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Pentavalent Vaccine Introduction in Armenia
- As part of a major financing arrangement led by GAVI, MACVF was instrumental in directing RA Ministry of Health’s decision to introduce the Pentavalent Vaccine and add this important vaccine to the National Immunization Program.
- On October 13, 2010, RA’s Minister of Health, Harutyun Kushkyan and ANMF’s Chief Volunteer Officer, Raffy Ardhaldjian, signed a grant agreement stating MACVF’s pledge to co-finance the introduction of the Pentavalent Vaccine from 2011 through 2015.
MR Campaign / Post-campaign Assessment Report
- As part of the Global Measles Immunization Strategy and the joint collaboration of ANMF and the Ministry of Health of Nagorno-Karabagh, the Measles and Rubella (MR) mass campaign was launched in Nagorno-Karabagh on May 15, 2008. The campaign is within the scope of the National Strategy on Measles Elimination and CRS Control.
- The mass campaign process was divided into three phases: pre-campaign, mass campaign, and post-campaign activities.
- Pre-Campaign: The pre-campaign activities involved micro-planning and initial campaign needs’ pre-assessments, which were conducted by ANMF public health consultants. Activities included were the delivery of vaccines, procurement of cold chain supplies, and social mobilization activities such as the printing of posters and educational materials. ANMF public health specialists ensured that the mass campaign was well organized and properly equipped.
- Mass Campaign: During the mass campaign, visits were organized to monitor the course of the campaign. The initial proposal embodied 8-17 year old schoolchildren into the first phase of the MR campaign. However, it was later decided that children between the ages of 2 and 5 should also be included. This decision was based on the fact that 1 and 6 year old children were getting the MMR vaccine from its introduction into NK in 2007. This decision dictated that all 7 year old children got the first dose of MMR vaccine in 2007 and 6 year old children would then get the MMR vaccine throughout the 2008 calendar year.
- Post-Campaign: The post-campaign assessment compared the campaign’s official data to actual statistics. The post campaign assessment was conducted by MACVF public health consultant, Zara Beglaryan, from September 27 to October 4, 2008 and included the Martuni, Shushi, and Stepanakert regions. During the field visit of the MACVF public health expert to Nagorno-Karabagh, some discrepancies between the official coverage rate and actual coverage rate were identified.
The MR Campaign in Armenia
- The MACVF campaign to introduce the MMR vaccine launched in Nagorno-Karabagh in partnership with the Health Ministries of Armenia and Nagorno-Karabagh and the financial support of Karabagh Telecom. By the end of 2007, some five thousand children between the ages of one and six were vaccinated. The campaign aimed to eliminate Measles and Rubella and foster Congenital Rubella Syndrome (CRS) prevention in NKR. Under this drive, the MACVF, in partnership with the Health Ministry of RA and Karabagh Telecom, provided 100% of the annual national requirement (for the year of 2007) of the MMR vaccine for the selected target population.
- The Mass Measles and Rubella (MR) immunization campaign launched in Armenia in October 2007. Initiated by the Ministry of Health of the RA, the drive was supported by MACVF, UNICEF, WHO, the Vishnevskaya-Rostropovich Foundation, and other partners. The campaign was conducted within the framework of the World Health Organization (WHO) strategy to eliminate measles and prevent Congenital Rubella Syndrome throughout the European region by the year 2010.
- A post-campaign assessment by international experts disclosed a coverage rate of 98%, surpassing the targeted 95% set by the Ministry of Health. As 96% of the target figure was vaccinated October 1st through the 13th, the figure rose as a result of a “mop-up” campaign that followed in the second half of October. An important result of the post-campaign assessment in Armenia was that no severe adverse effects following immunization were reported.
- To bring the program to fruition, the MACVF secured $180,000 for the MR vaccine procurement: a one-time grant of $100,000 was generously provided by Armenia’s leading mobile operator, VivaCell, and an additional $60,000 was donated by FIDEC (Fighting Infection Diseases in Emerging Countries) from the Armenian community in Argentina.
- To expand its program, the MR mass immunization campaign planned to move to the Republic of Nagono-Karabakh in 2008. The donation of $17,000 generously provided by Karabakh Telecom in October of 2007 was directed towards covering the costs of Karabakh’s MR campaign.
