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Supplies and Logistics

Joint WHO-UNICEF letter to Regional Directors on Yellow Fever outbreak response

30 June 2016 - The yellow fever situation is unprecedented this year. In addition to small outbreaks occurring in endemic countries such as Brazil, Peru and Uganda, a large yellow fever epidemic —the first epidemic of this disease to hit the country in 30 years- has been ongoing in Angola since December 2015. The epidemic started in the capital city Luanda and has now spread to most provinces, resulting in the current total of 3,294 cases and 347 deaths. The exportation of cases via unvaccinated travellers returning from Angola to China, the Democratic Republic of Congo (DRC), Kenya, Morocco and the Republic of Congo, has led, unfortunately, to the establishment of local transmission in DRC. This chain of events means the central African region is now affected by two large yellow fever urban epidemics requiring urgent mass emergency vaccination in the areas with intense transmission.1

Since the beginning of the Angola outbreak, the Global Yellow Fever Partnership (WHO/UNICEF/CDC/GAVI) has supported the affected countries (Angola, DRC, and Uganda) in their efforts to rapidly interrupt yellow fever transmission and prevent its spread across borders. In particular, the Partnership has facilitated, through the International Coordinating Group (ICG)2mechanism, the procurement and delivery of over 17 million doses of yellow fever vaccine from the emergency stockpile for urgent mass vaccination campaigns in these countries. Cases are declining now and a well-planned additional emergency campaign is imminent to stop the ongoing transmission in Kinshasa and in the cross border areas between Angola and DRC.

The yellow fever vaccine production is limited globally and various mechanisms have been put in place to ensure timely access for the affected countries: temporary reallocation of vaccine from preventative campaigns and routine Expanded Programme on Immunization (EPI) to increase vaccine availability to respond to the outbreaks, increase in production and dose sparing strategies. Despite this, current global stocks remain insufficient should multiple simultaneous urban outbreaks occur.

All countries with endemic sylvatic yellow fever should be ready to detect early any case of yellow fever and rapidly implement a set of coordinated interventions to stop transmission especially in urban settings. It includes rapid emergency vaccination, clinical management, social mobilization, risk communication, vector control and screening/vaccination of travelers.

The Global Yellow Fever Partnership, in collaboration with the ICG, will prioritize supply of yellow fever vaccine as follows:

  • Reactive mass vaccination campaigns in affected countries.
  • Pre-emptive vaccination campaigns in high risk non affected areas to mitigate spread within the affected countries and across borders. Priority will be given to high-risk border areas and other non-border areas that are at high risk due to economic migration and trade activities.

Given the limited availability of vaccine currently:

  • Preventative vaccination campaigns will be postponed until the global vaccine stock is adequately replenished.
  • Countries that implement yellow fever vaccination as part of their routine EPI programmes will receive staggered shipments through UNICEF. Countries will one month prior to depletion of national vaccine stocks. Shipments will include enough supply to cover two months of use for routine immunization programmes.

A supply update on yellow fever vaccine is available at:  https://www.unicef.org/supply/index_70799.html

We are committed to keeping you informed about the state of the yellow fever vaccine supply, and will provide regular updates on vaccine availability as the situation evolves.
We remain at your disposal should you have any further questions, and thank you again for your commitment and collaboration in the fight to control this unprecedented outbreak.

Signed:
Dr Sylvie C. Briand, Director, Department of Pandemic and Epidemic Diseases, WHO
Dr Jean-Marie Okwo-Bele, Director, Department of Immunization, Vaccines and Biologicals, WHO  
Mr Ted Chaiban, Director, Programme Division, UNICEF
Ms Shanelle Hall, Director, Supply Division UNICEF

1 For further details on the yellow fever outbreak response, please visit: http://www.who.int/emergencies/yellow-fever/response/en/ and http://www.who.int/topics/yellow_fever/en/

2 The ICG was created in 2001 and is consisting of representatives from the WHO, UNICEF, Medecins sans Frontieres (MSF) and the International Federation of Red Cross and Red Crescent Societies (IFRC). ICG facilitates access to vaccine in emergency by evaluating requests for vaccines from the stockpile taking into account the epidemiological situation, vaccination strategy, pre-existing stocks in the country and operational aspects of the epidemic response. The ICG analyses all the information to ensure informed and fair decision on the amount of vaccine to be shipped. 


 

 

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