News In this issue
News
Brazil Launches a Book Celebrating the
40th Anniversary of its National Im-munization Programme
Retirement from WHO service
GAVI seeking independent review committee (IRC) members
2
2
3
Meetings / workshops
Regional Meeting on Sentinel Rotavirus
Surveillance, Bacterial Pneumonia and Meningitis
Intercountry meeting on Measles / Rubella control and elimination
2nd Workshop to Share Lessons Learned in the Development and Imple-
mentation of Electronic Immunization Registries Mid-Level Management workshop
Meeting of the Regional Technical Advi-sory Group on Immunization
Towards expanded Immunization cov-
erage in India: National Training and Programme Review with State Immun-ization Officers
Twenty-ninth Meeting of the Caribbean EPI Managers held at Runaway Bay in
Jamaica
3
4 5
6
7
8
Resources 9
Calendar 10
Links 11
Important Milestone for the pooled vaccine procurement
initiative in the Eastern Mediterranean region Nadia Teleb, WHO Regional Office for the Eastern Mediterranean
A session on Pooled Vaccine Procurement (PVP)
Initiative was held during the technical meetings of
the Sixtieth Session of the WHO Regional Commit-
tee for the Eastern Mediterranean, in Muscat,
Oman, on Sunday 27 October 2013. During the
session, Member States were briefed on the pro-
gress of the PVP initiative by WHO/EMRO and
UNICEF Supply Division. During 2013, important
steps have been taken by WHO, UNICEF and oth-
er partners for responding to Member States’ re-
quests. In June 2013, a technical inter-country
workshop for the establishment of PVP System was
held in Sharm El Sheikh, Egypt. Participants to the
meeting provided comprehensive feedback about
their countries and country specific action plans for
participating in the PVP initiative were developed
(both for Stage 1 though UNICEF and Stage two
through WHO EMRO).
Acknowledging the challenges of middle income countries on sustainability and access to
affordable prices, especially on new and under-utilized vaccines, Member States indicated
their strong commitment on the PVP initiative and adopted Resolution EM/RC60/R1
which urges Member States to take immediate action, if they are interested middle-
income countries, to participate in the pooled vaccine procurement system and to sign a
memorandum of understanding with WHO and UNICEF to complete the participation
process by end 2013, and requests WHO/EMRO Regional Director to confirm with in-
terested Member States their commitment to implementing the proposed pooled vaccine
procurement system.
The PVP System is expected to strengthen immunization programmes by creating a com-
munication, coordination and cooperation platform throughout the region and will be
based on the principles of “Member State Ownership”, “Solidarity, Trust and Support”,
“Sustainability”, “Transparency” and “Mutual Learning”.
Global Immunization News (GIN) November 2013
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Resolution EM/RC60/R1
Brazil Launches a Book Celebrating the 40th Anniversary of its National
Immunization Programme Carla Magda Domingues and Antonia Teixeira, Ministry of Health, Brazil; Samia Samad, Pan American Health
Organization (PAHO-BRA), Brazil and Lucia Oliveira (PAHO-WDC)
On 18 September 2013, the Brazilian Ministry of Health (MOH) celebrated the
40th anniversary of its National Immunization Programme . To commemorate this
anniversary, the Brazilian MOH published 40 Anos: Programa Nacional de
Imunizações (40 Years: National Immunization Programme). Participating in the
celebration was Brazil’s Secretary of Health Surveillance, Jarbas Barbosa, and
National Immunization Programme (NIP) coordinator, Carla Magda Domingues.
The NIP´s initial goal was to provide free vaccines to the entire Brazilian
population at public health centers. Doctors Barbosa and Domingues contributed
introductions to the book indicating the gratitude and appreciation they have for
Brazil’s NIP and the strides it has made in the past forty years. The programme
was described as very successful, incorporating an important variety of public
health intervention components and accepted widely and positively by the
Brazilian population. Among the successes of the Programme, they highlighted its
impact on the elimination or reduction of diseases, such as smallpox, polio,
measles, and rubella. The Brazilian MOH attributes the continuous success of the NIP to the commitment of the
thousands of vaccinators, their dedication and work ethic. Health authorities also attributed the NIP success to a
cooperative government, task forces and activities carried out to promote health and disease prevention. Brazil’s 40 Anos: Programa Nacional de Imunizações
NIP current coordinator Carla Magda Domingues had kind words to say regarding the successful trajectory the
NIP has had since its birth in 1973. It has been recognized both nationally and internationally as a brilliant
execution in the scope of public health, defined by the prioritization of the promotion, prevention, and protection
of the health of the Brazilian population. She looks to the future to keep rebuilding and strengthening the
programme, so countries and regions that have recently started a National Programme on Immunization can find
motivation in the Brazilian experience.
