CSO Submission to the GVAP

The Gavi CSO Constituency and Steering Committee in July provided an official, independent submission to the annual Global Vaccine Action Plan (GVAP) report for the fourth year in a row.  This year’s submission, which will be featured in its entirety in the 2017 GVAP report, also included case studies from five Gavi-supported CSO country platforms (Ethiopia, Ghana, Malawi, Pakistan and Uganda).

The purpose of this year’s Gavi CSO Constituency submission was three-fold:

  1. To summarize activities by civil society in support of countries’ national immunization plans
  2. To highlight key findings from the 2016 Gavi CSO Constituency Survey 
  3. To provide a status update on the 2016 CSO recommendations


The report focuses on 15 countries as identified by the World Health Organization (WHO):

1.       Africa region (AFRO) – Benin, Burkina Faso, Ethiopia, Ghana, Kenya, Madagascar, Malawi, Mali, Nigeria, Sierra Leone, Togo, Uganda and Zambia

2.       Eastern Mediterranean (EMRO) – Pakistan

3.       South East Asia (SEARO) – India

 Similar to the independent civil society submissions to the annual GVAP Secretariat reports since 2014, this year the Gavi CSO Constituency Coordinator and the Gavi CSO Steering Committee directed and oversaw the work of an external consultant, who prepared the report. The work of the consultant was funded by the Immunization, Vaccines and Biologicals (WHO/IVB) Department of the World Health Organization (WHO), for which we are very grateful.

The consultant carried out a desk review of civil society documents, reports and national immunization plans. These included civil society materials prepared for World Immunization Week (April 2017), results from the 2016 Gavi CSO Constituency survey implemented by Catholic Relief Services (CRS), and current national comprehensive multi-year immunization plans (cMYPs).

Overall, activities conducted by civil society as described in national cMYPs include surveillance of vaccine preventable diseases (VPD), social and community mobilization, immunization promotion, advocacy, and community-based monitoring of adherence to immunization schedules.

The survey administered by CRS provided a rich picture of what CSOs are doing and the types of challenges they encounter. For example, the survey revealed that more than 85% of CSOs in Burkina Faso, Ethiopia, Kenya, Madagascar, Sierra Leone and Togo had encountered a child who had never been vaccinated.

The survey also asked CSOs a series of Yes/No questions about their involvement in specific, pre-defined activities that were organized around GVAP strategic objectives (SO) 1-4. For SO1, CSOs mostly carried out immunization-related information sharing for better CSO coordination and implementation of promising practices; a lesser number of organizations participated in national-level discussions on immunization and health. For SO2, CSOs indicated that most of their activities were in community education on immunization followed by advocacy towards local and national authorities and least, social research on immunization delivery. For SO3, CSOs mainly mobilized communities and raised awareness and interest in immunization through sensitizations and education and to a lesser extent conducted direct administration of vaccines. Finally for SO4, CSOs carried out the majority of activities in tracking community members who had defaulted on their immunization schedule.

The full GVAP report will be published by WHO in October and the link will be shared. In the meantime, if you would like a copy of the materials submitted by our Constituency, they can be found here.


An interview with Dr Clarisse Loumou, CSO Representative on the Gavi Board

posted Oct 5, 2017, 4:37 PM by GAVI CSO

Image result for Dr Clarisse Loumou

As a child Dr Clarisse Loumou dreamed of being a doctor and now she is a world renowned paediatrician, founder of a Civil Society Organisation (CSO) Alternative Santé and the Gavi CSO Steering Committee representative on the Gavi Board.

She began her career in one of the largest paediatric hospitals in Cameroon where she realised that sadly many mothers arrived too late for treatment. 

“I quickly learned that maternal health was a big issue for women but I was also shocked by the numbers of children dying not only because of lack of health information in the communities but also the inability of families to pay for care,” says Dr Loumou.

 Dr Loumou started Alternative Santé (NGO) in Cameroon because she saw it as the best way to bring solve this problem and work with women and children to get them proper mother and child services.

 Since joining the Gavi CSO Steering Committee in 2010, Dr Loumou has seen a great improvement in the understanding of the role that CSO play in supporting the work and aims of Gavi.

 “I’ve seen the impact of CSOs grow within Gavi because we’ve become more confident about the important role we have in developing new ideas and giving practical advice. We are also gaining efficiency and becoming more impact driven.”

CSOs are working on the ground in communities which means they provide vital feedback on the challenges and needs of implementing vaccination programs in country on a day-to-day basis.

