As health sector budgets grow slowly and the menu of health interventions expands, resources are being allocated more prudently and competing options must be considered carefully. Making evidence-based decisions about vaccine introduction now requires competencies beyond those traditionally found in many National Immunization Programs (NIPs). Decision makers increasingly require economic analysis to support decision-making for new vaccines, in addition to epidemiologic, logistical, and financial data.
The ProVac Initiative provides technical support to decision makers and strengthens national capacity to make evidence-based decisions in the context of new vaccine introduction.
ProVac empowers national teams to conduct their own economic analyses, leading to more informed decisions about the introduction of new and underutilized vaccines into the NIP. The country-led process increases trust and interest in the results by national authorities. ProVac helps to build local technical capacity, which in turn provides a number of important indirect benefits such as increased collaboration between national institutions, more effective planning for vaccine introduction, improved infrastructure for decision making, and a solid platform for the wider promotion of evidence-based decision making.
The ProVac Initiative was established by PAHO in the region of Latin America and the Caribbean in 2006 and has provided support for the evaluation of pneumococcal, rotavirus and HPV vaccines in over 14 countries. Due to its success in the Americas, PAHO received requests to implement ProVac more widely in World Health Organization (WHO) member countries. In response, the Initiative has expanded to provide increased technical assistance around evaluating the evidence for new vaccine introduction in non-PAHO countries, leading to the formation of the ProVac International Working Group (IWG).
The ProVac IWG is a pilot effort, which aims to transfer tools, methods, and lessons learned from the PAHO ProVac Initiative to other WHO regions for the promotion of evidence-based policy and decision making in low and middle income countries. The IWG will conduct several country-level cost-effectiveness analyses (CEA) on Hib, pneumococcal conjugate and rotavirus vaccine introduction using ProVac tools and will hold three regional workshops on ProVac tools and methods for CEA in AFRO, EMRO, and EURO regions. As a member of the ProVac IWG, the Sabin Vaccine Institute is developing and piloting a strategy for effectively communicating evidence to stakeholders. The outcome will be a guide for countries on how to promote informed, evidence-based decision making related to vaccine introduction.