Post00382 SOLAR + VAX INTRO + SURVEY REMINDER

Post00382 SOLAR + VAX INTRO + SURVEY REMINDER 9 October 2001 CONTENTS 1. HYBRID SOLAR? 2. RE: A "THINK PIECE" ON INTRODUCTION OF NEW VACCINE 3. ANNUAL TECHNET FORUM SUBSCRIBER SURVEY REMINDER Moderators Note: * If you have not already done so! * We would appreciate your comments on the usefulness and the content of the forum postings over the last year to enable us to improve the forum and to support you in your work in logistics for health. * Please hit your reply button and then complete the questionnaire at the end of this posting using your email program. ** The deadline for responding is Friday 12 October 2001. Thanks! ____________________________________________________________________________ ___________________________________*______________________________________ 1. HYBRID SOLAR? In Technet Forum Post00375, Item 3, 18 September 2001, a New Your Times article "Solar Power Is Reaching Where Wires Can't" By David Lipschultz, was posted. The article provided an update on the more favourable situation in terms of the lower cost and innovative financing of small scale solar power systems for rural areas in developing countries. http://www.nytimes.com/2001/09/09/business/09SOLA.html?todaysheadlines/Septe mber 9, 2001 Hybrid solar systems use both available sunlight and available mains electricity to charge batteries, and can provide very reliable power under appropriate conditions including limited hours of electricity and or sunlight. * John Lloyd, PATH/CVP asks about Technet subscribers experience with hybrid solar power systems. Replies to: [[email protected]][email protected][/email] or use your reply button! ___________________________________________________________________________ From: "John Lloyd" To: "Technet Moderator" Subject: RE: Post00375 + SOLAR Date: Fri, 21 Sep 2001 Good to hear about solar again. Does anyone have experience of 'hybrid' systems that run on PV panels and batteries but which also run on grid electricity when it is available? Seems to me that such systems might work well in areas with a bit of electricity. John Lloyd ____________________________________*______________________________________ 2. RE: A "THINK PIECE" ON INTRODUCTION OF NEW VACCINE In Post00373, 10 September 2001, Robert Steinglass, BASICS, contributed a thought provoking paper: "How to introduce new combination vaccines (tetravalent and pentavalent): some practical and ethical questions" In Post00375 18 September 2001, Alan Schnur, WHO/CHN, contributed to the discussion, pointing out that: ......" ... there are cost, training and logistics implications for this policy to provide full hepatitis B immunization to the "first" cohort, but I would submit that the ethical and programmatic considerations of sending children away from our immunization sessions only partially immunized must also be considered." In todays postings, John Lloyd PATH/CVP, explains the EPI policy, while Dianne Phillips, DOH/SA, explains South Africa's policy and the reasons for it. Anthony Battersby, FBA, points out the need for operational planning and a variety of vaccine presentations when new vaccines are introduced. Replies, comments and thoughts to: [[email protected]][email protected][/email] * or use your reply button! ___________________________________________________________________________ From: "John Lloyd" To: Technet Moderator Subject: RE: a "think piece" on introduction of new vaccine Date: Mon, 3 Sep 2001 Thanks Robert for, again, bringing a 'field' perspective to these important policy decisions. You may be thick skinned and I simple minded, but I would offer the following comments: First, No backlog or catchup. This was a policy of EPI at the start (although not universally accepted!) that children born after the launch have the right to a full series of a combo vaccine. Older kids get the rest of their DTP series, with DTP vaccine or combination vaccine, whichever is available. Thus, the first year of introduction achieves one cohort of infants with the full series plus a portion of the previous cohort who are partially immunized with the new antigens. This single policy deals with, I think, all of your thorns and keeps the management and stock control simple enough to be successfully explained, managed and accepted by the people. All the best, John --- Date: Wed, 05 Sep 2001 13:33:08 +0200 From: "Dianne Phillips" To: Technet Moderator Subject: Re: a "think piece" on introduction of new vaccine Hi All, In South Africa, we decided on a policy to administer DTP-Hib to all children presenting for 6, 10 or 14 week routine immunisation visit at the facilities. In the earlier implementation document it was stated that "as few cases of invasive Hib disease occur after the second birthday of a child, no older child requires nay further doses". We had no catch-up policy, mainly because of the added cost burden which we could not afford. In addition, children who had completed the primary schedule before the Hib implementation date were considered "older children" and received the 18 month booster of DTP as usual. Regards Dianne Domain Leader: Distribution Tel: +2712 3120329 National Cold Chain Manager Fax: +27123244525 Department of Health Mobile: +2782 8069253 Private Bag X828 PRETORIA South Africa 0001 --- Date: Tue, 18 Sep 2001 From: Anthony Battersby Subject: Post00373 NEW VAX INTRO Sender: Anthony Battersby To: Technet Moderator Dear Allan, Robert and I also discussed this issue at Technet [New Delhi meeting]. Thank goodness he has brought up these issues. What he is highlighting is the need for proper operational planning. A combo vaccine is a new vaccine and if there are children who are halfway through the old schedule then the service has an obligation to provide the vaccine that they need to complete it. This means that there will always have to be a stock of monovalent presentation of the additional vaccines (hib and/or Hep B) to cover those children. The problems highlighted by Robert are a direct result of "trying to run before you can walk". If countries are allowed to introduce the new vaccines in monovalent presentations then after a period of time it would be possible to convert to combo vaccine without having to deny any new child the new vaccines. Incidentally 25% wastage will be very difficult to achieve in countries where a large amount of immunisation is given through outreach and mobile sessions, unless there is to be a change in the recommendation that no opened vial that has been on outreach is kept after the end of the day, single dose presentations are to be used. Each country will have its own unique set of circumstances, the planning for introducing the new vaccines must be carried out for each country taking account of those circumstances. Presumably there will have to be a monovalent presentation of Hep B for the birth dose anyway. This also highlights the problem of giving 4 doses of Hep B, if the combo vaccine is used. Because the first dose is monovalent. We need to be a bit more sophisticated in our planning. It is not acceptable to commit countries to the cost of an additional dose of Hep B just to keep it simple. To introduce new vaccines in a combination form will require a period when the new vaccines are available in different presentations, if a programme is not able to cope with that level of complexity then it is not ready to extend its schedule. Anthony ____________________________________*______________________________________ 3. 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