 “CSOs provide a reality check is critical to the ongoing work of Gavi. The more CSOs that engage directly with the Gavi CSO platform or directly contact me or my advisor the better we can make the more effective we can make Gavi’s work. ”

 Among her achievements, Dr Loumou was instrumental in setting up the Francophone CSO Network for Vaccination and Immunization Advocacy (OAFRESS) in francophone African countries after she became aware francophone countries were almost totally absent from the Gavi CSO constituency forum. It was also clear that these countries were falling behind in vaccination coverage.

 “The lack of participation of francophone CSOs in the Gavi CSO constituency forum meant we needed to create a forum to bring this group on board. Now that it is established OAFRESS can develop sound advocacy in sub regional, regional, and global processes for francophone countries.”

 Looking forward Dr Loumou sees two main focuses for the CSOs when working with Gavi which are the enhancement of routine immunization – we  need to walk the talk and reach global country targets – and countries need to step up and increase their health financing so that progress are sustainable.

 “We need global solidarity on immunisation and we need everyone to pay their share – to be most effective we need agreement between country and a global obligations.”

 Since her early days as a young paediatrician Dr Loumou has become as a mother of three daughters who are regular reminders on the importance of child health and that motherhood is a complete life lesson.


Gavi CSO Steering Committee meeting in Geneva, Switzerland

posted Jun 19, 2017, 7:22 PM by GAVI CSO

The bi-annual Gavi CSO Steering Committee meeting has begun, hosted in Geneva, Switzerland, by the International Federation of Red Cross and Red Crescent Societies.  

During the meeting, which will run from 8-10 May, the Steering Committee will welcome five new Steering Committee members and say good bye and thank you to colleagues whose 3-year terms have finished.

The CSO Steering Committee will meet with Gavi Secretariat leadership, including Deputy CEO Dr. Anuradha Gupta, on 9 May.

Owning it: how targets can help countries vaccinate to save lives

posted May 8, 2017, 8:59 AM by GAVI CSO

Basic immunisation is still inaccessible to 1 in 7 children, and, over the last five years, improvements in global immunisation coverage rates have only increased incrementally. Yet, just six years ago, all countries agreed to reach 90% coverage of the basic vaccine package by 2015. So far, 68 countries are not reaching the target, and since 2010, the vast majority of these countries have not made improvement toward achieving it. Why does there remain such a large gap between commitments and action?

 This target, along with many others are set out in the Global Vaccine Action Plan (GVAP). But how can global goals, which are so easily missed, really drive change on the scale we need to see it? The GVAP sets out six principles that were supposed to do this and allow countries to realise the full benefits of immunisation to all people, regardless of where they are born, who they are, or where they live.

One of these guiding principles relates to the need for ownership of immunisation systems. Immunisation is a core part of primary healthcare, and plays a key role in strengthening the whole supply infrastructure and care system. With approximately 30 vaccines delivered every second, this is 30 points of contact a child and their wider family has with the health service, with the opportunity to be checked and treated for a number of other health concerns. However, it will only reach its full potential if governments show leadership and political will in committing to the full financing and delivery of the routine immunisation programme through country ownership.

Country ownership requires three distinct elements. Firstly, it must start with high level political commitments to improve immunisation rates at all levels of government. Secondly, sustainable domestic financing must also be a priority to support the continuation and improvement of services, particularly at a time when financial support from donors is changing. Finally, improved policy and programme implementation with a focus on equity is essential to reach all children with WHO recommended vaccines. Political commitments and domestic financing will be pointless without the technical capacity to turn ambitious commitments into action.

 There are critical roles for civil society, the donor community, and technical partners to play. Donors and technical partners must support this process through sharing skills and building government capacity, ensuring that changes in critical financing streams don’t take place until certain coverage levels have been reached. Civil society and parliaments have an equally important role to play in holding their governments to account, ensuring funds reach the right places and that all children are reached.

By  Dorothy Esangbedo, the President of the Union of National African Paediatric Societies and Associations (UNAPSA) and a member of the Executive Committee of the International Paediatric Association (IPA), and Amy Whalley is Head of Policy Advocacy at RESULTS UK. Originally published by Vaccines Work.


