WHO AFRO STRATEGIC PLAN FOR YELLOW FEVER CONTROL 20042007

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WHO AFRO STRATEGIC PLAN FOR YELLOW FEVER CONTROL
2004-2007

• Dr. Fenella Avokey
• 11th meeting of the African Task force on
  Immunization
• LUANDA, ANGOLA
• Dec. 2-4, 2003

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Yellow fever outbreaks in Africa

• More frequent outbreaks
• 2001-2003
• 16 outbreaks in 6 countries
• 675 cases and 109 deaths reported to WHO
• Estimated true no. of cases-gt20,000 and
  gt5500 deaths
• 2. Unexpected outbreaks in some areas.
  Kenya-1993, Sudan-2003,
• 3. Risk factors found in abundance in most
  countries of tropical Africa

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Yellow fever outbreak experience in Africa
Countries at risk
Ever experienced YF
Reported outbreak 1980-2003
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Categorisation of countries

• Group 1- very high risk
• Large epidemics in recent years
• High no. of reported cases
• Frequent epidemics and/or border countries with
  large recent epidemics, highly populated
• Generally poor health systems and weak
  infrastructure
• Countries in greatest need
• Political instability.

• Most of West and Central African countries
  Uganda, Kenya, Angola,

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Categorisation of risk

• Group 2- medium risk
• Few or no reported epidemics/cases in recent
  past
• Few districts bordering known epidemic zones
• No or weak preventive immunisation programmes
  recording low coverage

• Mauritania Chad, Niger Ethiopia,

• Group 3- low risk
• No reported epidemics for over 50 years
• Good preventive immunisation programmes with good
  coverage levels over 80

Great Lakes region, Tanzania, Gambia, Cape Verde,
Sao Tome Principe
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PROGRAMME OBJECTIVES

• To prevent outbreaks of yellow fever through
  increased immunization coverage of target
  population in countries at risk.
• To control outbreaks through early detection and
  laboratory confirmation followed by appropriate
  emergency mass vaccination response

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CONTROL STRATEGIES -1

• Vaccination with the yellow fever vaccine
• In routine immunisation programmes e.g. for EPI

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CONTROL STRATEGIES -2

• Vaccination with the yellow fever vaccine
• Preventive mass vaccination campaign in high-risk
  areas

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CONTROL STRATEGIES -3

• Surveillance and laboratory support

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CONTROL STRATEGIES - 4

• Outbreak response consisting of
• Emergency mass vaccination
• Enhanced epidemiological surveillance
• Vector control measures
• Appropriate community sensitisation
• Effective response co-ordination

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Recommended key activities

• Planning and management
• -National strategic plans with intersectoral
  involvement
• Strengthening of routine immunization programmes
• Supplementary immunization activities (SIAs)
• Ensuring vaccine supply
• - forecasting, good vaccine management,
  sustainable procurement capability
• Surveillance for outbreak detection and response

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Indicators for monitoring progress

• Routine immunisation
• of countries achieving 80 immunisation
  coverage for yellow fever vaccine in routine EPI
• Surveillance and laboratory support
• of districts reporting at least one suspected
  yellow fever case per year.
• of IgM results reported to the district or
  programme level within 7 days of receipt of
  sample
• Emergency Response/action
• of outbreaks reported to WHO and neighbouring
  countries within 48 hours of confirmation.

TARGET80
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Budget 2004-2007
excludes the cost of vaccines
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NEXT STEPS

• Finalisation of Regional Strategic Plan
• Development of an advocacy and communication
  strategy directed at countries and other
  stakeholders
• Implementation and monitoring of control
  activities

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Thank you for your kind attention