Retirement from WHO service Elsa Derobert and Claudio Politi, WHO HQ and Michael Hinsch and Sarah Schmitt, WHO HQ Consultants
After 40 years of dedicated work in the field of social protection,
development and health economics, Miloud Kaddar will retire at the
end of 2013. Passionate about his field, Miloud has committed much
of his work to health financing and the pharmaceutical sector. His
more recent focus has been on building country capacity in immuniza-
tion financing and health system development, best practices in vac-
cine procurement, pricing policies and transparency of vaccine prices.
His career has taken him many times around the globe, allowing him
to work in numerous countries, both in his functions as Senior Health
Economist and Adviser, and as associate professor and applied re-
searcher at various academic institutions.
Since 2002, Miloud has worked at WHO/IVB, focusing on vaccine financing, planning, procurement and pricing.
His focus has been on access, sustainability and country ownership of immunization programmes, placing a strong
emphasis on GAVI graduating and middle-income countries. Miloud has been active in every WHO region and
has been a welcome and valued contributor from country to global policy and academic level. His team will miss
his incredible enthusiasm, knowledge, honesty and integrity. We wish him every success in his future and hope he
will enjoy his retirement.
Although retiring, Miloud will remain active in the immunization and health system community. From December
2013 onward, he can be reached at this address.
Page 2
Global Immunization News (GIN) November 2013
Miloud Kaddar, retiring from WHO
GAVI seeking independent review committee (IRC) members Rehan Hafiz, GAVI Secretariat
The GAVI secretariat is seeking to replenish the current pool of suitable candidates for Independent Review
Committee (IRC) Members. They are aiming to bring in individuals with expertise in Health System Strengthening
(HSS), Immunization and in new interventions such as inactivated polio vaccine (IPV).
Following development of the required criteria and the areas of expertise for the members, the call has now been
posted on the GAVI website. This is also intended to be an opportunity to increase the pool of French speaking
reviewers and it is hoped will generate applications from individuals from Francophone countries.
The process is being undertaken on behalf of the GAVI Secretariat by Korn Ferry, a company that is among the top
global executive search firms.
Interested candidates can view more information at this link.
Candidates can also send their CV directly to thish mailbox created specifically for GAVI.
Page 3
Global Immunization News (GIN) November 2013
Meetings / workshops
Regional Meeting on Sentinel Rotavirus Surveillance, Bacterial Pneumonia and
Meningitis
Jennifer Sanwogou and Lucia Oliveira, PAHO/WHO
Location: Cancun, Mexico
Date: 9-11 December 2013
Participants: New vaccine surveillance representatives from 23 countries, PAHO and partners.
Purpose: 1) To review the sentinel surveillance situation of rotavirus, bacterial meningitis and pneumonia,
including its achievements and challenges; 2) To follow up on laboratory network performance in
sentinel surveillance, including its results and challenges; and 3) To discuss the results of the strategic
review of new vaccine surveillance and the relevant next steps.
Details: This meeting was a joint activity between PAHO and the SABIN Vaccine Institute. After five years
since the beginning of New Vaccines surveillance in the Region of the Americas, this meeting was a
good review and summary of what has been done in the region regarding surveillance and what will
be the next action steps for the coming years. During the last day of the meeting, the countries were divided into three groups to discuss data
quality, epidemiological and laboratory integration, and the WHO Global New Vaccines Surveillance
Network. The groups later presented better ways to analyze, integrate and report data, and the
activities required to continue being a part of the WHO Global New Vaccines Surveillance Net-
work.