CSO Asia Regional Meeting

posted May 7, 2017, 11:01 PM by GAVI CSO   [ updated May 8, 2017, 8:53 AM ]

 We are pleased to share with you the meeting report from the recent CSO Asia regional meeting, which took place in Dhaka, Bangladesh from 27-28 February, 2017, hosted by BRAC. CSO representatives from Bangladesh, Bhutan, India, Indonesia, Myanmar, Nepal, Papua New Guinea, and Sri Lanka attended. In addition, colleagues from Pakistan participated virtually in a number of sessions.  

During the meeting, participants identified common immunisation challenges across their respective countries, which became the backbone of a suggested roadmap for future CSO engagement and cooperation in the region. The five main areas for further collaboration are:

• Sustainable financing for immunization
• Equitable coverage
• Political will and advocacy
• Parental education and card retention
• Increasing CSO capacity

The full report is available here.

Vaccines Work, Let's Get to Work!-- Gumuz State, Ethiopia Friday, 28 April

posted Apr 30, 2017, 6:09 PM by GAVI CSO   [ updated May 1, 2017, 3:24 AM ]

Change will come and be sustainable if we work hard and get the appropriate support we need, and that our communities will be free from vaccine preventable diseases”. Hanan Rahma, Health Extension worker, Herkole Afendu Health Post, Assosa woreda, Benishangul Gumuz Regional State, Ethiopia 

Hanan Rahma, 22 years old, is a health extension worker (HEW), who has been working in Herkole Afendu Health Post for the last three years. Sherkole Afendu is located 50 Kms away from Assosa town, and is one of the hard-to-reach kebeles in Assosa woreda. 

Conducting routine immunization used to be difficult in this kebele, according to Hanan, due to the inaccessibility of some villages and low awareness in the community. Hanan indicated that she was once asked by a mother to provide guarantee that if she vaccinated her child, the child would not die. Hanan had to assure the caregiver to vaccinate the child.


The situation has now changed after the International Rescue Committee (IRC) started supporting immunization activities, Hanan says. The use of Enat Mastawesha and defaulter tracing tool (DTT) are among the key approaches introduced by the IRC, and have changed the situation according to Hanan. Enat Mastawesha is a color coded health calendar distributed to all eligible households (houses with pregnant women or infants) in village. The calendar is used by HEWs and the Health Development Armies (HDAs) during home visits, to address identified barriers of caregivers’ knowledge of the timing (and purpose) of critical maternal and child health services including immunization. The DTT is a simple carbon-copy registration form used at the health post to record basic infant/caregiver information and antigens missed for all defaulters in the community.

Using these tools, and with the support of community leaders, Hanan says that HEWs are able to mobilize the community for routine immunization. Hanan is also able to trace defaulter children in a timely manner, in order for the HEWs to get them caught up on missed vaccinations. She said, in 2016, her health post was able to perform well, achieving a Pentavalent 3 coverage of 95%, with Pentavalent1-Pentavalent3 dropout rate of 4%.

 Hanan expressed fulfillment in her job and the transformation of caregiver attitudes towards immunization in her community. Hanan believes her community is now better informed about the value of immunization in protecting their children and keeping them safe from vaccine-preventable illnesses. The same mother who needed reassurance before accepting immunization, now hopes her daughter would grow up healthy, go to school to become a health worker, and come back to help their community live healthier and better lives, just as Hanan is helping them do now.


Vaccines Work To Build A Secure World-- Bangui, Central African Republic Thursday, 27 April

posted Apr 30, 2017, 6:05 PM by GAVI CSO   [ updated May 1, 2017, 3:04 AM ]

The Central African Republic has been experiencing Civil War since 2012, which has caused disruptions to an already fragile health system.  According to the United Nations (UN) Office for the Coordination for Humanitarian Affairs (OCHA), half the 4.6 million people living in CAR rely on humanitarian assistance. 

Despite the ongoing conflict and challenging contexts, parents value and seek out immunisation services for their children. Here we witness a community immunsation sensitisation session supported by the Société de la Croix-Rouge centraficaine (Red Cross Society of Central African Republic). 

Health services provision, including immunisation, can help to rebuild states after pro-longed civil conflict by rebuilding the population's trust in the government's ability to provide services. In addition, Civil Society Organisations often play key roles in supporting the health system both during civil conflict and afterwards throughout the recovery process. 

Vaccines Work To Leave No One Behind-- Watrerloo, Sierra Leone Wednesday, 26 April

posted Apr 30, 2017, 6:02 PM by GAVI CSO   [ updated May 1, 2017, 3:05 AM ]

Focus 1000, the Gavi-supported CSO platform in Sierra Leone, works with "Lead Mothers" across the country, including in the Western Area Rural District, where the organisation recently interviewed Maserey Coker. Ms Coker is a lead mother in Waterloo Community and champions immunisation in her community. She is inspired by the difference that immunisation has made to her own children, helping them to live healthy lives, and encourages other parents to vaccinate their children. 