MMR campaign introduction in Nagorno-Karabagh
- The Ministry of Health of Nagorno-Karabakh and the Ani & Narod Memorial Foundation entered into an agreement through a Memorandum of Understanding to introduce the Measles, Mumps, and Rubella (MMR) vaccine into the National Immunization Program of the Republic of Armenia. Per the terms of the agreement, the MACVF donated MMR vaccines manufactured by Sanofi Pastour, based in Lyon, to the children of Nagorno-Karabagh.
- Extensive training programs were conducted in all the administrative centers of each region, as well as immunization sessions preceding the campaign. A total of 306 people participated in the training sessions which were prepared for upper and mid-level health personnel. Armenian Health Ministry experts and the MACVF immunization consultants with broad experience in conducting similar trainings in Armenia and abroad carried out the training.
Avian Flu Challenge in Nagorno-Karabagh
- Highly publicized reported cases of Avian Flu in Turkey, Azerbaijan, and Georgia prompted MACVF to expand its health awareness program in Armenia into the autonomous region of Nagorno-Karabagh. Evidence of the influenza pandemic in Nagorno-Karabakh caused great alarm amongst health administrators.
- On March 27, 2006, training for nurses and teachers throughout Nagorno-Karabagh was initiated by ANMF in collaboration with the NK Ministries of Education and Health, and the Hanganak NGO. Frida Yeritsyan, from the RA National Institute of Education, trained participants on how to effectively work with children on this issue. An epidemiologist and representatives from the NK Ministry of Agriculture and the NK Department of Emergency Situations answered specific questions while MACVF organized the distribution of informative literature.
Study of Immunization Program in NK
- ANMF provided a grant to the Center for Health Services Research and Development (CHSR) at the American University of Armenia (AUA) in Yerevan, to conduct a rapid assessment of the immunization program in Nagorno-Karabagh (NK). Drs. Gohar Hovhanissyan, Anahit Demirchyan and Michael Thompson led the study. It included in-depth interviews with key senior epidemiologists and pediatricians as well as reviews of immunization cards and medical records. The study focused on cross-section of children born in 2002 selected from a range of urban and rural health facilities. In addition, the opinions of the mothers of these children were collected regarding their views of the immunization program and their attitudes towards vaccination and their willingness to have their children vaccinated.
- The studies that followed found that healthcare providers in NK felt competent in administering the scheduled vaccines, thanks in part to training provided to them by UNICEF in Armenia.
- Mothers interviewed during the study were generally not aware of the specific types of vaccination their children received. However, they reported that they were compliant when called for vaccinations and were satisfied with the services received. The introduction of parent-retained vaccination cards in NK have helped educate parents on the timing and importance of immunizations and help remind them when the next vaccination is due.
- A new program to introduce a bundled measles, mumps, and rubella vaccine (MMR) went underway. The MMR vaccine was the first vaccine to be partially financed by the Millennium Armenian Children’s Vaccine Fund in Armenia. MACVF and the Canadian International Development Agency (CIDA) jointly funded a program to ensure that children in Armenia and Nagorno-Karabagh have access to the MMR vaccine. The Ministry of Health of Armenia and UNICEF Armenia jointly implemented the program with technical input from the World Health Organization (WHO). The program was implemented under the leadership of Dr. Sirak Sukiasyan, manager of the national Expanded Immunization Program (EPI), in partnership with UNICEF consultant Dr. Margarita Balasanyan, former EPI Manager and well respected EPI specialist in the region.
- AI2K commissioned a study on the prevalence of Hepatitis B in Armenia by the American University of Armenia’s Center for Health Services Research. The report from the study was presented to members of the Multi-Agency Mission to Armenia in March 2000.
- AI2K participated in the meeting of the Interagency Immunization Coordinating Committee (ICC) in Yerevan. The ICC was developed by the Ministry of Health of Armenia to stimulate a dialogue between agencies regarding topics such as immunization. Participants of the meeting included members from the UNICEF regional office in Europe, WHO, World Bank, USAID, the Bill and Melinda Gate’s Children’s Vaccine Program, as well as members of an interagency mission to Armenia, representing partners in the Global Alliance for Vaccine and Immunizations (GAVI).
