppository 321,178 L.L
A07EC02 PENTASA XTEND B Mesalazine - 2g 2g Granules for suspension 8,550,789 L.L
J07BD52 PRIORIX B Rubella virus live attenuated - ?10³ CCID50, Mumps virus live attenuated - ?103.7 CCID50, Measles virus live attenuated - ?10³ CCID50 Injectable lyophilised powder for solution+diluent 1,142,266 L.L
A07EC02 PENTASA B Mesalazine - 1g 1g Suppository 4,153,817 L.L
N02BE01 PANADOL ACTIFAST B Paracetamol - 500mg 500mg Tablet, film coated 159,917 L.L
J07BF03 POLIOMYELITIS VACCINE INACTIVATED B Poliomyelitis virus type 1 inactivated - 40D.U, Poliomyelitis virus type 2 inactivated - 8D.U, Poliomyelitis virus type 3 inactivated - 32D.U Injectable suspension 1,206,771 L.L
A07EC02 PENTASA B Mesalazine - 1g 1g Enema 2,791,161 L.L
N02BE01 PANADOL ADVANCE B Paracetamol - 500mg 500mg Tablet, film coated 438,093 L.L
N02BE01 PANADOL ADVANCE B Paracetamol - 500mg 500mg Tablet, film coated 137,072 L.L
N02BE01 PANADOL ADVANCE B Paracetamol - 500mg 500mg Tablet, film coated 389,714 L.L
N04BB01 PK-MERZ B Amantadine (sulfate) - 100mg 100mg Tablet, film coated 1,382,814 L.L
A07EC02 PENTASA B Mesalazine - 4g 4g Granules, prolonged release 7,826,190 L.L
A11AA PHARMATON KIDDI B Vitamin E - 15mg/15ml, Phosphorous - 200mg/15ml, Calcium - 130mg/15ml, Vitamin D3 - 600IU/15ml, D Panthenol - 10mg/15ml, Nicotinamide - 20mg/15ml Syrup 417,935 L.L
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