Vaccines Work To Fight Disease-- Jharkhand, India Tuesday, 25 April

posted Apr 30, 2017, 6:01 PM by GAVI CSO   [ updated May 1, 2017, 3:05 AM ]

The Alliance for Immunisation and Health (AiH), a Gavi-supported CSO platform in India, interviewed parents ahead of World Immunisation Week to learn why immunisation is important to them.  In the interview below, we meet parents in the village of Basdharwa, Koderma District, who are well aware of the protection offered by vaccines.

Thanks to Agence de Médecine Préventive for sharing this important example of how #vaccineswork to save lives in remote communities

Vaccines Work To Save Lives-- Lake Chilwa, Malawi, Monday, 24 April

posted Apr 30, 2017, 5:58 PM by GAVI CSO   [ updated May 1, 2017, 3:06 AM ]

Vaccine breakthroughs and immunization campaigns make for easy headlines, but they are only part of a more complex story. Behind the scenes, activities that ensure vaccines are delivered safely, on time and to the right people are a vital part of a vaccine’s journey from discovery to administration. This logistical challenge is especially demanding with communities who live in hard to reach areas or in temporary homes, or move around frequently, such as the large community of fishermen who live and work on Lake Chilwa in Malawi. A well-known hotspot for cholera outbreaks since the 1980s, the lake, which borders with Mozambique, is home to almost 90,000 people, and during the fishing season from March to May the lake sees a massive influx of fishermen, who settle along the shore, on the islands, or in floating homes on the lake, called zimboweras.

A major outbreak starting in December 2015 prompted the Malawi Ministry of Health to ask for support from Agence de Médecine Préventive’s (AMP) Vaxichol team and a group of international partners (MSF, UNICEF and WHO) to carry out an oral cholera vaccine (OCV) immunization campaign to control the outbreak, which was potentially triggered by one of the fishermen living in a floating home.

This community’s lifestyle makes it difficult for them to access safe water and sanitation, making them even more vulnerable to the disease and logistically more difficult to vaccinate, due to their remoteness and mobility, especially as OCV is taken in two doses 14 days apart. The key was to adapt the immunization strategies and activities to overcome unpredictable routines and hard to reach homes, in particular by giving them varying degrees of autonomy over the second OCV dose, depending on where they lived - the harbor, the islands, or the floating homes.


For the residents leaving in the harbor areas located on the shore (around 70,000) the two doses were given under medical supervision. On the islands, however, community leaders took charge of distributing the second dose, which had been delivered to them in cold boxes at the end of the first round. The islanders, more than 6,500, showed their immunization cards and those of other household members before receiving the corresponding number of doses to take on their own at home. This semi-autonomy for vaccine administration went even further with the hardest group to pin down, those living in the zimboweras, estimated at about 6,000 at this time. They received the second dose in a plastic bag during the first round and were told to keep it at home and take it two weeks later.

An anthropological assessment to understand people’s perceptions to these strategies found that the community-led second dose was a good idea, but there were concerns about taking it without medical supervision. While almost half of the fishermen on the floating homes were worried about storing the vaccine, which although heat stable should be kept between +2°C and +8°C. Their solution was to give their second dose to the owner of a cluster of floating homes, or a ‘tea room’, for storage and distribution.

These innovative approaches meant the campaign quickly reached the most people possible, while solving the logistical problem of a two-dose vaccine. Overall, 180,000 vaccines were delivered in a community where many of its citizens would previously have missed out, making it likely that the campaign helped to decrease the number of cholera cases and limit transmission of the disease in the fishing community. It also demonstrates that autonomy is an acceptable approach for administering a vaccine, and creates options to reach mobile, difficult to access populations, who are often the most vulnerable to cholera. These novel immunization approaches show the importance of building a strong collaboration with other stakeholders, including local leaders, counselors and chiefs, allowing the whole community to be involved.

The campaign was carried out in February and March 2016, with a second campaign organized in the same area in November and December, when full autonomy for the second dose was given to both islanders and floating home dwellers. A study to measure the short- to medium-term impact of these strategies is currently ongoing in the area.



 Thanks to Agence de Médecine Préventive for sharing this important example of how #vaccineswork to save lives in remote communities.  

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