Page 4
Global Immunization News (GIN) November 2013
Intercountry meeting on Measles / Rubella control and elimination
Nadia Teleb, WHO Regional Office for the Eastern Mediterranean
Location: Amman, Jordan
Date: 17-20 November 2013
Participants: National EPI Managers;
National officers for Mea-
sles surveillance; national
officers responsible for
measles laboratory sur-
veillance; partner organi-
zations like: CDC Atlanta,
GAVI Alliance and
UNICEF; Regional Tech-
nical Advisory Group
(RTAG) members; re-
gional validation commit-
tee (RVC) experts; chair-
persons of National Im-
munization Technical Ad-
visory Groups (NITAGs)
Group photo of the participants
Purpose: Review countries’ progress towards achieving the regional measles elimination target; Review and
follow up on the implementation of the different components of the regional strategy for measles
elimination; and review and update the national plans for strengthening measles and rubella elimi-
nation and control programme.
Details: After the review of the global and regional updates towards measles elimination, the meeting high-
lighted the progress in achieving and sustaining high population immunity against measles and ru-
bella. The discussions were on two main themes: (1) Maintaining low measles incidence, high
population immunity, and strong case based surveillance, for which presentations were made by
countries in the elimination process or close to elimination; and (2) Focusing on measles out-
breaks in Syria and other neighboring countries. Group work sessions reviewed the situations of
Member States in measles and rubella elimination in relation to population immunity and the sur-
veillance progress in achieving the targets of measles and rubella surveillance performance indica-
tors. The meeting included a session on enhancing rubella and congenital rubella syndrome (CRS) con-
trol and elimination in the Eastern Mediterranean Region, in which progress, challenges and next
steps were discussed with the Member States. In addition, a session on the Polio Eradication End-
game strategy included discussions on strengthening routine immunization and the introduction of
the Inactivated Polio Vaccine (IPV). National immunization programmes are recommended to have policies and relevant operational
plans to “catch-up” with the children who miss the first dose of the Measles Vaccine (MV) and
ensure that all children receive two doses of MV by the age of two.
Page 5
Global Immunization News (GIN) November 2013
Second Workshop to share lessons learned in the Development and
Implementation of Electronic Immunization Registries (EIRs)
Carla Magda Domingues and Antonia Texeira, Ministry of Health, Brazil; Samia Samad, PAHO Brazil and Carolina
Danovaro, PAHO, Washington DC
Location: Brazilia, Brazil
Date: 18-19 November 2013
Participants: Representatives from 17 countries of the
Americas, including 21 participants from
sub-national levels of Brazil; Albania; Ango-
la; Ghana; Sri Lanka; Tanzania; the Open
Source Medical Informatics initiative
(IMeCA) for Latin America; Training pro-
grammes in epidemiology and uublic health
interventions network (TEPHINET); PA-
HO; and WHO. BMGF, CDC, GAVI,
UNICEF and other WHO regions re-
ceived a Web link to follow the workshop
online.
Workshop participants, Brasilia, 18-19 Nov 2013
Purpose: To share practical experiences regarding the development and implementation of electronic immun-
ization registries (EIRs) in order to promote EIR strengthening; to define lessons learned and best
practices on the development and implementation of electronic immunization registries (EIRs), for
dissemination; to discuss countries’ needs regarding a practical field guide on EIRs; to jointly define
next steps on the EIR work among countries of the Americas and with PAHO/WHO.
Details: Representatives of Brazil’s Ministry of Health (MOH) and PAHO-Brazil welcomed participants to the
meeting, highlighting the importance of having accurate data to monitor increasingly complex immun-
ization programmes. Electronic Immunization Registries (EIRs) were cited as a powerful tool to im-
prove vaccination monitoring in order to increase coverage rates in an equitable manner. PAHO presented an overview of the current situation on the development and implementation of
EIRs in Latin America, along with the most recent recommendation of PAHO’s Technical Advisory
Group (TAG) on vaccine-preventable diseases, and the objectives of the workshop. The host coun-
try, Brazil, presented its experience implementing their national EIR. The workshop was divided in plenary sessions and work groups. Day one of the workshop focused
on practical issues related to primary data collection (including form design); flow and data entry;
online and offline EIRs; strategies to ensure EIR completeness, unique identifiers, confidentiality and
management of potential duplicate records. The groups also discussed the conditions, and risks, to
consider when proposing an immunization registry and how to monitor the implementation of an EIR
(data quality, denominator completeness, software functioning and acceptability, among others). Dur-
ing day two presentations and discussions focused on interoperability, confidentiality, data security,
EIR relationship with Health Information Systems, and the potential role of mHealth. Groups pro-
posed recommendations on EIR outputs for managers (reports, maps, graphs), making the EIR useful
for the local level (follow-up, recall/reminders), and on how to make EIRs interoperable with other
national information systems. As in the first Latin American workshop on EIRs in 2011, the openness and willingness of the partici-
pant countries to share experiences, products, successes and failures was commendable. PAHO acknowledges the generous contributions of Brazil MOH and the Bill and Melinda Gates Foun-
dation in making this workshop possible. To see the recording of the plenary sessions of this workshop (Video in original language) or Black-
board Recording (English translation): Monday 18 November Full day; Tuesday 19 November Part 1
AM; Part 2 PM; Part 3 PM; Part 4 PM.
