The role of Zambias expansive Inter-agency Coordinating Committee (ICC) in supporting efficient, effective, and evidence-based vaccine and health sector programming

Literature examining the functionality of Inter-agency Coordinating Committees (ICCs) is limited and outdated. We employed a qualitative study design to investigate the critical factors for improvements in routine immunization coverage for children under 1 year of age in Zambia from 2000-2018. Key informants identified the Zambian ICC as a success factor for improvements in vaccine programming. This article begins to fill the existing gap in literature by illustrating how Zambia bolstered its ICC for long-term functionality, expanded ICC membership and scope beyond Gavi requirements, and distinguished a complementary structure for the Zambian Immunization Technical Advisory Group (ZITAG). This study was nested within the Exemplars in Vaccine Delivery Project, part of the Exemplars in Global Health Program. Findings from this paper may contribute to decision-making processes, long-term engagement, membership, and mandates for ICCs in other countries.

ATAGI 2021 annual statement on immunisation (Last updated: 19 September 2021)

The Australian Technical Advisory Group on Immunisation (ATAGI) 2021 Annual Statement on Immunisation is the first publication in this series. It highlights the key successes, trends and challenges in the use of vaccines and control of vaccine preventable diseases (VPDs) in Australia in 2020. It also signals ATAGI’s priority actions for addressing key issues for 2021 and beyond.

COVID-19 vaccination for pregnant women: strategies for enhanced coverage

Following the recommendations from the National Technical Advisory Group (NTAG) on Immunization, the Government of India approved three vaccines – an inactivated vaccine, Covaxin and two non-replicating vector-based vaccines, Covishield and Sputnik V for restricted use in an emergency for pregnant women.(1)The late approval of vaccination of pregnant women was due to a lack of evidence, because pregnant women were excluded from previous COVID vaccination trials. The restricted use of this vaccine recommended by NTAG also complies with the regulations of the Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics. (2-4)

Overview of Polio Outbreak Response in Kenya, 2013 to 2015

Background: Globally, tremendous improvement has been made in Polio eradication since its inception in 1988. For the third time in a decade, Kenya has experienced a Polio outbreak along the border with Somalia. The affected areas were in Garissa County, replete with previous occurrences in 2006 and 2012. This article, give an account of series of events and activities that were used to stop the transmission within 13 weeks, an interval between the first and the last case of the 2013 outbreak. Methods: In an attempt to stop further transmission and time bound closure of the outbreak, many activities were brought to fore: the known traditional methods, innovative approaches, improved finances and surge capacity. These assisted in case detection, implementation, and coordination of activities. The external outbreak assessments and the six-monthly technical advisory group recommendations were also employed. Result: There were increased case detections of >=2/100,000, stool adequacy >=80%, due to enhanced surveillance, timely feedbacks from laboratory investigation and diagnosis. Sustained coverage in supplemental immunisation of > 90%, ensured that immune profile of >=3 polio vaccine doses was quickly attained to protect the targeted population, prevent further polio infection and eventual reduction of cases coming up with paralysis. Conclusion: Overall, the outbreak was stopped within the 120 days of the first case using 14 rounds of supplemental immunisation activities.

Development of a Study tool to Assess Gaps in Respectful Maternity Care in Health Facilities of India

Background: Maternal mortality perdures to be a major challenge for India like in other developing countries. Though the efforts to increase the institutional deliveries have resulted in appreciable results, it has not translated to the corresponding decline in maternal mortality rates. Dearth in quality of care especially concerning respectful maternity care in health facilities is considered as a major reason for this phenomenon. This work describes the development process of the study tool to assess respectful maternity care in the health facilities of India. Methods: A collaborative approach was employed for the development of a comprehensive tool to be used to assess respectful maternity care in the Indian setting. The tool development process comprised of four steps: 1) literature review and meeting with Technical Advisory Group; 2) the National Stakeholders workshop and development of the initial tool; 3) feedback on the tool from twenty tertiary care public health facilities from various regions of India; 4) the final tool and its validity approval by Technical Advisory Group. Results: A comprehensive tool was made comprising of indicators for assessing deficits in respectful maternity care, and for assessing contextual data of the health care facility. The initial tool was tested at twenty facilities. The changes suggested and observed were adapted, and the final tool was prepared. The Technical Advisory Group approved the content validity of the tool.Conclusions: A comprehensive tool was made to assess various aspects of respectful maternity care provided in tertiary Indian institutional settings aiding in in a deeper understanding of the phenomenon. This tool is recommended, especially to health care providers of India, for assessing the status of maternity care in health facilities and bringing the required interventions in the health care facilities.

Science-Based Targets: On Target?

Companies are increasingly seeking to align their actions with the goals of the Paris Agreement. Over 1000 such companies have committed to the science-based targets initiative which seeks to align corporate carbon reduction targets with global decarbonisation trajectories. These ‘science-based targets’ are developed using a common set of resources and target-setting methodologies, then independently assessed and approved by a technical advisory group. Despite the initiative’s rapid rise to public prominence, it has received little attention to date in the academic literature. This paper discusses development of the initiative based upon a quantitative assessment of progress against each component of the science-based targets set by 81 early adopters, using information gathered from company annual reports, corporate social responsibility websites and Carbon Disclosure Project (CDP) responses. The analysis reveals a mixed picture of progress. Though the majority of targets assessed were on track and, in some cases, had already been achieved, just under half of the companies assessed were falling behind on one or more of their targets. Progress varied significantly by target scope, with more limited progress against targets focused on Scope 3 emissions. Company reporting practices were highly variable and often of poor quality. This paper concludes with a range of recommendations to improve the transparency, consistency and comparability of targets within this key agenda-setting initiative.

Cumulative antibiogram and multidrug-resistant organisms in a regional equine referral hospital

Prudent use of antimicrobials is paramount to slow the development of resistance and for successful treatment. The use of cumulative antibiograms will allow evidence-based antimicrobial selection with consideration of local resistance patterns. We generated a “first-isolate-per-patient” cumulative antibiogram for a regional equine referral hospital. Bacterial organisms cultured from horses between 2011 and 2018, sample origin, antimicrobial susceptibilities, and multidrug-resistant (MDR) status were tabulated. Of 1,176 samples, 50% were culture positive. Overall, 93 of 374 (25%) were MDR. Of the MDR isolates, 11 (12%) were susceptible to high-importance antimicrobials only (as defined by the Australian Strategic and Technical Advisory Group on antimicrobial resistance). β-hemolytic streptococci were uniformly susceptible to penicillin (76 of 76); 17 of 20 (85%) non–β-hemolytic Streptococcus spp. were susceptible to penicillin. Despite veterinary-specific challenges in constructing an antibiogram, our study provides an exemplar of the clinical utility of regional-, farm-, or hospital-specific cumulative antibiograms for evidence-based empirical antimicrobial selection by veterinarians prior to susceptibility result availability.

Diagnostics and the neglected tropical diseases roadmap: setting the agenda for 2030

Accurate and reliable diagnostic tools are an essential requirement for neglected tropical diseases (NTDs) programmes. However, the NTD community has historically underinvested in the development and improvement of diagnostic tools, potentially undermining the successes achieved over the last 2 decades. Recognizing this, the WHO, in its newly released draft roadmap for NTD 2021–2030, has identified diagnostics as one of four priority areas requiring concerted action to reach the 2030 targets. As a result, WHO established a Diagnostics Technical Advisory Group (DTAG) to serve as the collaborative mechanism to drive progress in this area. Here, the purpose and role of the DTAG are described in the context of the challenges facing NTD programmes.