In seeking possible funding sources, they also calculate potential cost savings from reducing vaccine wastage through implementation of an open vial policy, by switching to lower cost vaccines (e.g., from the mouse-brain derived to the live JE vaccine), or other cost saving measures. As an MOH policy, the ACCD will not recommend that a vaccine be introduced into the NPI if the

country cannot sustain its financing, even if co-financing (through GAVI) or full donor support are available for a limited period of time. Therefore, the situation never arises PS-341 nmr in Sri Lanka in which the ACCD makes a recommendation that the Ministry of Finance determines is not financially feasible. Since different professionals may hold different views regarding whether and how a new vaccine should be introduced, and since their opinions can be critical to the success of the vaccine’s introduction, the next step, after data are gathered and analyzed by a working group, is to discuss the introduction of the vaccine at an annual Immunization Stakeholders’ Forum. The purpose of the Forum is to seek a wider, national consensus on the decision to introduce the new vaccine and to identify potential areas of concern and obstacles to its introduction. The Forum is attended by administrators and technical experts from the Ministry of Health and academia, as well as representatives from professional medical organizations,

the national drug regulatory authority and international agencies, such as WHO and UNICEF. The Forum consists of several sessions on global advances in vaccines, Selleckchem PD173074 and for any new vaccine under consideration, there are presentations on a needs assessment for the vaccine, economic considerations, and proposed vaccination strategies. The presentations are followed by panel discussions, working group sessions and group presentations. The Forum concludes with a plenary discussion, during which a consensus is reached on the introduction of the vaccine into

the NPI. On occasion, Forum participants recommend that a new working group be formed to gather additional evidence and analysis about particular concerns and issues raised during the meeting. If the Forum recommends the introduction of the vaccine, NPI managers then develop the strategies CYTH4 to introduce the new vaccine into the program. Once these recommendations are made by the Immunization Stakeholders’ Forum, they are submitted to the ACCD for approval. All of the steps involved in considering the introduction of a new vaccine, including the collection and analysis of data and the holding of the annual Forum, simplify the decision-making process for the ACCD. However, even at this stage, the Committee may appoint a new working group to further clarify important issues regarding, for instance, the epidemiology of the disease, the type of vaccine, or its safety profile.