Page 6
Global Immunization News (GIN) November 2013
Meeting of the Regional Technical Advisory Group on Immunization
Nadia Teleb, WHO Regional Office for the Eastern Mediterranean
Location: Amman, Jordan
Date: 21 November 2013
Participants: Regional Technical Advisory Group
(RTAG) members; Regional Valida-
tion Committee (RVC) experts;
chairpersons of National Immuniza-
tion Technical Advisory Groups
(NITAGs); partners: CDC Atlanta,
Network for Education and Support
in Immunization (NESI)
Group photo of the participants
Purpose: To review the current situation of measles and rubella in the Region; to review the mandate and
agree on the Terms of Reference of the proposed RVC; to define internal procedures and re-
sponsibilities of the proposed members of the RVC; to revise and endorse the regional guidelines
for measles and rubella (MR) elimination verification and agree on the criteria, parameters, and
procedures for documenting and verifying the achievement of elimination in the countries of the
EMR, in consultation with the RTAG members.
Details: Informative sessions included detailed discussions on: The progress towards measles elimination
in the Eastern Mediterranean Region: RTAG decided that the Measles Elimination target in the
Region should not be further postponed for keeping the momentum and enhancing commitment
of decision makers; Scaling up the use of Rubella vaccine and developing a regional target for Ru-
bella/ Congenital Rubella Syndrome (CSR) elimination: Rubella elimination target for the Region
was recommended to be set as 2020; Establishment of the RVC and development of regional
guidelines for the documentation and verification of MR elimination; the situation of new vaccine
introductions in the Region; Enhancing introduction of the Inactivated Polio Vaccine (IPV) in the
context of Polio End Game strategy; and Strengthening NITAGs and their role in achieving nation-
al EPI targets: Given that nearly all of the Member States in the Region have already established
NITAGs, the regional strategy will focus on strengthening the functions and quality of decision
support processes of NITAGs. NITAGs are encouraged to support EPI programme and decision
makers on above discussed topics, as well as considering collaborating with education institutions
to support human resources needs of the national immunization programmes.
Page 7
Global Immunization News (GIN) November 2013
Towards expanded Immunization coverage in India: National Training and
Programme Review with State Immunization Officers
Balwinder Singh, WHO Country office for India
Location: New Delhi, India
Date: 3-6 December 2013
Participants: Fifty State Immunization Officers
(SIOs) and state-level officers from
partner organizations participated in
the workshop that was supported by
WHO Country Office for India. Ex-
perts from the Ministry of Health and
Family Welfare (MoHFW), WHO,
UNICEF and other stakeholders facili-
tated the workshop. The WHO Rep-
resentative to India and the Additional
Secretary & Mission Director
(National Health Mission), MoHFW,
Government of India were the special
invitees.
Participants of the training with the WHO Representative to India
Purpose: To strengthen the technical and managerial capabilities of the State Immunization Officers of India in
immunization programme management, including effective planning, implementation and monitoring of
the programme in the states.
Details: The overall emphasis was on leveraging the success of polio eradication in India to strengthen routine
immunization (RI). The workshop built on the lessons learnt and was successful in enhancing the ca-
pacity of the SIOs to review and develop coverage improvement plans for routine immunization in
their states. The SIOs were provided technical updates on current topics of interest in the field of immunization
and updated on programmatic priorities in India and individual states. Feedback from the participants
has clearly indicated an improved understanding of all aspects of the programme: microplanning for
routine immunization, strengthening of immunization review mechanisms, conducting training of
frontline workers, monitoring RI programme to identify gaps and take corrective actions, Adverse
Event following Immunization (AEFI) reporting, vaccine-preventable diseases (VPD) surveillance and
development of communication plans. Given the success of this initiative, MoHFW has agreed to extend support to the states for conduct-
ing similar training workshops for their district immunization officers (DIOs) and a training calendar
for this was prepared during the workshop.