- In addition to the meeting in March, the ICC also met in June, July, and August of the same year to prepare for the proposal to be submitted to the GAVI secretariat for the procurement of the Hepatitis B vaccine for up to five years.
- AI2K met with representatives of the Canadian International Development Agency (CIDA) in Ottawa and later with the Medical Assistance Program (MAP) in Montreal to discuss potential partnerships.
- AI2K met with the United Armenia Fund staff to discuss a potential partnership in the logistics of vaccine delivery to Armenia via United Armenia Fund’s charter planes.
- AI2K applied to USAID for a $400,000 matching grant for the Millennium Armenian Children’s Vaccine Fund (MACVF).
- ANMF initiated the MACVF at the Investment Fund for Foundations and contributed $200,000 of its own funds towards the capital fund.
- The Global Fund for Children’s Vaccines included Armenia as one of the recipient developing countries for five years of funding towards the procurement and introduction of the Hepatitis B vaccine.
- The Ani & Narod Memorial Foundation launched one of its most important initiatives: the Armenia Immunization 2000 (AI2K) campaign. The campaign mobilized the international community and the Armenian Diaspora in efforts to protect children in Armenia from vaccine-preventable diseases.
- AI2K participated in a workshop with experts in the immunization field at the BASICS office in Arlington, VA to discuss the role and relevance of its conception. To find out more about BASICS organization, please visit their website at http://www.basics.org/
- Dr. Haroutune Armenian, Professor of Epidemiology at John’s Hopkins University and President of the American University of Armenia, and Dr. Albert Kapikian, Head of the Epidemiology Department at the National Institute of Allergy and Infectious Diseases (NIAID), were appointed to the honorary board of AI2K. Dr. Kapikian is noted for being one of the key researchers and founders of the Rotavirus vaccine.
- AI2K received start-up funding from the Cafesjian Family Foundation, enabling the campaign to further develop its concepts and forge strategic partnerships with other organizations.
- AI2K formed the Program Advisory Council comprised of healthcare professionals, whose responsibilities include advising on programs and researching grants. Members of the Program Advisory Council have included:Dr. Kim Arzoumanian, PhD Johns Hopkins School of Hygiene and Public Health
Dr. Margarita Balasanian, Head of the National Immunization Program in Armenia
Sharon Chekijian, Yale Medical School
Aram Kaligian, Tufts Medical School
Dr. Julie Kulhanjian, Children’s Hospital Oakland
Dr. Lilian Mahrokian, Hyde Park Medical Care
Doris S. Mugrditchian, MD, Masters in Public Health
Renita O’Connell, Stanford University
Robert Steinglass, Technical Advisor, BASICS project
- Ani & Narod Memorial Foundation signed a Memorandum of Understanding with the Ministry of Health of the Republic of Armenia on September 6, 1999 to pilot AI2K.
- AI2K began publishing a quarterly newsletter, AI2K Update, to inform its constituents about the program’s goals and accomplishments.
- Dr. Margarita Balasanian and Raffy Ardhaldjian (CEO, ANMF) met with Dr. Mark Kane, Director of the Program for Appropriate Technology in Health (PATH) in Seattle, to present the AI2K mission. Their goal was to determine the feasibility of including Armenia as one of the 74 countries eligible for the procurement of the Hepatitis B vaccine through funds made possible by the Bill and Melinda Gates Children’s Vaccine Program. These efforts, coupled with parallel efforts by UNICEF Armenia, resulted in PATH calling for Armenia to submit a proposal to the Global Alliance for Vaccine and Immunizations (GAVI) Secretariat for the procurement of the Hepatitis B vaccine. PATH also invited AI2K to participate in the Multi-Agency Mission to Armenia, developed to evaluate the National Immunization Program of Armenia.
- The first meeting of the Program Advisory Council of AI2K convened at the Charles Hotel in Cambridge, MA on November 26, 1999. Dr. Margarita Balasanian, from Armenia, discussed vaccine and immunization statistics in Armenia. Robert Steinglass followed with a presentation of key issues to consider in the introduction of the Hepatitis B vaccine to Armenia. Other primary topics on the agenda included sustainability of the six basic vaccines (Expanded Immunization Program [EPI]) and significance of introducing the Hepatitis B vaccine into Armenia.