News Release

Experts Meet In Canada To Discuss Vaccine Progress

Meeting Announcement

Pan American Health Organization

Washington, DC, (PAHO) April 8, 1999: Immunization experts from all over the Americas will meet April 12-16 in Ottawa, Canada to look at vaccine issues and chart the course of immunization programs in the Americas.

The Pan American Health Organization's Technical Advisory Group on Vaccine Preventable Diseases brings together experts in vaccines, disease surveillance, laboratories, research, quality control, safety, financing and production, to discuss key issues. These include measles eradication in the Americas, new horizons in the control of rubella, the re-emerging problem of yellow fever, keeping the Americas polio-free, research on new vaccines, and related topics.

Regional vaccine campaigns save the lives of more than 200,000 children in Latin America and the Caribbean each year, according to PAHO. Currently over 80 percent of children in the Americas under 1 year old are vaccinated against diphtheria, pertussis (whooping cough), tetanus, poliomyelitis, measles and tuberculosis. When PAHO's Expanded Program on Immunization started 20 years ago, that figure was only 25 percent. Thanks to the broad-based support in the hemisphere in promoting vaccination, the Americas are the only region in the world to have eliminated polio and are on track to eradicating measles -- which kills 1 million people worldwide each year -- by 2000. The eradication plan aims for 95 percent vaccination coverage in all districts of all countries in the region and periodic follow-up campaigns targeting pre-school children

Measles eradication in the Americas is a primary focus of the meeting. Since 1994, when Ministers of Health of the Americas adopted the goal of eradicating measles from the Western Hemisphere by the year 2000, the countries have made tremendous progress. PAHO's campaign to eliminate measles from the Americas by the year 2000 succeeded in cutting cases from 250,000 in 1990 to 2,109 in 1996. However, staggered outbreaks occurred in Argentina, Bolivia, Brazil and other countries last year, resulting in over 10,000 confirmed measles cases. So far in 1999, there have only been 162 cases of measles in the Americas.

Children in the Americas also are receiving new vaccines in their routine immunizations. Today 80 percent of the countries vaccinate against rubella and mumps; yellow fever inoculations are given in all but one of the countries where that disease is endemic; and countries are inoculating for hepatitis B and, increasingly, Haemophilus influenza type B.

Besides its impact on early childhood mortality, PAHO Director Dr. George A.O. Alleyne sees wider applications for vaccine technology to improve health and reduce poverty. He has called for "a major effort for research, development, production and utilization of vaccines," through international and intersectoral cooperation. PAHO has encouraged regional collaborations to improve vaccine development and manufacture.

For example, vaccine production standards and quality-control policies vary widely throughout the countries of the Americas. To assure vaccine quality for all people of the region, governments and vaccine manufacturers are partnering in the Regional System for Vaccines. This network works to standardize reference reagents, promote good manufacturing and laboratory practices, and conduct studies to develop materials and regional reference standards for vaccines. The Pan American Health Organization, founded in 1902, works with all the countries of the Americas to improve the health of their peoples and raise their living standards. It serves as the Regional Office for the Americas of the World Health Organization.

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For further information contact: Daniel Epstein, tel. 202-974-3459 , fax 202-974-3143, Office of Public Information, email epsteind@paho.org, http://www.paho.org.

The schedule for the PAHO meeting, which will be at the Holiday Inn Chaudiere in Ottawa, is as follows:

Monday, 12 April, 1999
8:30 a.m. Opening of Meeting:

Welcome by Health Canada, Hon. Allan Rock, Minister of Health (invited)
Introduction by Collaborating Agencies and Governments: Dr. D.A. Henderson, Chairman
PAHO, UNICEF, USAID, CIDA, World Bank, Inter American Development Bank, Spain, Netherlands, France, Japan, Rotary International, CDC, March of Dimes

10:00 a.m. Session 1: Measles Eradication In The Americas
Progress in the Americas -- Dr. Ciro de Quadros
Lessons Learned from Recent Outbreaks: Case Studies: Argentina; Bolivia; Brazil: Sao Paulo

Discussion and Recommendations
ANDEAN REGION, CENTRAL AMERICAN REGION, SOUTHERN CONE REGION AND BRAZIL: Chile, Brazil, Uruguay;
NORTH AMERICAN REGION:
Canada - Dr. John Waters, Mexico - Dr. José Ignacio Santos; United States of America - Dr. John Livengood

Tuesday, 13 April, 1999
8:30 a.m. Session 1 (cont.):
CARIBBEAN REGION:
Progress in the Caribbean -- Dr. Beryl Irons - Haiti; Dominican Republic - Dr. Zacarias Garib
Discussion and Recommendations

REGIONAL LABORATORY NETWORK
Summary of Laboratory Findings - Dr. Bill Bellini
Summary of Laboratory Findings - Dr. Bill Bellini
Measles Virology - Dr. Bill Bellini
Measles Serological Testing - Dr. Sam Ratnam
Measles-Strain Nomenclature - Dr. Paul Rota
Discussion and Recommendations

Coffee Break

Summary of Measles Surveillance Evaluations -- Dr. Gina Tambini
Progress on Measles Control/Elimination in other WHO Regions -- Dr. Jean-Marc Olivé
Summary and Conclusions

Session 2: Control Of Rubella: New Horizons
Chairman: Dr. Michael Katz
Rubella/CRS Control Initiatives:
The Burden of CRS: Dr. Merle Lewis
Review of Country Experiences:
English Speaking Caribbean - Dr. Beryl Irons; United States of America - Dr. John Livengood; Mexico - Dr. José Luis Díaz Ortega