Page 8
Global Immunization News (GIN) November 2013
Twenty-ninth Meeting of the Caribbean EPI Managers held at Runaway Bay in
Jamaica
Primnath Ritoe, PAHO/WHO Representation, Kingston, Jamaica
Location: Runaway Bay, St Ann, Jamaica
Date: 18 – 21 November 2013
Participants: Ninety-one participants representing thirty coun-
tries in the Caribbean sub-region, including the
French and Dutch speaking Caribbean, the Carib-
bean Public Health Agency (CARPHA), the United
Kingdom Overseas Territories, the Netherlands,
University of the West Indies (MONA), Ministry
of Health (Jamaica) and PAHO.
The Minister of Health, Jamaica, and participants.
Photo: PWR/JAM/EPI
Purpose: To analyze and share experiences on the Expanded Programme on Immunization (EPI). Special
areas of discussion were the analysis of the status of the EPI in each country; areas requiring
strengthening; the targets, objectives and budget for 2014; information on selective scientific top-
ics of common interest in relation to immunization; status of verification of Measles, Rubella and
Congenital Rubella Syndrome (CRS) elimination in the Americas; discussion of status and advanc-
es made in the surveillance and management of vaccine preventable diseases; and the introduction
of new and underutilized vaccines in the national immunization schedules.
Details: The Governments and peoples of the Caribbean Community are committed to the sustainability
of the immunization program. Completing the activities of verification and documentation of elim-
ination of measles, rubella and CRS in the Caribbean countries was one of the main achievements
of the previous year. The overall vaccination coverage for administered vaccines for 2012 shows
overall improvement compared to the years before.
The year 2012 has been challenging with maintaining current services and implementing activities
regarding the transfer of the EPI office at CAREC to PAHO office, Jamaica as of January 1st, 2013.
One significant milestone in disease surveillance was the installation of the ISIS application – PA-
HO platform for VPD surveillance – in the EPI Unit in PAHO Jamaica and in the Surveillance Unit
of the Ministry of Health of Jamaica.
Prior to the 29th EPI Managers’ Meeting, a one-day training workshop on immunization was held
for the EPI Managers, on November 18. The purpose of the meeting was to present technical
updates, clarify selected issues and discussing the changes within the programme.
The Henry C. Smith Immunization Award was presented this year to Turks and Caicos Islands.
Barbados received the first price for surveillance, while the second and third places went to
Montserrat and Belize, respectively.
Resources
Page 9
Global Immunization News (GIN) November 2013
SAGE Decade of Vaccines (DoV) Global Vaccine Action Plan (GVAP) Assessment
Report 2013
The SAGE Decade of Vaccines (DoV) Global Vaccine Action Plan (GVAP) Assessment
Report 2013” is now available online. This can be accessed from the following web
link: Check out the “Annual Reports” section.
The Global Vaccine Action Plan (GVAP) was endorsed by the World Health Assem-
bly in May 2012 to achieve its “Decade of Vaccines” vision of universal access to im-
munization.
As requested by the Member States, the WHO Strategic Group of Experts (SAGE)
presents, in this report, a review of the progress with the implementation of the
GVAP and makes recommendations to national governments, international organiza-
tions and development partners for actions required to meet the goals and objectives
of the plan.
At the November 2013 meeting. SAGE endorsed the following recommendations as the major areas of necessary
focus: 1. Improving data quality, 2. Increasing immunization coverage, 3. Accelerating progress towards measles and
rubella/CRS elimination, and 4. Enhancing country ownership of national programmes. This should allow the DoV
Working Group to prioritize the specific issues to focus on during the next few years.
For information on the Decade of Vaccines and the Global Vaccine Action Plan please send an email.
Planning an information systems project? PATH/WHO toolkit can help Dan Brigden, WHO Consultant
An online version of the ICT Toolkit developed by project Optimize has been published on the TechNet-21.org web-
site.
The original document, entitled Planning an information systems project: A toolkit
for public health managers, is available as a PDF on the PATH and WHO websites,
and provides guidance to public health managers planning the implementation of in-
formation and communications technology in health information systems. It draws
on lessons learned by project Optimize, a five-year collaboration between the
World Health Organization and PATH, to help optimize the vaccine supply chain.
