Enhancing evidence-based capacity for evidence-based decision making with regard to introduction of new vaccines: Pan American Health Organization's ProVac initiative

The Pan American Health Organization (PAHO) estimates that 16,000 deaths occur annually in Latin America and the Caribbean (LAC) due to rotavirus diarrhea; each year, another 22,000 children die from invasive pneumococcal disease and 32,000 women die from cervical cancer caused by human papillomavirus. Vaccines against these priority diseases present opportunities for substantial gains in health, contributing to the achievement of the Millennium Development Goals. The relative value of these vaccines depends on disease burden, vaccine price, effective delivery strategies, and available resources for their introduction into National Immunization Programs. As these elements vary between countries, the decision to introduce new and more costly vaccines requires that policy decisions are grounded in high-quality evidence that reflects national conditions and programmatic capacity. This strategic approach departs from a history of policy driven by less formal regional and global mechanisms.

Since 2004, PAHO has spearheaded the ProVac Initiative, striving to enhance national evidenced-based capacity to make informed policy decisions on new vaccine introduction. The Bill and Melinda Gates Foundation, Centers for Disease Control and Prevention, World Health Organization, and the PneumoADIP and Rotavirus Vaccine Project of GAVI have been critical supporters. The work plan for 2008—2013 will continue to address the following objectives: strengthening policy infrastructure and process; developing and enhancing tools for economic analysis; collecting data and conducting analyses; making evidence-based decisions; effectively planning for vaccine introduction when appropriate; developing strategies to iteratively assess progress and periodically revisit key decisions; and promoting scientific, technical, and policy-relevant partnerships.