12:30 - 14:00 p.m. Lunch
14:00 p.m. Surveillance of Congenital Rubella Syndrome and Other Rubella-Associated Adverse Pregnancy Outcomes in Canada - Dr. Theresa Tam
The Manitoba Outbreaks: Lessons Learned- Dr. Lawrence Elliott Vaccination Strategies Bahamas- Dr. Marceline Dahl-Regis Review of Rubella Surveillance Guidelines- Dr. Beryl Irons Review of CRS Surveillance Guidelines- Dr. Merle Lewis Laboratory Issues in Rubella Surveillance - Ms. Victoria Morris-Glasgow Discussion and Recommendations

Session 3: Maintaining Polio Eradication In The Americas
Chairman: Dr. Frederick C. Robbins
Eight Years without Poliomyelitis in the Americas- Dr. Gina Tambini
Status of Polio Eradication in the World- Dr. Jean-Marc Olivé

17:30 p.m. Adjournment
Wednesday, 14 April, 1999
8:30 a.m. Session 3 (cont.):
Canada's Working Group on Polio Eradication: Challenges Beyond
Certification - Dr. Adwoa Bentsi-Enchill
Review of Laboratory Network- Dr. Jorge Boshell
Quality Control of Polio Laboratory Network- Dr. Spencer Lee
Sustaining AFP Surveillance: Country Reports: Argentina, Brazil

Stopping Polio Vaccinations: When and How? Containment - Dr. Mark Pallansch
Vaccination Policy Dr. Stephen Cochi
Discussion and Recommendations

Session 4: Neonatal Tetanus Control
Regional Report- Dr. Carlos Castillo; Country Reports from Brazil, Mexico, Peru, Haiti, Guatemala
Discussion and Recommendations

12:30 - 14:00 p.m. Lunch
14:00 p.m. Session 5: Yellow Fever: A Re-Emerging Public Health Problem
Overview of the Americas - Dr. Otavio Oliva
Country Updates from Brazil, Bolivia, Guyana, Peru,Colombia, Ecuador, Venezuela
Discussion and Recommendations

Session 6: Progress In The Introduction Of Haemophilus Influenzae Type B Vaccine
Introduction of Hib Vaccine in the Region - Dr. Jose Luis Di Fabio
Lessons Learned from Uruguay and Chile-Dr. Mauricio Landaverde

17:30 p.m. Adjournment
Thursday, 15 April, 1999
8:30 a.m. Proposal for an Epidemiological Surveillance System of Bacterial Meningitis and Pneumonia in the Region. - Dr. Jose Luis Di Fabio
Discussion and Recommendations

Session 7: Other Diseases Preventable By Immunization
Hepatitis B: Status of Country Vaccination Programs - Dr. Mauricio Landaverde
The Use of Combined Vaccines- Dr. Jose Luis Di Fabio
PAHO EPI Revolving Fund: 20 years of Providing Quality Vaccines at Low Prices: A Review - Mr. Peter Carrasco
Adult Immunization- Dr. Héctor S. Izurieta
Vitamin A Supplementation to Protect Small Children: Presentation by "The Micronutrient Initiative" -- Canada - Ms. Jenny Cervinskas
Increasing Supplementation of Vitamin A using Immunization Contacts in Nicaragua - Dr. Juan José Amador
Discussion and Recommendations

Coffee Break

Session 9: Research And Development Of Vaccines In The Region
Vaccine R&D, Production and Quality Control:Issues in Vaccine R&D - Dr. Regina Rabinovich
Vaccine Production: Viability of Vaccine Production in Mexico- Dr. Aurelio Alvirez

12:30 - 14:00 p.m. Lunch
14:00 p.m. Joint Ventures Between Public and Private Vaccine Manufactures: The Brazilian Experience - Dr. Akira Homma
Who is Responsible for the Vaccine Quality Used in a Country? - Dr. Otavio Oliva
Discussion and Recommendations

A Panel on Vaccine Safety Issues
Moderator:Dr. Neal Halsey
Background and Introduction - Dr. Neal Halsey
Hib Vaccine and Diabetes - Dr. Regina Rabinovich
Hepatitis B and Multiple Sclerosis - Dr. Neal Halsey
MMR and Autism - Dr. David Salisbury
Immunization Safety: A global priority - Dr. Philippe Duclos
The Press and Science - Dr. Lawrence Altman (invited) - Dr. Richard Horton (invited)
Discussion and Recommendations

Coffee Break

Surveillance of Adverse Events: Canadian Experience - Dr. Robert Pless
Proposal of a Regional Surveillance System - Dr. Otavio Oliva
What Do We Know About of Safe Syringe Practices in the Countries? - Mr. Peter Carrasco
Discussion and Recommendations

17:30 p.m. Adjournment
Friday, 16 April, 1999
8:30 a.m. Session 10: Financing Of Immunization Programs
World Bank Partnership in Immunization:Pilot Project in Bolivia - Dr. Daniel Cotlear
Financing Mechanisms in Colombia - Dr. Socorro Muñoz
IDB Perspective - IDB
Discussion and Recommendations

Coffee Break

1999 PAHO Immunization Award

12:30 - 14:00 p.m. Lunch
14:00 - 15:00 p.m. Session 11: Final Report
Conclusions and Recommendations
15:00 p.m. Closure of Meeting



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