The ICT toolkit focuses on the planning phase of an information systems project. It
proposes an eight-step process that can help managers:
Choose the solution that best fits their needs and context.
Obtain the external help and expertise they need.
Develop, scale, and then sustain their chosen solution.
The online version of the toolkit provides links to internet content such as documents, websites and YouTube mov-
ies that the PDF was not able to include. It also enables registered TechNet users to comment on and rate individual
pages. Jan Grevendonk, co-author of the ICT Toolkit, explains the benefits of these new features: “We wanted to
take the PDF and turn it into something dynamic and interactive, a place for public health managers to share experi-
ences and learn from each other. Hopefully this will help to stimulate more in-depth discussion within the immuniza-
tion community about ICT project planning.”
Visit the online version of the ICT Toolkit today.
An online version of the ICT
Toolkit has just been released.
Credit: WHO.
Page 10
Calendar January 2014
16-25 WHO Executive Board Geneva, Switzerland
27-28 SEARO GAVI Regional Working Group meeting TBD
February
18-19 Next Generation Vaccine Delivery Technology Meeting Geneva, Switzerland
24-7Mar AFRO IST Expanded Programme on Immunization Managers meeting TBD
March
4-6 Global Vaccine Research and Immunization Research Forum (GVIRF) Bethesda, USA
18-21 WPRO Regional Verification Commission Meeting Seoul, Republic of Korea
April
7-11 Workshop on vaccine safety (AEFI) surveillance and communication capacity building TBD
23-30 World Immunization Week Global
29-30 Global Measles and Rubella Management Meeting Geneva, Switzerland
Global Immunization News (GIN) November 2013
May 2014
15-24 67th World Health Assembly Geneva, Switzerland
20-22 Expert consultation on accelerated control of Japanese encephalitis in the Western Pacif-
ic Region
Manila, Philippines
June
3-5 Third Workshop for NRAs for Vaccines in Western Pacific Manila, Philippines
24-26 AFRO Ministerial Conference Addis Ababa, Ethiopia
TBD WPRO 23rd Expanded Programme on Immunization Technical Advisory Group Meeting Manila, Philippines
Page 11
WHO Regional Websites Routine Immunization and New Vaccines (AFRO)
Immunization (PAHO)
Vaccine-preventable diseases and immunization (EMRO)
Vaccines and immunization (EURO)
Immunization (SEARO)
Immunization (WPRO)
Newsletters Immunization Newsletter (PAHO) The Civil Society Dose (GAVI CSO Constituency) TechNet Digest RotaFlash (PATH) GAVI Programme Bulletin (GAVI)
Organizations and Initiatives American Red Cross Child Survival Agence de Médecine Préventive Africhol EpiVacPlus LOGIVAC Project SIVAC Johns Hopkins International Vaccine Access Center Vaccine Information Management System PneumoACTION JSI Africa Routine Immunization Systems Essentials Project IMMUNIZATIONbasics PAHO ProVac Initiative PATH Vaccine Resource Library Rotavirus Vaccine Access and Delivery Malaria Vaccine Initiative Meningitis Vaccine Project RHO Cervical Cancer Sabin Vaccine Institute Sustainable Immunization Financing
UNICEF Immunization Supplies and Logistics USAID Maternal and Child Health Integrated Program WHO Department of Immunization, Vaccines & Biologicals New and Under-utilized Vaccines Implementation ICO Information Centre on HPV and Cancer Immunization financing Immunization service delivery Immunization surveillance, assessment and monitoring SIGN Alliance Other Coalition Against Typhoid Dengue Vaccine Initiative European Vaccine Initiative Gardasil Access Program GAVI Alliance International Association of Public Health Logisticians International Vaccine Institute Measles & Rubella Initiative Multinational Influenza Seasonal Mortality Study TechNet-21 Vaccines Today
UNICEF Regional Websites Immunization (Central and Eastern Europe)
Immunization (Eastern and Southern Africa)
Immunization (South Asia)
Immunization (West and Central Africa)
Child survival (Middle East and Northern Africa)
Health and nutrition (East Asia and Pacific)
Health and nutrition (Americas)
Links
Global Immunization News (GIN) November 2013
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