In this case, SIVAC would provide support to the country to help

In this case, SIVAC would provide support to the country to help them identify available data on disease burden, health Paclitaxel economics, and vaccine safety, as well as data on logistical and cold chain issues. SIVAC would also help in the analyses of the decision-making process related to rotavirus vaccine introduction in other countries; participate in evaluating the implications of the introduction of the vaccine in terms of organization, infrastructure and finances; and define the target population. The expected duration for the provision of SIVAC support and

evaluation is about one and a half years per country, but this may vary depending on the circumstances of each specific case. SIVAC focuses on making this process sustainable in order to facilitate the country’s future decision-making process. Therefore, SIVAC concentrates on mobilizing expertise at the country or sub-regional level, in concert with other international initiatives and organizations. This process is reviewed with each country, and recommendations for improving the functioning of the NITAG are developed. As with the creation of NITAGs, SIVAC aims to promote a country-driven process. The assistance provided can take various forms and depends on the countries’ needs and states of advancement

in the creation of their committees (Table 2). SIVAC find more assists NITAGs in both process and structural changes. Two forms of SIVAC assistance are provided: • Scientific and technical assistance to committee members. This can be country-specific, e.g., a national health economist providing input and training for economic analyses and including these analyses in the evidence-based decision-making process. It can also be more global, e.g., providing training to all committee members on economic analyses or providing training to committee members on the process of decision making by bringing them to other countries where NITAGs are already functioning well.

In West Africa, several countries may not have the capacity to establish NITAGs for various reasons (e.g., lack of expertise, recent conflicts, budget issues, and others). SIVAC has proposed that, as an intermediate step before establishing NITAGs in these countries, only support could be provided to establish an inter-country Immunization Technical Advisory Group (ITAG) that would include several or all of the countries of West Africa. The host for this inter-country ITAG could be the West African Health Organisation (WAHO), which is the technical health agency of the Economic Community of West African States (ECOWAS) and has responsibility for health matters for the 15 signatory countries in West Africa. This committee’s mandate would be advisory rather than binding upon member states. Suggestions have been made regarding its focus (e.g., common health problems such as meningitis, pneumonia or malaria); its composition (e.g.

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